Skip to main content
Log in

Association between dual task-related decrease in walking speed and real versus imagined Timed Up and Go test performance

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background and aims

To examine whether older people with markedly dual task-related decreases in walking speed — a marker of disturbed higher-level gait control and falls — have a larger discrepancy between real and imagined Timed Up and Go (TUG) test times than those with less dual task-related decreases in walking speed.

Methods

Based on a prospective cross-sectional study, 193 older adults (mean age 77.4 ± 5.9 years; 44.0 % women) referred to and consecutively assessed at a Swiss university clinic for a gait analysis to assess either gait disorders, fall risk or memory disorders were included. For all participants, walking speed was measured using a GAITRite® electronic walkway system during usual walking at self-selected pace and while dual tasking (i.e., usual walking and simultaneously counting backwards out loud). In addition, real Timed Up and Go (TUGr) and imagined Timed Up and Go (TUGi) (i.e., the time needed to imagine performing the TUGr) times were measured with a stopwatch. Differences between both walking conditions for walking speed (delta of walking speed) and both TUG conditions (delta of TUG time) were calculated. Age, gender, height, total number drugs taken per day, daily use of psychoactive drugs, use of walking aid, history of falls, Mini-Mental State Examination score, near vision and education level were used as covariables in this analysis.

Results

Participants were categorized into two groups based on being in the lowest tertian (i.e., <33 %: group A corresponding to participants undisturbed by dual task) or not (i.e., ≥33 %: group B corresponding to participants disturbed by dual task) of the delta of walking speed. In both groups, TUGr and TUGi times were similar (P = .169 and P = .839). In both groups, TUGi was faster than TUGr (P < .001). Delta of TUG time was significantly greater in group B compared to group A (P < .001). After adjustment for all covariables, only the delta of walking speed was significantly associated with the delta of TUG time (P = <.001). Stepwise backward regression showed that polypharmacy (P = .017) and delta of walking speed (P = <.001) were associated with an increase in delta of TUG time, whereas an increased MMSE score (P = .030) was associated with a decrease in delta of TUG time.

Conclusion

These findings show that a large discrepancy between real and imagined TUG performances is significantly correlated with a decrease in walking speed while dual tasking, and thus may also be a surrogate marker of disturbed higher-level gait control. The quickly and easily performed TUG tests may represent a feasible, practical screening tool for early detection of higher-level gait disorders in older adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Beauchet O et al (2005) Dual-task-related gait changes in the elderly: does the type of cognitive task matter? J Mot Behav 37(4):259–264

    PubMed  CAS  Google Scholar 

  2. Beauchet O et al (2005) Dual-task-related gait changes in transitionally frail older adults: the type of the walking-associated cognitive task matters. Gerontology 51(1):48–52

    Article  PubMed  Google Scholar 

  3. Sheridan PL et al (2003) Influence of executive function on locomotor function: divided attention increases gait variability in Alzheimer’s disease. J Am Geriatr Soc 51(11):1633–1637

    Article  PubMed  Google Scholar 

  4. Kressig RW et al (2008) Gait variability while dual-tasking: fall predictor in older inpatients? Aging Clin Exp Res 20(2):123–130

    PubMed  Google Scholar 

  5. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39(2):142–148

    PubMed  CAS  Google Scholar 

  6. Shumway-Cook A, Brauer S, Woollacott M (2000) Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther 80(9):896–903

    PubMed  CAS  Google Scholar 

  7. Beauchet O et al (2010) Imagined Timed Up & Go test: a new tool to assess higher-level gait and balance disorders in older adults? J Neurol Sci 294(1–2):102–106

    Article  PubMed  Google Scholar 

  8. Jeannerod M (1994) The representing brain: neural correlates of motor intention and imagery. Behav Brain Sci 17(2):187–245

    Article  Google Scholar 

  9. Bakker M et al (2007) Motor imagery of gait: a quantitative approach. Exp Brain Res 179(3):497–504

    Article  PubMed  CAS  Google Scholar 

  10. Personnier P et al (2010) Temporal features of imagined locomotion in normal aging. Neurosci Lett 476(3):146–149

    Article  PubMed  CAS  Google Scholar 

  11. Malouin F, Richards CL (2010) Mental practice for relearning locomotor skills. Phys Ther 90(2):240–251

    Article  PubMed  Google Scholar 

  12. Hutchinson S et al (2002) Age-related differences in movement representation. Neuroimage 17(4):1720–1728

    Article  PubMed  CAS  Google Scholar 

  13. Mulder T et al (2007) Motor imagery: the relation between age and imagery capacity. Hum Mov Sci 26(2):203–211

    Article  PubMed  Google Scholar 

  14. Mutsaarts M, Steenbergen B, Bekkering H (2007) Impaired motor imagery in right hemiparetic cerebral palsy. Neuropsychologia 45(4):853–859

    Article  PubMed  Google Scholar 

  15. de Vries S, Mulder T (2007) Motor imagery and stroke rehabilitation: a critical discussion. J Rehabil Med 39(1):5–13

    Article  PubMed  Google Scholar 

  16. Yaguez L et al (1999) Motor learning by imagery is differentially affected in Parkinson’s and Huntington’s diseases. Behav Brain Res 102(1–2):115–127

    Article  PubMed  CAS  Google Scholar 

  17. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198

    Article  PubMed  CAS  Google Scholar 

  18. Kressig RW, Beauchet O (2006) Guidelines for clinical applications of spatio-temporal gait analysis in older adults. Aging Clin Exp Res 18(2):174–176

    PubMed  Google Scholar 

  19. de Laat KF et al (2010) Gait in elderly with cerebral small vessel disease. Stroke 41(8):1652–1658

    Article  PubMed  Google Scholar 

  20. Wei G, Luo J (2010) Sport expert’s motor imagery: functional imaging of professional motor skills and simple motor skills. Brain Res 1341:52–62

    Article  PubMed  CAS  Google Scholar 

  21. Dunsky A et al (2008) Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil 89(8):1580–1588

    Article  PubMed  Google Scholar 

  22. Dunsky A et al (2006) Motor imagery practice in gait rehabilitation of chronic post-stroke hemiparesis: four case studies. Int J Rehabil Res 29(4):351–356

    Article  PubMed  Google Scholar 

  23. Gentili R et al (2010) Motor learning without doing: trial-by-trial improvement in motor performance during mental training. J Neurophysiol 104(2):774–783

    Article  PubMed  Google Scholar 

  24. Ueno T et al (2010) Comparison between a real sequential finger and imagery movements: an FMRI study revisited. Brain Imaging Behav 4(1):80–85

    Article  PubMed  Google Scholar 

  25. Fleming MK, Stinear CM, Byblow WD (2010) Bilateral parietal cortex function during motor imagery. Exp Brain Res 201(3):499–508

    Article  PubMed  Google Scholar 

  26. Sauvage C et al (2011) Reevaluating brain networks activated during mental imagery of finger movements using probabilistic Tensorial Independent Component Analysis (TICA). Brain Imaging Behav 5(2):137–148

    Article  PubMed  Google Scholar 

  27. Beauchet O et al (2005) Relationship between dual-task related gait changes and intrinsic risk factors for falls among transitional frail older adults. Aging Clin Exp Res 17(4):270–275

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie A. Bridenbaugh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bridenbaugh, S.A., Beauchet, O., Annweiler, C. et al. Association between dual task-related decrease in walking speed and real versus imagined Timed Up and Go test performance. Aging Clin Exp Res 25, 283–289 (2013). https://doi.org/10.1007/s40520-013-0046-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-013-0046-5

Keywords

Navigation