Dual task walking in healthy aging: Effects of narrow and wide walking paths

Abstract

Dual-task walking may lead to gait instability and a higher fall risk in older adults, particularly when walking in a busy city street. Challenging street features such as narrow sidewalks not only discourage walking, but are also likely to be taxing for older adults’ cognitive resources and gait characteristics. The aim of this study was to assess the way older adults’ gait characteristics are affected by walking on a narrow path while performing a challenging cognitive task in lab conditions imitating common urban environments. Nineteen young and eighteen older adults walked on a narrow (40cm) and a wide (80cm) path and performed a cognitive (n-back) task individually adjusted to 80% accuracy. The two tasks were performed separately (Single-Task) and concurrently (Dual-Task). Both groups walked faster, and their step width was narrower on the narrow path. During dual-task walking on the narrow path, older adults showed significant dual-task costs in the cognitive task, gait speed, step width, and stride length. Dual-task walking was associated with decreased gait speed and stride length in both age groups, suggesting that dual-task walking may adversely affect gait, particularly when walking on narrow paths. These conditions may lead to gait instability and an increased fall risk for older adults, particularly when walking along the narrow sidewalks commonly found within the built environment. However, more research is needed in an urban setting to determine the extent of the fall risk narrow sidewalks present for older adults.

Beam width and arm position but not cognitive task affect walking balance in older adults

“…Prioritizing cognition over walking speed is also supported by a lack of increase in cognitive errors while dual-tasking. A previous study did not find any difference in cognitive performance between walking on a narrow or wide path 29 , which supports our result. It remains to be determined if a difference of 2 cm in beam width and/or diversity in participants’ fitness underlie the differences in beam walking distance in the present and the previous study 10 .…”

Dual-task walking improvement with enhanced kinesthetic awareness in Parkinson’s disease with mild gait impairment: EEG connectivity and clinical implication

“…On the other hand, we did not compare stride-awareness effect between people with PD and healthy adults in the present study. Based on previous studies, shortened stride length is the most consistent finding of walking impairment in PD, particularly under dual-task walking conditions ( Kelly et al, 2012 ), but shortened stride length is not necessary to be a specific gait symptom for healthy older adults ( Fallahtafti et al, 2021 ; Hennah et al, 2021 ). For example, prominent dual-task interference on step length of healthy older adults may only be observed when walking along a narrow path (width = 40 cm), but not when walking along a wide path (width = 80 cm)( Hennah et al, 2021 ).…”

“…Based on previous studies, shortened stride length is the most consistent finding of walking impairment in PD, particularly under dual-task walking conditions (Kelly et al, 2012), but shortened stride length is not necessary to be a specific gait symptom for healthy older adults (Fallahtafti et al, 2021;Hennah et al, 2021). For example, prominent dual-task interference on step length of healthy older adults may only be observed when walking along a narrow path (width = 40 cm), but not when walking along a wide path (width = 80 cm) (Hennah et al, 2021). Adopting an awareness strategy of focusing on "taking big steps" might not be an appropriate walking strategy for healthy older adults.…”

Risk Assessment of Falls Among Older Adults Based on Probe Reaction Time During Water-Carrying Walking

“…The sample size of this study was calculated under the following conditions: α=0.05, inspection efficiency 1-β=0.8. Referring to the literature 26 and combined with the previous case analysis, 27 when the significance level was 0.05 on both sides and the confidence level was set to 80%, the effect was set to 0.8, and considering a 10% dropout rate, each group required 21 participants, with a minimum total sample size of 42. As the proportion of falls among older adults is 20–30%, the overall sample size was expected to be 100.…”