Clinic Study Of Three-dimensional(3D)gait Analysis In Patients With Cognitive Impairment Under Single And Dual Task

Objective: To explore the relationship between gait parameters(spatiotemporal and kinematic)and cognitive function in patients with cognitive impairments under single and dual task condition.Method: Twenty-three patients with mild cognitive impairment(MCI),thirty four patients with subjective cognitive decline(SCD)and 25 normal cognitively(NC)elderly were included in this study.Three-dimensional motion capture system and modeling analysis software were used to collect and analyze gait spatiotemporal(step length,step speed,cadence and gait cycle)and kinematic(angle and range of motion of ankle,knee,hip)parameters.Result:Cadence(steps/min)of the MCI group(101.07±11.48)was significantly lower than the cadence of the SCD group(110.09±10.36)(P=0.002)and NC group(107.29±10.04)(P=0.045),NC group was lower than SCD group,but the result was not significant(P=0.318);stride time(s)of the MCI group(1.21±0.13)was significantly longer than NC group(1.12±0.10)(P=0.007)as well as SCD group(1.13±0.12)(P=0.007);SCD group was longer than NC group(1.12±0.10s),but the result was not significant(P=0.853);There were no significance in step and speed between groups(P>0.05)。The step length(m)and gait speed(m/s)of the NC group significantly decreased under the dual task condition(P<0.01).Meanwhile,the step length,gait speed and cadence of the SCD group significantly decreased under the dual task condition(P<0.05)while the gait speed,cadence and stride time significantly decreased under the dual task condition in MCI group(P<0.01).Correlation analysis showed a positive correlation between gait speed,long-term delayed recall,recognition and Boston naming test(r=0.31,P=0.005;r=0.17,P=0.014;r=0.23,P=0.005)under single condition,a negative correlation between gait cycle and recognition(r=-0.28,P=0.015)under single task condition,a positive correlation between cadence and long-term delayed recall,recognition(r=0.28,P=0.01;r=0.31,P=0.002)under dual task condition while a negative correlation between gait cycle and recognition and a positive correlation between Trial making test,TMT-A&B(r=-0.34,P=0.001;r=0.29,P=0.001;r=0.23,P=0.022).Ankle peak dorsiflexion,knee peak extension and knee range of motion(ROM)was smaller in NC group compared to SCD(P=0.008;P=0.045;P=0.016)and MCI group(P=0.025;P=0.005;P=0.011);SCD group was smaller than MCI group,but the result was not significant(P=1.000;P=0.199;P=0.068)knee heel-strike angle was larger in NC group compared to MCI group(P=0.007),and larger in SCD group than MCI group(P=0.010),NC group was larger than SCD group,the result was not significant(P=0.679);hip peak extension was larger(P=0.012)while hip ROM was smaller(P=0.002)in NC group than SCD group;While hip peak extension was larger in NC group than MCI group,but the result was not significant(P=0.188).hip ROM was significantly larger in SCD group than MCI group(P=0.011),NC group was smaller than SCD group,the result was not significant(P=0.698);Hip toe-off angle was larger in NC group than SCD group(P=0.025).Ankle peak plantarflexion angle,ROM,heel-strike and toe-off angle,knee peak flexion and toe-off angle,hip heelstrike ankle were not significantly different between groups(P>0.05).Conclusion: Gait spatiotemporal parameters under dual task condition changed significantly in patients with MCI comparing to NC,which could be indicative as an early sign of cognitive decline in older people.Furthermore,gait kinematic parameters vary in patients with different level of cognitive function.