RESUMEN

While mobility aids (e.g., four-wheeled walkers) are designed to facilitate walking and prevent falls in individuals with gait and balance impairments, there is evidence indicating that walkers may increase attentional demands during walking. We propose that walkers may reduce attentional demands under conditions that challenge balance control. This study investigated the effect of walker use on walking performance and attentional demand under a challenged walking condition. Young healthy subjects walked along a straight pathway, or a narrow beam. Attentional demand was assessed with a concurrent voice reaction time (RT) task. Slower RTs, reduced gait speed, and increased number of missteps (>92% of all missteps) were observed during beam-walking. However, walker use reduced attentional demand (faster RTs) and was linked to improved walking performance (increased gait speed, reduced missteps). Data from two healthy older adult cases reveal similar trends. In conclusion, mobility aids can be beneficial by reducing attentional demands and increasing gait stability when balance is challenged. This finding has implications on the potential benefit of mobility aids for persons who rely on walkers to address balance impairments.

Asunto(s)

Accidentes por Caídas/prevención & control , Atención/fisiología , Equilibrio Postural/fisiología , Andadores , Caminata/fisiología , Adulto , Anciano , Análisis de Varianza , Femenino , Humanos , Masculino , Limitación de la Movilidad , Tiempo de Reacción/fisiología , Análisis y Desempeño de Tareas

RESUMEN

One male with unilateral osteoarthritis (OA) of the knee underwent testing of corticospinal (CS) excitability (as quantified from motor-evoked potentials (MEPs) in the rectus femoris (RF) using transcranial magnetic stimulation) and quadriceps muscle strength. Baseline data indicated reduced MEP amplitudes in the RF of the affected limb compared to the unaffected limb. Increases in RF MEP amplitudes from both limbs were observed immediately following a 30-minute exercise session focusing on muscle strengthening. Following an 8-week muscle strengthening intervention, the participant exhibited increased MEP amplitudes and muscle strength in the affected limb. These findings suggest that alterations in peripheral muscle function found in patients with knee OA may have an origin centrally within the motor cortex and that interlimb differences may be evident in those with unilateral disease. These findings also suggest that CS excitability may be improved following a muscle strengthening intervention.