This study aimed to investigate the effectiveness of dual-task training (DTT) compared to single-task training (STT), on gait parameters in elderly patients with mild dementia (MD). Twenty-four elderly patients with MD were randomly assigned to the DTT (n = 13) or the STT group (n = 11). The DTT group performed a specific cognitive-motor DTT, while the STT group received only motor task training. Both training sessions lasted 8 weeks, with a frequency of 3 days per week, and the cognitive functions and gait parameters were measured. A statistically significant interaction effect was found between the two groups in stride length, stride velocity, cadence, step length, swing phase, stance phase, and double support phase (p < 0.05). After 8 weeks, the DTT group showed significant improvement in spatiotemporal parameters, except for the kinematic parameters (p < 0.05). In the between-group analysis, the DTT group showed more improvement than the STT group in stride velocity, step length, swing phase, stance phase, and double support (p < 0.05). These findings suggest that improvements in spatiotemporal gait parameters after DTT are reported in patients with MD. Our results can guide therapists to include dual tasks in their gait rehabilitation programs for the treatment of mild dementia.
Background and Objectives: The loss of dopamine neurons in the nigrostriatal tract (NST) is one of the main pathological features of Parkinson’s disease (PD), and degeneration of the NST leads to the motor symptoms observed in PD, which include hypokinesia, tremors, rigidity, and postural imbalance. In this study, we used diffusion tensor tractography (DTT) to investigate the aging of the NST in normal human subjects to elucidate human brain structures. Materials and Methods: Fifty-nine healthy subjects were recruited for this study and allocated to three groups, that is, a 20 to ≤39 year old group (the young group), a 40 to ≤59 year old group (the middle-aged group), and a ≥60 year old group (the old group). DTT scanning was performed, and NSTs were reconstructed using the probabilistic tractography method. NSTs were defined by selecting fibers passing through seed and target regions of interest placed on the substantia nigra and the striatum. Results: A significant negative correlation was observed between age and fractional anisotropy and tract volume (TV) of the NST. Mean TV values of the NST were significantly lower in the old group than in the young and middle-aged groups (p < 0.05). The TV values of the NST were significantly reduced with age for men and women (p < 0.05). Conclusion: We found that aging of the NST began in the 3rd decile and progressed steadily throughout life until old age, when it exhibited significant degeneration. We suspect these results are related to the correlation between the incidence of PD and age.
The forward shoulder posture (FSP) results from shoulders being pulled forward by shortened anterior shoulder girdle muscles. The objective of this study was to investigate the short-term effectiveness of the reverse plank exercise on parascapular muscle thickness and forward shoulder angle (FSA) in patients with FSP. Participants were divided into the FSP and non-FSP (NFSP) groups based on the observed angle between the horizontal line of the C7 spinous process and the acromion process. All participants performed a total of five sets of reverse plank exercises at 30 s per set. FSA and muscle thickness of the pectoralis major (PM), serratus anterior (SA), upper trapezius (UT), and lower trapezius (LT) were measured before and after the reverse plank exercise. The muscle thicknesses of the SA and LT, and the FSA, were significantly increased after exercise in the FSP group (p < 0.05). Muscle thickness of the PM and UT significantly decreased after the exercise. In the NFSP group, muscle thickness of the LT was significantly increased, and muscle thickness of the PM and UT were significantly reduced after exercise (p < 0.05). Upon using between-group analysis, there were significant differences between the FSA, SA, UT, and LT groups (p < 0.05). The reverse plank exercise has the short-term benefit of correcting and preventing FSP by increasing SA and LT thickness while decreasing PM and UT thickness. We believe that the reverse plank exercise significantly improved the ability to prevent FSP in FSP-related muscles and was beneficial in achieving optimal postural alignment.
Purpose: Gait termination (GT) is the transition from steady-state walking to a complete stop, occurring under planned gait termination (PGT) or unplanned gait termination (UGT) conditions. This study aimed to investigate the biomechanical differences between PGT and UGT, which could help develop therapeutic interventions for individuals experiencing difficulty with GT. Methods: Twenty healthy adults performed three walking trials, followed by PGT and UGT trials. Gait termination was analyzed in three phases as follows: Phase 1 (pre-stopping), Phase 2 (initial stopping phase), and Phase 3 (terminal stopping phase). Spatiotemporal, kinematic, and kinetic data during each phase were compared between conditions. Results: The GT time and GT step length were significantly different between the PGT and UGT trials. Ankle range of motion (ROM) demonstrated significant differences in Phase 1, with the PGT having a slightly lower ankle ROM than the UGT. In Phase 2, the hip, knee, and ankle ROM exhibited significant differences between the conditions. Finally, in Phase 3, UGT showed reduced hip ROM but increased knee ROM and kinetic parameters compared to PGT. Conclusion: Our results indicate that the ankle joint primarily contributes to deceleration during the initial preparation for generating braking force during PGT. Conversely, UGT reveals disrupted kinesthetic control due to instability, leading to a preference for a hip and knee strategy to absorb force and control the center of mass for a safe and rapid GT in response to unexpected stimuli. These findings provide valuable insights into the biomechanical mechanisms underlying body stability during GT and may contribute to the development of effective rehabilitation strategies for individuals with gait impairment.
There is a correlation between cognitive inhibition and compensatory balance response; however, the correlation between response inhibition and gait termination is not clear. Objectives: The purpose of this study was to investigate the gait parameters of the lower extremity that occurred during unplanned gait termination (UGT) in two groups classified by the stop-signal reaction time (SSRT). Methods: Twenty young adults performed a stop-signal task and an unplanned gait termination separately. UGT required subjects to stop on hearing an auditory cue during randomly selected trials. The spatiotemporal and kinematic gait parameters were compared between the groups during UGT. Results: In phase one, the fast group had a significantly greater angle and angular velocity of knee flexion and ankle plantar flexion than the slow group (p < 0.05). Phase two showed that the fast group had a significantly greater angle and angular velocity of knee extension than the slow group (p < 0.05). Concerning the correlation analysis, the angle and angular velocity of knee flexion and ankle plantar flexion showed a negative correlation with the SSRT during UGT in phase one (p < 0.05). Phase two showed that the angle and angular velocity of knee extension was negatively correlated with the SSRT during UGT (p < 0.05). Conclusion: The shorter the SSRT, the greater the angle and joint angular velocity of the ankle or knee joint that were prepared and adjusted for gait termination. The correlation between the SSRT and UGT suggests that a participant’s capacity to inhibit an incipient finger response is associated with their ability to make a corrective gait pattern in a choice-demanding environment.
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