Efeitos da realização de tarefas duplas no desempenho da marcha em idosos

Abstract

Maintaining stability in the march was traditionally considered an automatic task or a reflex control, requiring motor responses to sensory stimuli, but requiring minimal cognitive resources. Thus, gait control would be undertaken by subcortical centers and spinal regions. However, recent evidence suggests that maintaining postural stability requires control cerebral of subcortical areas and eventually the request of higher brain areas requiring cognitive and sensorimotor processing. Thus, the march is not just an automated process, but rather depends on cognitive function.Changes in gait patterns in the context of performing dual tasks, have been frequently reported among the elderly, as well as limitations on balance control. Some studies have suggested that the gait alterations related to dual tasks mainly result from interference caused by a competitive demand for attention sources, or by an interference in neural net of motor and frontal cortex. They also suggest that walking requires high levels of attention with increasing age.Among the studies included in this review, we observed that the spatio temporal gait (speed, cadence, time of support, lateral deviation of travel, length and width of the step and the last) and other parameters of variability of gait (stride of support time, stride velocity, stride length), suffer significant changes during the march with the completion of another task in the elderly. These changes suggest that the realization of a dual task has a destabilizing effect on the gait of elderly people, and this may increase the risk of falls.A summary of studies shows that the gait parameters are modified during execution of a dual task, and that some of these parameters, and are better indicators or predictors of instability and therefore to increased risk of falling.Taking into account that older people cope with daily life in diverse contexts in which they perform an additional task during walking, it would be interesting to guide them to focus their attention on the task of running, or if they are wandering, they do not perform other tasks simultaneously . On the other hand, would be able to train the elderly in dual tasks, to improve their performance, thus increasing their safety, so the elderly can extend the benefits of this training to the various everyday situations.