title: Physical training-related changes in gait variability while single and dual tasking in older adults: magnitude of gait variability at baseline matters.
abstract: OBJECTIVE
  Few studies have examined the effects of physical training programs on gait variability while single and dual tasking, and they reported mixed results. The aim of this study was to compare the stride time variability while single and dual tasking before and after a physical training program developed to improve gait stability in French community-dwelling older adults.
  
  
  METHODS
  A prospective pre-post interventional cohort study.
  
  
  METHODS
  The community-dwelling area of "Pays de la Loire", France.
  
  
  METHODS
  Forty-eight older adults (mean age ± standard deviation 72.2±8 years; 75% female).
  
  
  METHODS
  Physical training program consisted in 12 sessions scheduled to attend physical exercises 1 time a week with total time duration of 3 months. Coefficient of variation (CoV) of stride time under three walking conditions (i.e., walking alone, walking while backward counting, and while performing a verbal fluency task) was determined while steady-state walking using the SMTEC® footswitches system before and after the physical training program. Participants were separated into two groups based on being or not in the highest tertile (i.e., worst performance with cutpoint >4.4%) of the CoV of stride time while walking alone.
  
  
  RESULTS
  After physical training compared to before period, a significant decrease in CoV of stride time (i.e., better gait performance) while walking alone (2.8±2.8% versus 7±7.1%, P=0.001) but not while dual tasking (P=0.600 for counting backward and P=0.105 for verbal fluency task) was shown in participants who had highest (i.e., worst) gait variability at baseline. In addition, physical training modified the strategy of dual tasking in participants with highest gait variability at baseline compared to the other participants. Before training, a significant decrease in CoV of stride time (7±7.1% versus 4.9±4.6%, P=0.017) while counting backward was shown, but there was a significant increase after training (2.8±2.8% versus 5.4±5.8%, P=0.007).
  
  
  CONCLUSIONS
  Physical training reduced gait variability while walking alone in participants with gait instability, and influenced their strategy for dual tasking.
  
  
  CONCLUSIONS
  Physical program training developed in the community to improve gait stability should included participants with high gait variability.
authors.affiliation: Division of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, France - olbeauchet@chu-angers.fr.
authors.forename: O
authors.initials: O
authors.lastname: Beauchet
authors.forename: C
authors.initials: C
authors.lastname: Launay
authors.forename: C
authors.initials: C
authors.lastname: Annweiler
authors.forename: B
authors.initials: B
authors.lastname: Fantino
authors.forename: G
authors.initials: G
authors.lastname: Allali
authors.forename: L
authors.initials: L
authors.lastname: De Decker
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005602:France; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D010806:Physical Education and Training / Q000379:methods*; D011446:Prospective Studies; D016138:Walking / Q000502:physiology*