RESUMO
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.
RESUMO
Age-related effects of task switching have been extensively studied based on cognitive tasks and simple motor tasks, but less on complex cognitive-motor tasks involving dynamic balance control while walking. The latter tasks may especially be difficult and relevant for older adults in terms of safe mobility in daily life. The aim of the present study was, therefore, to examine age-related changes in task-switching adaptability using a novel voluntary gait adaptability test protocol. Fifteen healthy young (27.5 ± 2.9 years) and 16 healthy old (70.9 ± 7.6 years) adults carried out 2 different visual target stepping tasks (either target avoidance or stepping) twice in a block (A-B-A-B, 2 min per task; three blocks in total) without any intrablock breaks. Our results showed that old adults showed significantly more step errors both in Tasks A and B as well as more interference effects than young adults. Age-related differences in step accuracy were significant in the anterior-posterior direction both in Task A and B but not in the mediolateral direction. Both in step errors and accuracy, no interaction effects of age and trial were shown. Our results suggest that old adults could not cope with rapid and direct task changes in our voluntary gait adaptability task as young adults. Since the significant main effect of trial for Task B, but not Task A appears to be due to different task complexity, further studies may determine the effect of task complexity or task switch timing.
