SPATIOTEMPORAL PARAMETER CHANGES IN DIFFERENT WALKING CONDITIONS IN POSSIBLE DEMENTIA IN ALZHEIMER'S DISEASE PATIENTS

Abstract

Introduction: Dementia affects not only cognitive domains but motor skills as well. Demented patients experience difficulties in gait as dementia progresses. Gait is evaluated through spatial, temporal and combined spatio-temporal parameters. The values of these parameters vary with the simultaneous execution of a second dual task in demented patients.
Purpose: The evaluation of changes in spatiotemporal parameters during walking under four conditions, simple gait, walking with a simple and complex kinetic task and walking under cognitive task in patients with Alzheimer's disease.
Method: We evaluated 20 patients diagnosed with Possible Dementia in Alzheimer's disease [1], mean aged 72.9 ± 2 years. The participants undertook the MMSE scale (scores between 16-23/30). The gait pattern was evaluated by a biomechanical analysis system. Participants were called to walk at their natural speed, performing a sufficient number of repetitions (10), under all walking conditions. The evaluated temporal parameters were: stride time (sec), step duration (sec), double support time(sec) and single support time (sec). The spatial parameters that were studied were: stride and step length while the combined spatio-temporal parameters computed were frequency (steps / minute) and gait speed (m / sec). A variance analysis for repeated measurements with repeated factors was applied for each walking condition while for the comparison of multiple comparisons, bonferroni test was performed (p <.05).
Results: Gait velocity as well as gait frequency, were found significantly lower during dual cognitive task than in the other three conditions. On the other hand, stride length and step length were unaffected by the type of the walking condition. Step duration, single and double support time, were increased only during dual cognitive task.
Conclusion: The implementation of a dual cognitive task in gait, influences considerably the walking parameters. Dual cognitive task could be used to identify gait disturbance in demented patients.