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- The balance confidence scale, health status and a multitasking evaluation protocol in the elderlyPublication . Coutinho, António; Pinheira, Vítor; Rodrigues, Abel; Cordeiro, Nuno; Leitão, CatarinaFalls are a serious health problem for elderly people. In Portugal, falls are about 70 % of accidents in the elderly. The aging process can be understood as the set of changes structural and functional, namely in motor, sensory and cognitive functions. These changes interfere with functional performance, with the execution of activities of daily living (ADL), quality of life (QOL) and mobility functional. After a fall elderly develops a fear of falling related with low levels of balance confidence. Furthermore, the ability to maintain dynamic balance during postural task involves more attentional demands and high levels of environment control. The ability to perform a Dual Task (DT) is essential for the elderly, as it allows functional independence. However, in the elderly population this capacity may be reduced, since the elderly may have limitations in the hablity of information processing because the implementation of DT requires more attention resources. Another of the capacities affected by the implementation of DT in elderly population is gait.The main objectives are: to evaluate an Experimental Protocol (EP)of Dual Task including Gait, Motor and cognitive challenges; to correlate scores of EP with scores of The Activities-Specific Balance Confidence Scale, SF-12 and MMSE and with the difference between TUG and Cognitive TUG. An experimental protocol was tested in four different occasions to evaluate functional performance related in walking, cognition and coordination in double and Emultiple tasks, along a path (6mx0.4m). Eight different tasks conjugations were tested: a) walking straight, b) counting back, c) coordinating the upper limbs and d) overcoming the obstacle. We also used a Balance Confidence Scale and SF-12. The score of the experimental protocol is done by counting errors. Execution of double task, motor and cognitive, focused on 4 components: coordination, muscle strengthening, dual-task and balance. 4 weeks program, with a total of 12 sessions. Evaluation: T0 (pre-intervention), T1 (post-intervention) and T2 (follow-up 1 month after) T3 . SF-12, MMSE, 6 Meter Experimental Protocol and kinematic evaluation. A sociodemographic characterization was used. Most complex tasks of the experimental protocol (Task 7: walk in straight line, overcome obstacle with upper limb coordination, and Task 8: walk in straight line, overcome obstacle with upper limb coordination and count backward) had significant correlations with Balance Confidence, with health status (MMSE), in mental health domain SF-12, but strongest in physical health domain. This happens in all four moments of evaluation. In our conclusion we can use tasks 7 and 8 of the experimental protocol to evaluate the cognitive, motor and coordination levels using o much more quickly and easy way for the elderly. A much more extensive and intensive study must be done.
- Dual and multitasks in older people: a proposal to measure performance in cognitive and motor tasksPublication . Pinheira, Vítor; Coutinho, António; Rodrigues, Abel; Leitão, CatarinaIn elderly people, double or multitasking (cognitive and motor) are severely impaired, associated with reduced cognitive function and loss of automatic capacity of the motor and musculoskeletal system. The activation of brain areas of cognitive control during the task demonstrates the relationship of cognitive functions with motor function, so that the ability of the dual task has a great impact on the performance of daily activities. However, there is no consensus on measures to evaluate multiple tasks. Methods An experimental protocol was tested four times over 8 months in a sample of 126 eldelly (60-98 years old 78.98 ± 8.34) to evaluate functional performance reported in walking, cognition and coordination in double and multiple tasks , along a path (6mx0.4m). We test eight different tasks conjugations of a) walking straight, b) counting back, c) coordinating the upper limbs and d) overcoming the obstacle. We also used MMSE, TUG and TUG-Cognitive and an IADL scale. The score of the experimental protocol is done by counting errors. Results Time differences between TUG-Cognitive and TUG are used to compare several task conjugations of the protocol. Statistically significant correlation with the differences between TUG-Cognitive time and TUG and MMSE was found to a dual task (walking and counting back) na to a multiple task (walking in a straight line with coordination of the upper limb and counting) Conclusions The ability of older people to perform dual and multi-tasks can be measure with a easy protocol including task as walkink, count backward and upper limb coordination.
- Effects of Nintendo Wii® program in dual-task performance in older adultsPublication . Rodrigues, Abel; Pinheira, Vítor; Coutinho, António; Leitão, Catarina; Monteiro, Ana; Henriques, ElsaA sedentary lifestyle has a strong impact on the older population; so participation in physical activity is important for enhanced physical and mental function, increasing health and well-being. In the elderly, dual-task activities are severely impaired which is why the Nintendo Wii® may be an important tool to maintain the proper functioning of the physical and mental levels among the elderly. This study sought to determine the effect of Nintendo Wii® training on dual-task performance, cognition, balance confidence, the health status and instrumental performances of daily life activities in older adults. A total of 18 participants aged 75.17±8.86 years were included. All participants were women, retired and living in their own residence. The training included a 15-minute exercise session using Wii®Fit twice a week for 8 weeks. The group was measured before and after the intervention (T0 and T1) and in 3 and 6 months follow-up (T2 and T3). Social demographic factors were assessed at T0 and T3. Cognition, general health status, confidence in balance, performance of instrumental activities of daily life, dual and multi-task performances were assessed at all evaluation moments. The mental component of health status and experimental protocol between T0 and T1 showed a statistically significant improvement. In T2 and T3 interval, there was a significant improvement in mental health status. From the baseline to T1, participants showed a statistical significant improvement in the mental component of health status and in experimental dual-task protocol. It can be concluded that the Nintendo Wii®Fit training program significantly improved dual and multi-task performances among older adults.