Physical-Cognitive Intervention to Enhance Velocity and Other Gait Characteristics in Mexican Older Adults

Tuesday, 23 July 2013: 2:10 PM

Bertha Cecilia Salazar, PhD
Nursing College, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
Juana Edith Cruz, DNS
Nursing Graduate school, Universidad Veracruzana, Monterrey, Mexico
Esther C. Gallegos, PhD, FAAN
School of Nursing, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
Maria E. Garza, BSm MS
Graduate School, teaches in the master and undergraduate program, Universidad Autonoma de Nuevo Leon, School of Nursing, Monterrey,, Mexico
Perla Lizeth Hernandez, BS, MNS
School of graduates, Nursing College, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico

Learning Objective 1: The learner will be able to describe gait characteristics of a sample of Mexican older adults and relation to sociodemographics and symptoms of depression.

Learning Objective 2: The learner will be able to know the effects of a physical-cognitive intervention upon usual and dual gait characteristics

Purpose: To test the effects of a physical-cognitive intervention upon gait parameters using a dual task (walking and counting backwards or naming animales) in older adults of Monterrey, Mexico. 

Methods: Cuasi-experimental design, experimental and control group. The experimental group received an exercise program combined with cognitive exercises. for 12 weeks, three times per week, one hour per session. Sample size 144 participants in each group. The intervention and data collection were done in senior centers of Monterrey and metropolitan area. Data were collected at baseline, end of 5th week, and after the intervention. Inclusion criteria were sedentary (less than 9.4 mets according to Voorips, et al. 1991, questionnaire), free of exercise contraindication, able to walk raising their legs from the floor. Gait charecteristics were measured using the computerized GaitRite CIR System walkway (8.83m X 90.17 cm, long by width) with electronic sensors. The Center Epidemiologic Studies Depression Scale was applied.  Participants were trained to walk through the walkway and instructed to walk at their usual speed starting one meter before and after the walkway. In a second trail participants were asked to count backwards while they walked, starting with a random number. A research assisstant walked closely behind each participant.  

Results: Mean age was 72.62 years, SD = 6.33. At baseline the mean of gait velocity during dual tasking was 0.7939 m/s, SD = 21.81, and 0.6596 m/s, SD = 21.72, experimental and control group respectively, and during usual walking means were 0.9447 m/s, SD = 18.81, and 0.8554,  SD = 20.58, experimental and control group.  Mann-Whitney U test showed significant differences at baseline, therefore a more stringent significant value was use.  Experimental group showed significant differences (p < 0.01) in several gait parameters (velocity, cadence, step time, swing time, among others) of the dual task walking (walking and counting backwards).  

Conclusion:  The intervention improved gait parameters in the dual task modality.  Training older adults to perform a cognitive task such as counting or naming animals while walking may help them to navigate in public environments preventing falls.