Walking is more like catching than tapping: gait in the elderly as a complex cognitive task
Walking is more like catching than tapping: gait in the elderly as a complex cognitive task
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DOI：
10.1007/s00221-005-2280-3
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发表时间：
2005-08-01
影响因子：
2
通讯作者：
Giladi, N
中科院分区：
文献类型：
--
作者：
Hausdorff, JM;Yogev, G;Giladi, N
行走通常被视为一种自动化的、过度学习的、有节奏的运动任务，甚至可以被认为是另一种自动化运动任务--有节奏的手指敲击的下肢模拟。因此，有人可能会假设，行走与简单的节奏任务（如敲击）有关，而不是与复杂的运动任务（如捕捉）有关。然而，令人惊讶的是，我们发现，在老年人中，日常行走与复杂的运动任务（如捕捉移动物体）的共同点比轻拍更多。敲击性能，包括平均敲击间隔和敲击间隔的变异性，与任何步态参数（步态速度，平均步幅时间和步幅时间变异性）没有显着相关。相比之下，捕捉游戏的性能显着相关的步行措施，这表明步行更像是捕捉比它是像轻敲。例如，具有较高步态速度的参与者在捕捉时往往具有较短的第一次移动时间，更好的捕捉准确性和更少的捕捉错误。步幅时间的变化显着相关的每一个措施的捕捉。具有较低步幅时间变异性（更稳定的步态）的参与者具有更好的捕捉准确性，更短的首次移动时间，在移动光标以捕捉下落物体时更少的方向变化，以及更少的捕捉错误。为了理解这种关联，我们将行走表现与Stroop测试（一种经典的执行功能测试）和记忆测试的表现进行了比较。散步与更高层次的认知资源有关，特别是执行功能，但与记忆或一般认知功能无关。例如，较低（较好）的步幅时间变异性与Stroop测试的较高（较好）分数显著相关，但与记忆测试无关。同样，当参与者根据他们在Stroop测试和记忆测试中的表现进行分层时，步幅时间变异性取决于前者，而不是后者。这些发现强调了步态和认知功能的相互联系，表明即使是常规行走也是一项复杂的认知任务，与更高水平的认知功能相关，并提出了治疗老年人步态和跌倒风险的替代方法。
Walking is generally viewed as an automated, over-learned, rhythmic motor task and may even be considered the lower-limb analog of rhythmic finger tapping, another automated motor task. Thus, one might hypothesize that walking would be associated with a simple rhythmic task like tapping rather than with a complex motor task like catching. Surprisingly, however, we find that among older adults, routine walking has more in common with complex motor tasks, like catching a moving object, than it does with tapping. Tapping performance, including both the average tapping interval and the variability of tapping interval, was not significantly associated with any gait parameter (gait speed, average stride time and stride time variability). In contrast, catch game performance was significantly associated with measures of walking, suggesting that walking is more like catching than it is like tapping. For example, participants with a higher gait speed tended to have lower times to first move when catching, better catching accuracy, and less catching errors. Stride time variability was significantly associated with each of the measures of catching. Participants with a lower stride time variability (a more steady gait) had better catching accuracy, lower time to first move, fewer direction changes when moving the cursor to catch the falling object, and less catching errors. To understand this association, we compared walking performance to performance on the Stroop test, a classic measure of executive function, and tests of memory. Walking was associated with higher-level cognitive resources, specifically, executive function, but not with memory or cognitive function in general. For example, a lower (better) stride time variability was significantly associated with higher (better) scores on the Stroop test, but not with tests of memory. Similarly, when participants were stratified based on their performance on the Stroop test and tests of memory, stride time variability was dependent on the former, but not the latter. These findings underscore the interconnectedness of gait and cognitive function, indicate that even routine walking is a complex cognitive task that is associated with higher-level cognitive function, and suggest an alternative approach to the treatment of gait and fall risk in the elderly.