Introduction: The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives: To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method: Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results: A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway® system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion: The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.
Introduction Adequate motor coordination (MC) of the lower limbs is essential for most of the motor tasks. Therefore, it is important to know the psychometric properties of the tests employed to assess lower limb MC, so that professionals could have a better basis to choose the most adequate assessment tools. Objectives To investigate the psychometric properties and clinical utility of instruments used to assess lower limb MC, by means of a critical review of the literature. Materials and methods A search was conducted in six databases looking for studies which evaluated reliability, validity, sensitivity to changes, or clinical utility of the tests employed to assess lower limb MC. The articles were assessed and the data of their psychometric properties were extracted by two researchers, independently. Results The search returned 1361 studies, 1,325 were excluded after analyses. The hand search yielded four eligible articles, totaling nine included articles. The included studies evaluated the psychometric properties of eight tests, but only three were specific to assess lower limb MC and the others were sub-items of other scales, which assess other domains. None of the tests provided data for all of the basic psychometric properties. Final remarks According to the results of this review, none of the tests had their basic psychometric properties reported, which is necessary to be investigated in future studies. This review may facilitate the search and selection of lower limb MC tests by researchers and clinicians.
Previous studies suggested cervical spondylosis as a risk factor for development of obstructive sleep apnoea (OSA). We aimed to assess lumbar disc degeneration in patients with OSA and correlate the findings with symptoms and disease severity. Twenty-seven patients with OSA and 29 non-OSA controls underwent sleep studies and lumbar magnetic resonance imaging (MRI), and completed the Epworth Sleepiness Scale and the 24-item Roland‐Morris Disability Questionnaire questionnaires. Plasma klotho was determined with enzyme-linked immunosorbent assay.Patients with OSA had higher number of disc bulges (4.6±3.7 vs. 1.7±2.5, p<0.01) and anterior spondylophytes (2.7±4.2 vs. 0.8±2.1, p<0.01), increased Pfirrmann score (16.7±4.7 vs. 13.2±4.1, p<0.01) and vertebral fatty degeneration (7.8±4.7 vs. 3.8±3.7, p<0.01). Markers of OSA severity, including the apnoea-hypopnoea index, oxygen desaturation index and percentage of total sleep time spent with saturation <90% as well as plasma levels of klotho were correlated with the number of disc bulges and anterior spondylophytes following adjustment on age, gender and body mass index (all p<0.05). Markers of disc degeneration were related to chronic pain.OSA is associated with lumbar spondylosis likely through chronic intermittent hypoxaemia inducing inflammation in the lumbar discs. Our study highlights the importance of lumbar imaging in patients with OSA reporting lower back pain.
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