Shedding light on walking in the dark: The effects of reduced lighting on the gait of older adults with a higher-level gait disorder and controls

被引:13
作者
Kesler A. [2 ]
Leibovich G. [1 ]
Herman T. [1 ,3 ]
Gruendlinger L. [1 ]
Giladi N. [1 ,3 ,4 ]
Hausdorff J.M. [1 ,3 ,5 ]
机构
[1] Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv
[2] Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel-Aviv
[3] Department of Physical Therapy, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv
[4] Department of Neurology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv
[5] Division on Aging, Harvard Medical School, Boston, MA
关键词
gait; variability; vision; fall risk; aging; lighting; Higher-Level Gait Disorders;
D O I
10.1186/1743-0003-2-27
中图分类号
学科分类号
摘要
Objective: To study the effects of reduced lighting on the gait of older adults with a high level gait disorder (HLGD) and to compare their response to that of healthy elderly controls. Methods: 22 patients with a HLGD and 20 age-matched healthy controls were studied under usual lighting conditions (1000 lumens) and in near darkness (5 lumens). Gait speed and gait dynamics were measured under both conditions. Cognitive function, co-morbidities, depressive symptoms, and vision were also evaluated. Results: Under usual lighting conditions, patients walked more slowly, with reduced swing times, and increased stride-to-stride variability, compared to controls. When walking under near darkness conditions, both groups slowed their gait. All other measures of gait were not affected by lighting in the controls. In contrast, patients further reduced their swing times and increased their stride-to-stride variability, both stride time variability and swing time variability. The unique response of the patients was not explained by vision, mental status, co-morbidities, or the values of walking under usual lighting conditions. Conclusion: Walking with reduced lighting does not affect the gait of healthy elderly subjects, except for a reduction in speed. On the other hand, the gait of older adults with a HLGD becomes more variable and unsteady when they walk in near darkness, despite adapting a slow and cautious gait. Further work is needed to identify the causes of the maladaptive response among patients with a HLGD and the potential connection between this behavior and the increased fall risk observed in these patients. © 2005 Kesler et al; licensee BioMed Central Ltd.
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共 41 条
[1]  
Whitman G.T., DiPatre P.L., Lopez I.A., Liu F., Noori N.E., Vinters H.V., Baloh R.W., Neuropathology in older people with disequilibrium of unknown cause, Neurology, 53, pp. 375-382, (1999)
[2]  
Sudarsky L., Geriatrics: Gait disorders in the elderly, N Engl J Med, 322, pp. 1441-1446, (1990)
[3]  
Sudarsky L., Gait disorders: Prevalence, morbidity, and etiology, Adv Neurol, 87, pp. 111-117, (2001)
[4]  
Bloem B.R., Gussekloo J., Lagaay A.M., Remarque E.J., Haan J., Westendorp R.G., Idiopathic senile gait disorders are signs of subclinical disease, J Am Geriatr Soc, 48, pp. 1098-1101, (2000)
[5]  
Nutt J.G., Marsden C.D., Thompson P.D., Human walking and higher-level gait disorders, particularly in the elderly, Neurology, 43, pp. 268-279, (1993)
[6]  
Nutt J.G., Classification of gait and balance disorders, Adv Neurol, 87, pp. 135-141, (2001)
[7]  
Giladi N., Herman T., Reider-Groswasser I.I., Gurevich T., Hausdorff J.M., Clinical characteristics of elderly patients with a cautious gait of unknown origin, J Neurol, 252, pp. 300-306, (2005)
[8]  
Herman T., Giladi N., Gurevich T., Hausdorff J.M., Gait instability and fractal dynamics of older adults with a "cautious" gait: Why do certain older adults walk fearfully?, Gait Posture, 21, pp. 178-185, (2005)
[9]  
Huber V., Giladi N., Herman T., Peretz C., Gruendlinger L., Hausdorff J.M., A prospective study of older adults with a high level gait disorder: Evidence for a neurodegenerative process, Gait Posture, (2005)
[10]  
Heasley K., Buckley J.G., Scally A., Twigg P., Elliott D.B., Stepping up to a new level: Effects of blurring vision in the elderly, Invest Ophthalmol Vis Sci, 45, pp. 2122-2128, (2004)