Just like crossing a treacherous path with hidden rocks and fallen branches requires careful footwork, older adults with mild cognitive impairment (MCI) must navigate obstacles in their daily lives. In this study, researchers examined the kinematic strategies used by adults with MCI when crossing obstacles. By analyzing the movements of their pelvis, legs, and toes, the researchers found that patients with MCI adapted unique strategies to successfully cross obstacles. During leading-limb crossing, individuals with MCI increased pelvic anterior tilt and hip abduction while decreasing knee adduction. Meanwhile, during trailing-limb crossing, they exhibited reduced pelvic posterior tilt and ankle dorsiflexion. The study suggests that these altered strategies may compensate for cognitive challenges and maintain toe-obstacle clearance. By monitoring changes in obstacle-crossing kinematics and clearance patterns, healthcare professionals could potentially detect early signs of compromised obstacle-crossing ability in individuals with MCI. This research opens a pathway for further exploration into the kinematic adaptations of individuals with MCI and the impact of multiple cognitive domains on their functional abilities.

IntroductionMild cognitive impairment (MCI) is considered a transitional stage between soundness of mind and dementia, often involving problems with memory, which may lead to abnormal postural control and altered end-point control when dealing with neuromechanical challenges during obstacle-crossing. The study aimed to identify the end-point control and angular kinematics of the pelvis-leg apparatus while crossing obstacles for both leading and trailing limbs.Methods12 patients with MCI (age: 66.7 ± 4.2 y/o; height: 161.3 ± 7.3 cm; mass: 62.0 ± 13.6 kg) and 12 healthy adults (age: 67.7 ± 2.9 y/o; height: 159.3 ± 6.1 cm; mass: 61.2 ± 12.0 kg) each walked and crossed obstacles of three different heights (10, 20, and 30% of leg length). Angular motions of the pelvis and lower limbs and toe-obstacle clearances during leading- and trailing-limb crossings were calculated. Two-way analyses of variance were used to study between-subject (group) and within-subject (obstacle height) effects on the variables. Whenever a height effect was found, a polynomial test was used to determine the trend. A significance level of α = 0.05 was set for all tests.ResultsPatients with MCI significantly increased pelvic anterior tilt, hip abduction, and knee adduction in the swing limb during leading-limb crossing when compared to controls (p < 0.05). During trailing-limb crossing, the MCI group showed significantly decreased pelvic posterior tilt, as well as ankle dorsiflexion in the trailing swing limb (p < 0.05).ConclusionPatients with MCI adopt altered kinematic strategies for successful obstacle-crossing. The patients were able to maintain normal leading and trailing toe-obstacle clearances for all tested obstacle heights with a specific kinematic strategy, namely increased pelvic anterior tilt, swing hip abduction, and knee adduction during leading-limb crossing, and decreased pelvic posterior tilt and swing ankle dorsiflexion during trailing-limb crossing. The current results suggest that regular monitoring of obstacle-crossing kinematics for reduced toe-obstacle clearance or any signs of changes in crossing strategy may be helpful for early detection of compromised obstacle-crossing ability in patients with single-domain amnestic MCI. Further studies using a motor/cognitive dual-task approach on the kinematic strategies adopted by multiple-domain MCI will be needed for a complete picture of the functional adaptations in such a patient group.

Read Full Article (External Site)