A scoping review of voluntary gait adaptability tasks requiring cognitive demands in older adults

Phys Act Nutr. 2023 Mar;27(1):30-40. doi: 10.20463/pan.2023.0004. Epub 2023 Mar 31.

Abstract

Purpose: Voluntary gait adaptability is a complex construct that requires cognitive demands and dynamic balance control; it also has implications for the daily lives of older adults. This ability has been extensively studied, however, a comprehensive overview of appropriate tasks for measuring voluntary gait adaptability in older adults is lacking. Our scoping review aimed to identify existing voluntary gait adaptability tasks for older adults, summarize the specific methodological features requiring cognitive demands found in previous studies, and categorize these tasks according to experimental procedure and setup.

Methods: A comprehensive literature search was performed using six databases (PubMed, SPORTDiscus, Web of Science, CINAHL, MEDLINE, and Embase). This included studies that investigated voluntary gait adaptability in older adults (≥ 65 years old) with and without neurological disorders, with a focus on experimental tasks requiring cognitive function (e.g., response to visual or auditive stimuli) while walking.

Results: Sixteen studies were included; most involved visual stimuli, such as obstacles, stairs, or colored cues, and few required auditory stimuli. The studies were categorized according to the experimental procedure, for example, ascent/descent of obstacles (n = 3), inconsistent surfaces (n = 1), lateral gait adjustment (n = 4), obstacle avoidance (n = 6), and stepping tasks (n = 2), as well as experimental setup, including instrumented treadmills (n = 3), stairs (n = 3), and walkways (n = 10).

Conclusion: The results show wide heterogeneity between studies regarding experimental procedures and setup. Our scoping review highlights the need for additional experimental studies and systematic reviews on voluntary gait adaptability in older adults.

Keywords: aging; balance control; cognitive function; falls; mobility; voluntary gait adaptability.