A scoping review of voluntary gait adaptability tasks requiring cognitive demands in older adults.

Kyungwan Kim, Marie Vinent, Lena Deller, Wiebren Zijlstra
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Abstract

[Purpose] Voluntary gait adaptability is a complex construct that requires cognitive demands and dynamic balance control; it also has implications for the daily lives of older adults. This ability has been extensively studied, however, a comprehensive overview of appropriate tasks for measuring voluntary gait adaptability in older adults is lacking. Our scoping review aimed to identify existing voluntary gait adaptability tasks for older adults, summarize the specific methodological features requiring cognitive demands found in previous studies, and categorize these tasks according to experimental procedure and setup. [Methods] A comprehensive literature search was performed using six databases (PubMed, SPORTDiscus, Web of Science, CINAHL, MEDLINE, and Embase). This included studies that investigated voluntary gait adaptability in older adults (≥ 65 years old) with and without neurological disorders, with a focus on experimental tasks requiring cognitive function (e.g., response to visual or auditive stimuli) while walking. [Results] Sixteen studies were included; most involved visual stimuli, such as obstacles, stairs, or colored cues, and few required auditory stimuli. The studies were categorized according to the experimental procedure, for example, ascent/descent of obstacles (n = 3), inconsistent surfaces (n = 1), lateral gait adjustment (n = 4), obstacle avoidance (n = 6), and stepping tasks (n = 2), as well as experimental setup, including instrumented treadmills (n = 3), stairs (n = 3), and walkways (n = 10). [Conclusion] The results show wide heterogeneity between studies regarding experimental procedures and setup. Our scoping review highlights the need for additional experimental studies and systematic reviews on voluntary gait adaptability in older adults.

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老年人需要认知需求的自愿步态适应性任务的范围审查。
目的:自主步态适应性是一个复杂的结构,需要认知需求和动态平衡控制;这对老年人的日常生活也有影响。这种能力已被广泛研究,然而,对测量老年人自主步态适应性的适当任务的全面概述是缺乏的。我们的范围综述旨在确定现有的老年人自愿步态适应性任务,总结在以往研究中发现的需要认知需求的具体方法特征,并根据实验程序和设置对这些任务进行分类。方法:采用PubMed、SPORTDiscus、Web of Science、CINAHL、MEDLINE、Embase等6个数据库进行文献检索。这包括调查有或无神经系统疾病的老年人(≥65岁)的自主步态适应性的研究,重点是行走时需要认知功能(例如,对视觉或听觉刺激的反应)的实验任务。结果:纳入16项研究;大多数涉及视觉刺激,如障碍物、楼梯或彩色线索,很少需要听觉刺激。这些研究根据实验程序进行分类,例如,上升/下降障碍物(n = 3),不一致表面(n = 1),侧向步态调整(n = 4),避障(n = 6)和步进任务(n = 2),以及实验设置,包括仪器跑步机(n = 3),楼梯(n = 3)和人行道(n = 10)。结论:研究结果在实验程序和设置方面存在广泛的异质性。我们的范围综述强调需要对老年人的自主步态适应性进行额外的实验研究和系统综述。
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