Re-evaluating the measurement and influence of conscious movement processing on gait performance in older adults: development of the Gait-Specific Attentional Profile
Young, W; Ellmers, T; Kinrade, N; et al.Cossar, J; Cocks, A
Date: 9 July 2020
Journal
Gait and Posture
Publisher
Elsevier
Publisher DOI
Abstract
Background. Recent decades have seen increased interest in how anxiety–and associated
changes in conscious movement processing (CMP)–can influence the control of balance and
gait, particularly in older adults. However, the most prevalent scale used to measure CMP
during gait (the Movement-Specific Reinvestment Scale (MSRS)) is generic ...
Background. Recent decades have seen increased interest in how anxiety–and associated
changes in conscious movement processing (CMP)–can influence the control of balance and
gait, particularly in older adults. However, the most prevalent scale used to measure CMP
during gait (the Movement-Specific Reinvestment Scale (MSRS)) is generic (i.e., non-gaitspecific) and potentially lacks sensitivity in this context.
Methods. In a preliminary study, we first sought to evaluate if MSRS scores associated with
the number of CMP-related thoughts self-reported by older adults while walking. The next
aim was to develop and validate a new questionnaire (the Gait-Specific Attentional Profile,
G-SAP) capable of measuring gait-specific CMP, in addition to other attentional processes
purported to influence gait. This scale was validated using responses from 117 (exploratory)
and 107 (confirmatory factor analysis) older adults, resulting in an 11-item scale with four
sub-scales: CMP, anxiety, fall-related ruminations, and processing inefficiencies. Finally, in a
separate cohort of 53 older adults, we evaluated associations between scores from both the GSAP CMP subscale and the MSRS, and gait outcomes measured using a GAITRite walkway
in addition to participants’ fall-history.
Results. MSRS scores were not associated with self-reported thoughts categorised as
representing CMP. In regression analyses that controlled for functional balance, unlike the
MSRS, the G-SAP subscale of CMP significantly predicted several gait characteristics
including velocity (p=.033), step length (p=.032), and double-limb support (p=.015).
Significance. The G-SAP provides gait-specific measures of four psychological factors
implicated in mediating the control of balance and gait. In particular, unlike the MSRS, the
G-SAP subscale of CMP appears sensitive to relevant attentional processes known to
influence gait performance. We suggest that the G-SAP offers an opportunity for the research
community to further develop understanding of psychological factors impacting gait
performance across a range of applied clinical contexts.
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