RESUMEN

OBJECTIVE: Objectives were (1) to explore differences in gait-specific long-term memory structures and gait performance between knee osteoarthrosis patients and healthy subjects and (2) to identify the extent to which the gait-specific mental representation is associated with gait performance. DESIGN: Cross-sectional study. SUBJECTS: In total, 18 knee osteoarthrosis patients and 18 control subjects. METHODS: Spatio-temporal (gait speed, step length) and temporophasic (stance time, swing time, single support time, total double support time) gait parameters and gait variability were measured with an electronic walkway (OptoGait). The mental representation was assessed using the structural dimensional analysis of mental representations (SDA-M). RESULTS: (1) Patients showed significantly longer stance times ( P < 0.002) and total double support times, shorter swing times and single support times, a decreased gait speed ( P-values < 0.001) and structural differences in the gait-specific mental representation as compared with the healthy controls. (2) Correlation analyses revealed the mental representation of the human gait to be associated with actual gait performance in osteoarthrosis patients. Double support times were positively associated with the structural quality of the mental representation and step length variability was positively associated with the number of sequencing errors in the representation. CONCLUSION: The gait-specific mental representation and actual gait performance differ between patients with severe knee osteoarthrosis and healthy controls, and both are linked to one another. This finding suggests that musculoskeletal disorders can lead to changes in the mental representation of the gait, and as such the SDA-M could provide useful information to improve the rehabilitation following osteoarthrosis.

Asunto(s)

Marcha/fisiología , Memoria , Osteoartritis de la Rodilla/fisiopatología , Osteoartritis de la Rodilla/psicología , Anciano , Estudios de Casos y Controles , Estudios Transversales , Miedo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor

RESUMEN

The link between mental representation (MREP) structures and motor performance has been evidenced for a great variety of movement skills, but not for the human gait. Therefore the present study sought to investigate the cognitive memory structures underlying the human gait in young and older adults. In a first experiment, gait parameters at comfortable gait speed (OptoGait) were compared with gait-specific MREPs (structural dimensional analysis of MREP; SDA-M) in 36 young adults. Participants were divided into a slow- and fast-walking group. The proven relationship between gait speed and executive functions such as working memory led to the hypothesis that gait pattern and MREP differ between slow- and fast-walking adults. In a second experiment, gait performance and MREPs were compared between 24 young (27.9 years) and 24 elderly (60.1 years) participants. As age-related declines in gait performance occur from the seventh decade of life onward, we hypothesized that gait parameters would not be affected until the age of 60 years accompanied by unchanged MREP. Data of experiment one revealed that gait parameters and MREPs differed significantly between slow and fast walkers. Notably, eleven previously incurred musculoskeletal injuries were documented for the slow walkers but only two injuries and one disorder for fast walkers. Experiment two revealed no age-related differences in gait parameters or MREPs between healthy young and older adults. In conclusion, the differences in gait parameters associated with lower comfortable gait speeds are reflected by differences in MREPs, whereby SDA-M data indicate that the single limb support phase may serve as a critical functional period. These differences probably resulted from previously incurred musculoskeletal injuries. Our data further indicate that the human gait and its MREP are stable until the age of 60. SDA-M may be considered as a valuable clinical tool for diagnosis of gait abnormalities and monitoring of therapeutic effectiveness.