تأثیر تکلیف دوگانه، مجرد و ترکیبی بر راه‌رفتن زنان سالمند با تجربۀ افتادن و بدون تجربۀ افتادن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری رفتار حرکتی، پردیس بین‌الملل دانشگاه تهران واحد کیش

2 دانشیار گروه رفتار حرکتی، دانشگاه تهران

3 استادیار گروه فیزیولوژی ورزش، پردیس بین‌الملل دانشگاه تهران واحد کیش

چکیده

هدف از پژوهش حاضر، تعیین تأثیر تکلیف دوگانه، مجرد و ترکیبی بر راه‌رفتن زنان سالمند با تجربۀ افتادن و بدون تجربۀ افتادن می­باشد. بدین­منظور، 120 زن سالمند شهرستان بابل که در دامنۀ سنی 80ـ60 سال قرار داشتند­ به صورت داوطلبانه انتخاب شدند و به­شکل تصادفی در گروههای کنترل و تمرینی دوگانه، مجرد و ترکیبی جای گرفتند. جهت سنجش کیفیت راه­رفتن سالمندان­ از آزمون برخاستن و حرکت­کردن زماندار استفاده شد. پس از مرحلۀ پیش­آزمون، گروه‏های مختلف تمرینی بر­اساس برنامۀ مشخص با توجه به گروه خود،­­ به تمرین راه­رفتن با شرایط تکلیف مجرد، دوگانه و ترکیبی پرداختند و پس از دوماه، مجدداً در آزمون برخاستن و حرکت­کردن زماندار حضور یافتند. شایان­ذکر است که آزمون در دو شرایط تکلیف مجرد و تکلیف دوگانه برای تمام گروه‏ها انجام پذیرفت. نتایج آزمون تحلیل واریانس مختلط نشان می­دهد که اثر مداخله و اثر تعاملی مداخله در گروه در دو شرایط آزمون با اجرای تکلیف مجرد و تکلیف دوگانه معنادار می­باشد (0.05P اما تفاوت بین این دو شرایط در پس­آزمون معنادار نیست. این احتمال وجود دارد که افزایش قابلیت شناختی و جسمانی زنان سالمند، زمینهساز بهبود امتیازات کیفیت راه­رفتن آن­ها بوده است.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effect of Dual Task, Single Task, and Combined Task on Older Adults’ Gait, with or without the Experience of Falling

نویسندگان [English]

  • Azadeh Zanganeh 1
  • Mahmood Sheikh 2
  • Ahmad Farookhi 2
  • Reza Noori 3
چکیده [English]

The main aim of this study was to determine the effect of dual-task, single-task, and combined-task training on older adults’ gait, with or without the experience of falling. For this purpose, we recruited 120 volunteers in Babol in the 60–80 age range. The participants were randomly divided into different groups, including: two control groups, two experimental groups assigned with single task, two experimental groups assigned with dual task, and two groups assigned with combined task. To evaluate the quality of gait in older adults, we applied the ‘Timed up and go test (TUG).’ After pre-examining the participants according to the task their groups were assigned, they participated in single-task, dual-task, and combined-task exercises. After about two months, the subjects participated in TUG again. All groups were assessed in both single-task and dual-task conditions. The results of mixed ANOVA test showed that the effect of intervention, and the interactive effect of intervention and group under both test conditions were meaningful, but the post-test difference between these two conditions was not significant. Probably, the increase in cognitive and physical ability is the key reason for a better quality of gait.

کلیدواژه‌ها [English]

  • Quality of Gait
  • Attention Capacity
  • Older Adults
  • Falling
  1. ĠREZ G B. Pilates exercise positively affects balance, reaction time, muscle strength, number of falls and psychological parameters in 65+ years old women. Middle East Technical University; 2009.
  2. Seo B, Kim B, Singh K. The comparison of resistance and balance exercise on balance and falls efficacy in older females. Eur Geriatr Med. 2012; 3(5): 312-6.
  3. Khajavi D. Validation and reliability of Persian version of Fall Efficacy Scale-International (FES-I) in community-dwelling older adults. Iranian Journal of Ageing. 2013; 8(2): 39-47. (In Persian).
  4. Orr R, De Vos N J, Singh N A, Ross D A, Stavrinos T M, Fiatarone-Singh M A. Power training improves balance in healthy older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2006; 61(1): 78-85.
  5. Pajala S, Era P, Koskenvuo M, Kaprio J, Alén M, Tolvanen A, et al. Contribution of genetic and environmental factors to individual differences in maximal walking speed with and without second task in older women. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005; 60(10): 1299-303.
  6. De Rekeneire N, Visser M, Peila R, Nevitt M C, Cauley J A, Tylavsky F A, et al. Is a fall just a fall: Correlates of falling in healthy older persons. The Health, aging and body composition study. J Am Geriatr Soc. 2003; 51(6): 841-6.
  7. Fathi Rezaie Z­, Abdoli B­, ­Farsi A. ­­The comparison of falling risk of elderly by speed gait test under dual tasks conditions. Iranian Journal of Ageing. 2010; 5(16). (In Persian).
  8. Morrison S, Colberg S R, Mariano M, Parson H K, Vinik A I. Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care. 2010; 33(4): 748-50.
  9. Washburn R A, McAuley E, Katula J, Mihalko S L, Boileau R A. The physical activity scale for the elderly (PASE): Evidence for validity. J Clin Epidemiol. 1999; 52(7): 643-51.
  10. Moore J B, Korff T, Kinzey S J. Acute effects of a single bout of resistance exercise on postural control in elderly persons 1. Percept Mot Skills. 2005; 100(3): 725-33.
  11. Reinsch S, Mac­Rae P, Lachenbruch P A, Tobis J S. Attempts to prevent falls and injury: A prospective community study. The Gerontologist. 1992; 32(4): 450-6.
  12. Barnett A, Smith B, Lord S R, Williams M, Baumand A. Community‐based group exercise improves balance and reduces falls in at‐risk older people: A randomised controlled trial. Age Ageing. 2003; 32(4): 407-14.
  13. Buchner D M, Cress M E, de Lateur B J, Esselman P C, Margherita A J, Price R, et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1997; 52(4): ­218-­24.
  14. Lajoie Y, Teasdale N, Bard C, Fleury M. Attentional demands for static and dynamic equilibrium. Exp Brain Res. 1993; 97(1): 139-44.
  15. Ebersbach G, Dimitrijevic M R, Poewe W. Influence of concurrent tasks on gait: A dual-task approach. Percept Mot Skills. 1995; 81(1): 107-13.
  16. Toulotte C, Thevenon A, Watelain E, Fabre C. Identification of healthy elderly fallers and non-fallers by gait analysis under dual-task conditions. Clin Rehabil. 2006; 20(3): 269-76.
  17. Shumway-Cook A, Woollacott M H. Motor control: Translating research into clinical practice. Lippincott Williams & Wilkins; 2007.
  18. Ojha H A, Kern R W, Lin C-H J, Winstein C J. Age affects the attentional demands of stair ambulation: Evidence from a dual-task approach. Phys Ther. 2009; 89(10): 1080-8.
  19. Iranmanesh H, Arab Ameri E, Farrokhi A, Iranmanesh H. The effect of single task and dual task balance training on the balance of older adults. ­2014; 2(6): 195-215.­ (In Persian).
  20. Parker T M, Osternig L R, Lee H J, van Donkelaar P, Chou L S. The effect of divided attention on gait stability following concussion. Clinical Biomechanics. 2005; 20(4): 389-95.
  21. Sparrow W, Bradshaw E J, Lamoureux E, Tirosh O. Ageing effects on the attention demands of walking. Human Movement Science. 2002; 21(5): 961-72.
  22. Geurts A, Mulder T W, Nienhuis B, Rijken R. Dual-task assessment of reorganization of postural control in persons with lower limb amputation. Arch Phys Med Rehabil. 1991; 72(13): 1059-64.
  23. Wallmann H W. Comparison of elderly nonfallers and fallers on performance measures of functional reach, sensory organization, and limits of stability. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001; 56(9): 580-­3.
  24. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: A review of an emerging area of research. Gait Posture. 2002; 1­(6): 1-14.
  25. Aslankhani M, Farsi A, Fathi Rezaei Z, Zamani Sani H, Aghdasi M T. Validity and reliability of the timed up & go and the anterior functional reach tests in evaluating fall risk in elderly. Iranian Journal of Ageing. 2015; 10(1): 1-12. (In Persian).
  26. Folstein M F, Folstein S E, McHugh P R. ­Mini-mental state­: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
  27. Hauer K, Lamb S E, Jorstad E C, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing. 2006; 35(1): 5-10.
  28. Muir S W, Berg K, Chesworth B, Klar N, Speechley M. Quantifying the magnitude of risk for balance impairment on falls in community-dwelling older adults: A systematic review and meta-analysis. J Clin Epidemiol. 2010; 63(4): 389-406.
  29. Bloch F, Thibaud M, Dugué B, Breque C, Rigaud A, Kemoun G. Episodes of falling among elderly people: A systematic review and meta-analysis of social and demographic pre-disposing characteristics. Clinics. 2010; 65(9): 895-903.
  30. Evans D, Hodgkinson B, Lambert L, Wood J. Falls risk factors in the hospital setting: A systematic review. Int J Nurs Pract. 2001; 7(1): 38-45.
  31. Hedden T, Gabrieli J D. Insights into the ageing mind: A view from cognitive neuroscience. Nature Reviews Neuroscience. 2004; 5(2): 87-96.
  32. Sherrington C, Whitney J C, Lord S R, Herbert R D, Cumming R G, Close J C. Effective exercise for the prevention of falls: A systematic review and meta‐analysis. J Am Geriatr Soc. 2008; 56(12): 2234-43.
  33. Theill N, Schumacher V, Adelsberger R, Martin M, Jäncke L. Effects of simultaneously performed cognitive and physical training in older adults. BMC Neurosci. 2013; 14(1): 103.
  34. Rábago C A, Wilken J M. Application of a mild traumatic brain injury rehabilitation program in a virtual realty environment: A case study. J Neurol Phys Ther. 2011; 35(4): 185-93.
  35. Wulf G, Shea C, Park J H. Attention and motor performance: Preferences for and advantages of an external focus. Res Q Exerc Sport. 2001; 72(4): 335-44.
  36. Hess J A, Woollacott M. Effect of high-intensity strength-training on functional measures of balance ability in balance-impaired older adults. J Manipulative Physiol Ther. 2005; 28(8): 582-90.
  37. Sadeghi H, Hemati Nezhad M A, Baghban M. The effect of endurance training on a few kinematics parameters ingait of non-active elderly people. Iranian Journal of Ageing. 2009; 4(1): 0­. (In Persian).
  38. Silsupadol P, Lugade V, Shumway-Cook A, van Donkelaar P, Chou L S, Mayr U, et al. Training-related changes in dual-task walking performance of elderly persons with balance impairment: A double-blind, randomized controlled trial. Gait Posture. 2009; 29(4): 634-9.
  39. Silsupadol P, Shumway-Cook A, Lugade V, van Donkelaar P, Chou L S, Mayr U, et al. Effects of single-task versus dual-task training on balance performance in older adults: A double-blind, randomized controlled trial. Arch Phys Med Rehabil. 2009; 90(3): 381-7.
  40. Silsupadol P, Siu K C, Shumway-Cook A, Woollacott M H. Training of balance under single-and dual-task conditions in older adults with balance impairment. Phys Ther. 2006; 86(2): 269-81.
  41. Siu K C, Woollacott M H. Attentional demands of postural control: The ability to selectively allocate information-processing resources. Gait Posture. 2007; 25(1): 121-6.
  42. Lee H, Sullivan S J, Schneiders A G. The use of the dual-task paradigm in detecting gait performance deficits following a sports-related concussion: A systematic review and meta-analysis. J Sci Med Sport. 2013; 16(1): 2-7.
  43. Khoramian M, Golmohammadi B, Akbari H. The effect of the selective balanced on ball and core resistance training program on the older females. Journal of Motor Behavior. 2015; 7(19): 22-105. (In Persian).
  44. Pellecchia G L. Dual-task training reduces impact of cognitive task on postural sway. Journal of Motor Behavior. 2005­; 37(3): 239-46.