The role of dual-tasking, mindfulness, and rumination on gait in older adults with chronic pain.

BACKGROUND

Chronic pain is a debilitating condition in older adults that can lead to mobility impairments, disability, and premature death. While older adults with chronic pain demonstrate gait impairments compared to healthy older adults, how gait patterns change following cognitive or psychological tasks remain unclear.

RESEARCH QUESTION: How do gait patterns change from usual walking to dual-task walking, following an acute rumination task, and following an acute mindfulness task in older adults with chronic pain? Secondarily, what is the relationship between pain, number of pain medications, and gait?

METHODS

In this ancillary study, 21 participants walked over a four-meter instrumented walkway at their usual speed, while performing a cognitive task, following an acute mindfulness task, and following an acute rumination task. Participants also reported their pain interference and number of pain medications. Paired t-tests were used to determine differences in spatiotemporal gait measures from usual walking to dual-task, mindfulness, and rumination. Spearman's correlations determined the relationship between pain interference, medications, and gait measures.

RESULTS

Compared to usual walking, older adults walked slower, with shorter steps, and greater variability during dual-task walking. Following acute mindfulness, older adults walked with moderately longer steps, and following acute rumination, there were no changes in gait. Increased pain intensity was associated with greater gait variability and longer step time, and more pain medications were associated with slower gait speed.

SIGNIFICANCE: Nonpharmacological interventions, such as dual-task training or longer, repeated bouts of mindfulness training, should be explored as interventions to improve gait and mobility in older adults with chronic pain.