| چکیده انگلیسی مقاله |
Background and Purpose
Walking is a fundamental motor skill critical for maintaining independence and preventing falls among elderly adults. With advancing age, physiological and psychological changes—such as increased reaction time, reduced balance, diminished neuromuscular coordination, decreased muscle strength, and impaired postural control—often lead to altered gait patterns. These changes, which are not necessarily disease-related, result from a combination of physiological decline, environmental factors, and lifestyle choices, ultimately reducing physical fitness in the elderly. Declining physical fitness can disrupt mobility and increase fall risk, a major concern for this population. Walking, as a primary component of daily movement, is often affected by these age-related changes, making it a key indicator of functional independence in older adults.
Materials and Methods
Identifying factors influencing gait and developing effective interventions to mitigate age-related declines in walking performance have become important research areas. Previous studies have demonstrated that various training methods can positively influence gait patterns, including improvements in walking speed and related parameters. However, the role of environmental and task constraints in modifying gait parameters and reducing fear of falling remains poorly understood. While some research has explored task constraints manipulation, its specific effects on spatiotemporal gait parameters in elderly adults have not been thoroughly investigated.
This semi-experimental study included 30 healthy elderly men aged 59–80 years, randomly assigned to an intervention group (n = 15) or a control group (n = 15). Sample size was determined using G*Power software with an effect size of 0.9. Inclusion criteria included the ability to walk independently, normal or corrected-to-normal vision, capacity to follow simple instructions, and a Mini-Mental State Examination (MMSE) score above 24 to exclude cognitive impairment. Exclusion criteria included history of injuries limiting movement, medical conditions or medications affecting balance and mobility, and missing more than two consecutive training sessions.
The intervention group participated in an 8-week training program (three sessions per week) involving task constraints manipulation, while the control group maintained normal daily activities. The intervention aimed to limit movement in all three dimensions at varying speeds, challenging participants to adapt their gait patterns. An experienced staff member supervised the program to ensure proper engagement. Gait parameters—including stride length (cm), cadence (steps/min), gait velocity (km/h), and variability of velocity (%)—were measured using the FDM gait analysis system (Zebris, Germany). Cognitive status was assessed using the Persian version of the MMSE. Data were analyzed using SPSS version 22. The Shapiro-Wilk test assessed normality, Levene’s test evaluated homogeneity of variances, and one-way analysis of covariance (ANCOVA) compared pre- and post-test results between groups, with significance set at p < 0.05.
Results
ANCOVA results revealed significant improvements in the intervention group for several spatiotemporal gait parameters, including stride length (p < 0.05), cadence (p < 0.05), gait velocity (p < 0.05), and variability of velocity (p < 0.05). No significant change was observed in stride time (p = 0.07). These findings suggest that task constraints manipulation can effectively enhance gait performance in elderly adults by promoting adaptive movement strategies and improving motor control.
Conclusion
This study indicates that task constraints manipulation positively influences spatiotemporal gait parameters in elderly adults, potentially reducing fall risk and improving functional mobility. By creating training conditions that challenge participants to adapt their movement patterns, the intervention may enhance the performance of both peripheral and central systems involved in gait control. Improvements in stride length, cadence, and gait velocity suggest that task constraints manipulation facilitates the development of more efficient and stable walking patterns. These results align with previous research demonstrating the benefits of task-specific training in improving motor performance in older adults. The lack of significant change in stride time may indicate that this parameter is less sensitive to task constraints or may require a longer intervention period for measurable improvements.
In conclusion, task constraints manipulation is an effective intervention for improving gait performance in elderly adults. By promoting adaptive movement strategies and enhancing motor control, this approach may contribute to reducing fall risk and improving daily functional mobility. Future research should explore long-term effects and applicability to other populations, such as those with neurological or musculoskeletal impairments.
Article Message
Based on the findings of this study, training methods utilizing task constraints manipulation appear to be an effective approach for improving and facilitating daily activities, such as walking, in the elderly population. Implementing such methods in elderly training programs can enhance functional abilities and contribute to better overall mobility and quality of life. |