The Effect Of Daul Task Training To Improve Gait In Elderly With Vascular Mild Cognitive Impairment

Backgroud:The main clinical features of Vascular Mild Cognitive Impairment(VaMCI)include relative memory retention,impairment of attention and frontal executive function.Impairment of attention can affect the patient’s executive function in daily activities,especially the gait in the case of performing multiple tasks at the same time,increasing the risk of falling.Dual task training(DTT)can improve the patient’s time allocation and attention transfer strategy to reduce interference between tasks,improve patient attention,reduce the impact on executive function,and improve gait.In this study,VaMCI elders were combined with simplified Otago sports dual-task training to explore their improvement effects on VaMCI elders’ gait and cognitive function.Objective:The differences in gait parameters,balance function,overall cognitive function and attention were compared between subjects in the intervention group and the control group after the dual-task training intervention and subjects in the intervention group before and after the natural and dual-task walking.Methods:76 the elderly with VaMCI were recruited from three hospitals.Participants were divided into intervention group(IG)and control group(CG),In order to avoid contamination between the two groups,the hospitals were used to group them.The control group(38 cases)and the intervention group(38 cases)were not the same hospital,And corresponding interventions were conducted for 4 months.Subjects in the two groups were given knowledge related to the prevention of vascular mild cognitive impairment.The intervention group was also given dual task training twice a week for at least 60 minutes for 3 months.Using the wearable gait analyzer(IDEEA3.0),Timed Up&Go Test(TUGT),Montreal Cognitive Assessment-Beijing(MocA-BJ),and the Trail Making Test-A(TMT-A)were assessed at baseline,at 3 month and 4month.Results:A total of 71 subjects in this study completed all interventions and data collection(35 cases in the intervention group and 36 cases in the control group).Compare the gait parameters of natural walking,gait parameters of dual task walking,balance function,overall cognitive function,attention and excutive function of each group at various time points before and after intervention:(1)Gait parameters during natural walking:Compared with the control group,the stride time,single step time,standing time,step length,stride length,pace,and stride frequency of the intervention group at each time point were significantly improved(P<0.05).Compared with before intervention,the intervention group had significant improvement in stride time,single step time,standing time,step length,stride length,stride length,and stride frequency at each time point(P<0.05).(2)Gait parameters under dual task walking:Compared with the control group,the intervention group had significant improvements in stride time,single step time,standing time,step length,stride length,pace,and cadence at each time point in the intervention group(P<0.05);compared with before intervention,the stride time,single step time,standing time,step length,stride length,pace,and stride frequency of the intervention group at each time point were significantly improved(P<0.05).(3)Balance function:Compared with the control group,the balance function of the intervention group at each time point was significantly improved(P<0.05);compared to before the intervention,the balance function of the intervention group at each time point was significantly improved(P<0.05).(4)Overall cognitive function:Compared with the control group,the overall cognitive function of the intervention group at each time point was significantly improved(P<0.05);compared with before the intervention,the overall cognitive function of the intervention group at each time point Significantly changed(P<0.05).(5)Attention and Excutive function:Compared with the control group,the intervention group had a significant improvement in attention and excutive function at each time point(P<0.05);compared with before the intervention,the intervention group had a significant improvement in attention and and excutive function at each time point(P<0.05).Conclusion:Dual task training can effectively improve gait and cognitive function in the elderly with VaMCI and reduce the risk of falls in this population.An early intervention worthy of promotion in patients with VaMCI.