为期 24 周的双任务训练对老年人站立和行走时姿势控制复杂性的影响：随机对照试验的二次分析

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2025-03-31 DOI:10.1016/j.gaitpost.2025.03.031

Francis Trombini-Souza , Iara dos Santos Leal , Júlia Gomes de Alencar , Victória Alves de Brito , Lucas Martins Rodrigues

{"title":"为期 24 周的双任务训练对老年人站立和行走时姿势控制复杂性的影响：随机对照试验的二次分析","authors":"Francis Trombini-Souza , Iara dos Santos Leal , Júlia Gomes de Alencar , Victória Alves de Brito , Lucas Martins Rodrigues","doi":"10.1016/j.gaitpost.2025.03.031","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Functional decline in gait motor control and the capacity to maintain balance during upright standing posture in older adults is influenced by deterioration in the complexity of various physiological systems involved in these daily activities.</div></div><div><h3>Research question</h3><div>Is a 24-week dual-task protocol training, beginning with alternating cognitive demands and progressing to simultaneous dual-tasking, more effective than a control group training only with alternating dual tasks in improving the physiological complexity of postural control in older adults during upright standing posture under interoceptive and exteroceptive demands and gait under dual tasks?</div></div><div><h3>Methods</h3><div>This randomized controlled trial enrolled 60 community-dwelling older adults of both sexes, aged between 60 and 80. The experimental group (EG; <em>n</em> = 30) underwent training with progression from alternating dual-task (ADT) to simultaneous dual task (SDT) during activities such as gait, and static and dynamic functional balance. The control group (CG; <em>n</em> = 30) only underwent the ADT protocol throughout the six months of training. The primary outcome of this study was the physiological complexity of gait under dual task calculated by the refined composite multiscale fuzzy entropy method for the anteroposterior (AP), mediolateral (ML), and vertical (V) directions. The outcomes were acquired at baseline (T1) and after 24 weeks of intervention (T2). The analyses were based on the intention-to-treat principle, using generalized linear mixed models (GLMM) with a significance level of 5 %.</div></div><div><h3>Results</h3><div>No interaction or group effects were observed. However, both groups significantly improved body sway physiological complexity in the AP direction during gait under ST, ADT, and SDT and in the V direction under ADT and SDT. No change in complexity during upright standing posture under interoceptive and exteroceptive demand was significantly observed, regardless of the group.</div></div><div><h3>Significance</h3><div>Regardless of the training protocol, both groups significantly improved the physiological complexity of gait under dual task.</div></div>","PeriodicalId":12496,"journal":{"name":"Gait & posture","volume":"120 ","pages":"Pages 88-97"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of a 24-week dual-task training on postural control complexity during standing and walking in older adults: Secondary analysis from a randomized controlled trial\",\"authors\":\"Francis Trombini-Souza , Iara dos Santos Leal , Júlia Gomes de Alencar , Victória Alves de Brito , Lucas Martins Rodrigues\",\"doi\":\"10.1016/j.gaitpost.2025.03.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Functional decline in gait motor control and the capacity to maintain balance during upright standing posture in older adults is influenced by deterioration in the complexity of various physiological systems involved in these daily activities.</div></div><div><h3>Research question</h3><div>Is a 24-week dual-task protocol training, beginning with alternating cognitive demands and progressing to simultaneous dual-tasking, more effective than a control group training only with alternating dual tasks in improving the physiological complexity of postural control in older adults during upright standing posture under interoceptive and exteroceptive demands and gait under dual tasks?</div></div><div><h3>Methods</h3><div>This randomized controlled trial enrolled 60 community-dwelling older adults of both sexes, aged between 60 and 80. The experimental group (EG; <em>n</em> = 30) underwent training with progression from alternating dual-task (ADT) to simultaneous dual task (SDT) during activities such as gait, and static and dynamic functional balance. The control group (CG; <em>n</em> = 30) only underwent the ADT protocol throughout the six months of training. The primary outcome of this study was the physiological complexity of gait under dual task calculated by the refined composite multiscale fuzzy entropy method for the anteroposterior (AP), mediolateral (ML), and vertical (V) directions. The outcomes were acquired at baseline (T1) and after 24 weeks of intervention (T2). The analyses were based on the intention-to-treat principle, using generalized linear mixed models (GLMM) with a significance level of 5 %.</div></div><div><h3>Results</h3><div>No interaction or group effects were observed. However, both groups significantly improved body sway physiological complexity in the AP direction during gait under ST, ADT, and SDT and in the V direction under ADT and SDT. No change in complexity during upright standing posture under interoceptive and exteroceptive demand was significantly observed, regardless of the group.</div></div><div><h3>Significance</h3><div>Regardless of the training protocol, both groups significantly improved the physiological complexity of gait under dual task.</div></div>\",\"PeriodicalId\":12496,\"journal\":{\"name\":\"Gait & posture\",\"volume\":\"120 \",\"pages\":\"Pages 88-97\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gait & posture\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0966636225001638\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gait & posture","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966636225001638","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

摘要

背景：老年人直立站立时步态运动控制和保持平衡能力的功能下降受到日常活动中各种生理系统复杂性恶化的影响。研究问题：一项为期24周的双任务方案训练，从交替的认知需求开始，发展到同时的双任务，在改善老年人在内感受性和外感受性要求下直立站立姿势和双任务下步态的生理复杂性方面，是否比对照组只进行交替的双任务训练更有效？方法本随机对照试验纳入60名年龄在60 ~ 80岁的社区老年人。实验组(EG；n = 30)在步态、静态和动态功能平衡等活动中接受了从交替双任务（ADT）到同步双任务（SDT）的训练。对照组(CG；n = 30)在六个月的训练中只接受ADT方案。本研究的主要结果是双任务下步态的生理复杂性，采用精细复合多尺度模糊熵法计算前位（AP）、中外侧（ML）和垂直(V)方向。结果在基线（T1）和干预24周后（T2）获得。分析基于意向治疗原则，使用广义线性混合模型（GLMM），显著性水平为5 %。结果两组间无相互作用和组效应。然而，两组均显著改善了ST、ADT和SDT步态下AP方向和ADT和SDT步态下V方向的身体摇摆生理复杂性。内感受性和外感受性要求下直立站立姿势的复杂性无显著变化。无论采用何种训练方案，两组均显著改善了双任务下步态的生理复杂性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effects of a 24-week dual-task training on postural control complexity during standing and walking in older adults: Secondary analysis from a randomized controlled trial

Background

Functional decline in gait motor control and the capacity to maintain balance during upright standing posture in older adults is influenced by deterioration in the complexity of various physiological systems involved in these daily activities.

Research question

Is a 24-week dual-task protocol training, beginning with alternating cognitive demands and progressing to simultaneous dual-tasking, more effective than a control group training only with alternating dual tasks in improving the physiological complexity of postural control in older adults during upright standing posture under interoceptive and exteroceptive demands and gait under dual tasks?

Methods

This randomized controlled trial enrolled 60 community-dwelling older adults of both sexes, aged between 60 and 80. The experimental group (EG; n = 30) underwent training with progression from alternating dual-task (ADT) to simultaneous dual task (SDT) during activities such as gait, and static and dynamic functional balance. The control group (CG; n = 30) only underwent the ADT protocol throughout the six months of training. The primary outcome of this study was the physiological complexity of gait under dual task calculated by the refined composite multiscale fuzzy entropy method for the anteroposterior (AP), mediolateral (ML), and vertical (V) directions. The outcomes were acquired at baseline (T1) and after 24 weeks of intervention (T2). The analyses were based on the intention-to-treat principle, using generalized linear mixed models (GLMM) with a significance level of 5 %.

Results

No interaction or group effects were observed. However, both groups significantly improved body sway physiological complexity in the AP direction during gait under ST, ADT, and SDT and in the V direction under ADT and SDT. No change in complexity during upright standing posture under interoceptive and exteroceptive demand was significantly observed, regardless of the group.

Significance

Regardless of the training protocol, both groups significantly improved the physiological complexity of gait under dual task.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.