601
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Walshe EA, Patterson MR, Commins S, Roche RAP. Dual-task and electrophysiological markers of executive cognitive processing in older adult gait and fall-risk. Front Hum Neurosci 2015; 9:200. [PMID: 25941481 PMCID: PMC4400911 DOI: 10.3389/fnhum.2015.00200] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/26/2015] [Indexed: 11/13/2022] Open
Abstract
The role of cognition is becoming increasingly central to our understanding of the complexity of walking gait. In particular, higher-level executive functions are suggested to play a key role in gait and fall-risk, but the specific underlying neurocognitive processes remain unclear. Here, we report two experiments which investigated the cognitive and neural processes underlying older adult gait and falls. Experiment 1 employed a dual-task (DT) paradigm in young and older adults, to assess the relative effects of higher-level executive function tasks (n-Back, Serial Subtraction and visuo-spatial Clock task) in comparison to non-executive distracter tasks (motor response task and alphabet recitation) on gait. All DTs elicited changes in gait for both young and older adults, relative to baseline walking. Significantly greater DT costs were observed for the executive tasks in the older adult group. Experiment 2 compared normal walking gait, seated cognitive performances and concurrent event-related brain potentials (ERPs) in healthy young and older adults, to older adult fallers. No significant differences in cognitive performances were found between fallers and non-fallers. However, an initial late-positivity, considered a potential early P3a, was evident on the Stroop task for older non-fallers, which was notably absent in older fallers. We argue that executive control functions play a prominent role in walking and gait, but the use of neurocognitive processes as a predictor of fall-risk needs further investigation.
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Affiliation(s)
- Elizabeth A Walshe
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
| | - Matthew R Patterson
- Insight Center for Data Analytics, University College Dublin Dublin, Ireland
| | - Seán Commins
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
| | - Richard A P Roche
- Department of Psychology, Maynooth University Maynooth, Kildare, Ireland
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602
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Wang XQ, Pi YL, Chen BL, Wang R, Li X, Chen PJ. Cognitive motor intervention for gait and balance in Parkinson's disease: systematic review and meta-analysis. Clin Rehabil 2015; 30:134-44. [PMID: 25872519 DOI: 10.1177/0269215515578295] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 02/14/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to assess the effect of cognitive motor intervention (CMI) on gait and balance in Parkinson's disease. DATA SOURCES PubMed, Embase, Cochrane Library, CINAHL, Web of Science, PEDro, and China Biology Medicine disc. METHODS We included randomized controlled trials (RCTs) and non RCTs. Two reviewers independently evaluated articles for eligibility and quality and serially abstracted data. A standardized mean difference ± standard error and 95% confidence interval (CI) was calculated for each study using Hedge's g to quantify the treatment effect. RESULTS Nine trials with 181 subjects, four randomized controlled trials, and five single group intervention studies were included. The pooling revealed that cognitive motor intervention can improve gait speed (Hedge's g = 0.643 ± 0.191; 95% CI: 0.269 to 1.017, P = 0.001), stride time (Hedge's g = -0.536 ± 0.167; 95% CI: -0.862 to -0.209, P = 0.001), Berg Balance Scale (Hedge's g = 0.783 ± 0.289; 95% CI: 0.218 to 1.349, P = 0.007), Unipedal Stance Test (Hedge's g = 0.440 ± 0.189; 95% CI: 0.07 to 0.81, P =0.02). CONCLUSIONS The systematic review demonstrates that cognitive motor intervention is effective for gait and balance in Parkinson's disease. However, the paper is limited by the quality of the included trials.
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Affiliation(s)
- Xue-Qiang Wang
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Yan-Ling Pi
- Department of Rehabilitation Medicine, Shanghai Punan Hospital, Shanghai, China
| | - Bing-Lin Chen
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Ru Wang
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Xin Li
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Pei-Jie Chen
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai, China
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603
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Yang L, Liao L, Lam F, He C, Pang M. Psychometric properties of dual-task balance assessments for older adults: A systematic review. Maturitas 2015; 80:359-69. [DOI: 10.1016/j.maturitas.2015.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/22/2014] [Accepted: 01/01/2015] [Indexed: 11/24/2022]
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604
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Rizzo JR, Raghavan P, McCrery JR, Oh-Park M, Verghese J. Effects of emotionally charged auditory stimulation on gait performance in the elderly: a preliminary study. Arch Phys Med Rehabil 2015; 96:690-6. [PMID: 25542677 PMCID: PMC4526239 DOI: 10.1016/j.apmr.2014.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/01/2014] [Accepted: 12/03/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the effect of a novel divided attention task-walking under auditory constraints-on gait performance in older adults and to determine whether this effect was moderated by cognitive status. DESIGN Validation cohort. SETTING General community. PARTICIPANTS Ambulatory older adults without dementia (N=104). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES In this pilot study, we evaluated walking under auditory constraints in 104 older adults who completed 3 pairs of walking trials on a gait mat under 1 of 3 randomly assigned conditions: 1 pair without auditory stimulation and 2 pairs with emotionally charged auditory stimulation with happy or sad sounds. RESULTS The mean age of subjects was 80.6±4.9 years, and 63% (n=66) were women. The mean velocity during normal walking was 97.9±20.6cm/s, and the mean cadence was 105.1±9.9 steps/min. The effect of walking under auditory constraints on gait characteristics was analyzed using a 2-factorial analysis of variance with a 1-between factor (cognitively intact and minimal cognitive impairment groups) and a 1-within factor (type of auditory stimuli). In both happy and sad auditory stimulation trials, cognitively intact older adults (n=96) showed an average increase of 2.68cm/s in gait velocity (F1.86,191.71=3.99; P=.02) and an average increase of 2.41 steps/min in cadence (F1.75,180.42=10.12; P<.001) as compared with trials without auditory stimulation. In contrast, older adults with minimal cognitive impairment (Blessed test score, 5-10; n=8) showed an average reduction of 5.45cm/s in gait velocity (F1.87,190.83=5.62; P=.005) and an average reduction of 3.88 steps/min in cadence (F1.79,183.10=8.21; P=.001) under both auditory stimulation conditions. Neither baseline fall history nor performance of activities of daily living accounted for these differences. CONCLUSIONS Our results provide preliminary evidence of the differentiating effect of emotionally charged auditory stimuli on gait performance in older individuals with minimal cognitive impairment compared with those without minimal cognitive impairment. A divided attention task using emotionally charged auditory stimuli might be able to elicit compensatory improvement in gait performance in cognitively intact older individuals, but lead to decompensation in those with minimal cognitive impairment. Further investigation is needed to compare gait performance under this task to gait on other dual-task paradigms and to separately examine the effect of physiological aging versus cognitive impairment on gait during walking under auditory constraints.
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Affiliation(s)
- John-Ross Rizzo
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - J R McCrery
- Department of Physical Medicine and Rehabilitation, Rusk Rehabilitation, New York University Langone Medical Center, New York, NY
| | - Mooyeon Oh-Park
- Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers, Kessler Foundation, West Orange, NJ
| | - Joe Verghese
- Division of Cognitive and Motor Aging, Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY.
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605
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Age-associated differences in global and segmental control during dual-task walking under sub-optimal sensory conditions. Hum Mov Sci 2015; 40:211-9. [DOI: 10.1016/j.humov.2014.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Revised: 12/05/2014] [Accepted: 12/10/2014] [Indexed: 11/23/2022]
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606
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Schott N. [Trail walking test for assessment of motor cognitive interference in older adults. Development and evaluation of the psychometric properties of the procedure]. Z Gerontol Geriatr 2015; 48:722-33. [PMID: 25801510 DOI: 10.1007/s00391-015-0866-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/07/2014] [Accepted: 01/19/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Activities of daily living (ADL), such as walking, often involve the added complexity of walking while doing other activities (i.e. dual task walking). A complex walking task may require a greater motor and mental capacity, resulting in decrements in gait performance not seen for simple walking tasks. AIM The purpose of this study was to determine if the trail walking test (TWT), the mobile adaptation of the trail making test (TMT), could be a reliable and valid early detection tool to discriminate between non-fallers and fallers. MATERIAL AND METHODS This study examined dual task costs of a cognitive and a sensorimotor task (walking) in 94 older adults aged 50-81 years (average age M = 67.4 years, SD ± 7.34). Based on the idea of the paper and pencil TMT, participants walked along a fixed pathway (TWT-1), stepped on targets with increasing sequential numbers (i.e. 1, 2, 3, TWT-2), and increasing sequential numbers and letters (i.e. 1, A, 2, B, 3, C, TWT-3). The dual task costs were calculated for each task. Additionally, the following tests were conducted: TMT, block tapping test (BTT), timed up and go (TUG) test, 30s chair rising test, 10 m walking time test with and without head turns, German physical activity questionnaire (German PAQ-50 +) and the activities-specific balance confidence (ABC-D) scale. RESULTS The TWT performance times as well as errors increased with increasing age. Reliability coefficients were high (interclass correlation ICC > 0.90). Correlations between the different TWT conditions and potential falls-related predictors were moderate to high (r = -0.430 to 0.699). Of the participants 34 % reported falling in the past year. The stepwise logistic regression analysis revealed that the dual task costs for the numbers and letters (odds ratio OR 1.162, 95 % confidence interval CI 1.058-1.277, p = 0.002), the ABC-D (OR 0.767, 95 % CI 0.651-0.904, p = 0.002) and exercise (OR 1.027, 95 % CI 1.008-1.046, p = 0.006) were significantly related to falls and 91.6 % of cases were correctly classified. CONCLUSION The results indicate that high-level cognitive processes interfere with automatic processes such as walking. The TWT which converts a relevant fall risk-associated standard neuropsychological test (TMT) with increasing cognitive load into a mobility task, was shown to be a feasible, reliable and valid tool for older adults to discriminate between non-fallers and fallers.
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Affiliation(s)
- Nadja Schott
- Institut für Sport und Bewegungswissenschaft, Universität Stuttgart, Allmandring 28, 70569, Stuttgart, Deutschland.
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607
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Cognitive-motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences. BIOMED RESEARCH INTERNATIONAL 2015; 2015:720856. [PMID: 25839039 PMCID: PMC4369906 DOI: 10.1155/2015/720856] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/29/2015] [Accepted: 02/03/2015] [Indexed: 11/23/2022]
Abstract
Individuals with multiple sclerosis (MS) regularly exhibit deficits in motor and cognitive function. Recent evidence suggests that these impairments are compounded when motor and cognitive task are performed simultaneously such as walking while talking. The changes incurred during simultaneous performance of motor and cognitive tasks are a result of cognitive-motor interference (CMI) and operationalized as dual task costs (DTC). Recently in MS, research has been conducted to understand and analyze the impact of CMI. The purpose of this paper was to review the current literature related to the evidence, correlates, and consequences of CMI in MS. Relevant literature was collected from the results of a PubMed search for terms including “Cognitive-motor interference” or “Cognitive-motor interaction” or “Dual task” and “multiple sclerosis.” Overall, 20 papers were included for review which focused on CMI during balance and walking tasks. The finding that there is a lack of evidence pertaining to changes in the cognitive domain as well as to the specific consequences of CMI in MS was noted. Future work should aim to fill these gaps and ultimately investigate the usefulness of targeted interventions in reducing the deleterious effects of CMI in individuals with MS.
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608
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Wang X, Pi Y, Chen P, Liu Y, Wang R, Chan C. Cognitive motor interference for preventing falls in older adults: a systematic review and meta-analysis of randomised controlled trials. Age Ageing 2015; 44:205-12. [PMID: 25377745 DOI: 10.1093/ageing/afu175] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We conducted a systematic review to determine the effect of cognitive motor interference (CMI) for the prevention of falls in older adults. METHODS We searched studies through Medline, Embase, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc. Only randomised controlled trials examining the effects of CMI for older people were included. The primary outcome measure was falls; the secondary outcome measures included gait, balance function and reaction time. RESULTS A total of 30 studies of 1,206 participants met the inclusion criteria, and 27 studies of 1,165 participants were used as data sources for the meta-analyses. The pooling revealed that CMI was superior to control group for fall rate [standard mean difference (SMD) (95% CI)=-3.03 (-4.33, -1.73), P<0.0001], gait speed [SMD (95% CI)=0.36 (0.07, 0.66), P=0.01], step length [SMD (95% CI)=0.48 (0.16, 0.80), P=0.003], cadence [SMD (95% CI)=0.19 (0.01, 0.36), P=0.03], timed up and go test [SMD (95% CI)=-0.22 (-0.38, -0.06), P=0.007], centre of pressure displacement [SMD (95% CI)=-0.32 (-1.06, 0.43), P=0.04] and reaction time [SMD (95% CI)=-0.47 (-0.86, -0.08), P=0.02]. CONCLUSION The systematic review demonstrates that CMI is effective for preventing falls in older adults in the short term. However, there is, as yet, little evidence to support claims regarding long-term benefits. Hence, future studies should investigate the long-term effectiveness of CMI in terms of fall prevention in older adults.
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Affiliation(s)
- Xueqiang Wang
- Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Yanling Pi
- Department of Rehabilitation Medicine, Shanghai Punan Hospital, Shanghai, China
| | - Peijie Chen
- Sport Medicine and Rehabilitation Center, Shanghai University of Sport, Shanghai, China
| | - Yu Liu
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Ru Wang
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Chetwyn Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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609
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Halil M, Cemal Kizilarslanoglu M, Emin Kuyumcu M, Yesil Y, Cruz Jentoft AJ. Cognitive aspects of frailty: mechanisms behind the link between frailty and cognitive impairment. J Nutr Health Aging 2015; 19:276-83. [PMID: 25732212 DOI: 10.1007/s12603-014-0535-z] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Whereas physical impairment is the main hallmark of frailty, evidence suggests that other dimensions, such as psychological, cognitive and social factors also contribute to this multidimensional condition. Cognition is now considered a relevant domain of frailty. Cognitive and physical frailty interact: cognitive problems and dementia are more prevalent in physically frail individuals, and those with cognitive impairment are more prone to become frail. Disentangling the relationship between cognition and frailty may lead to new intervention strategies for the prevention and treatment of both conditions. Both frailty and cognitive decline share common potential mechanisms. This review examines the relationship between frailty and cognitive decline and explores the role of vascular changes, hormones, vitamin D, inflammation, insulin resistance, and nutrition in the development of physical frailty and cognitive problems, as potential underlying mechanisms behind this link. Dual tasking studies may be a useful way to explore and understand the relation between cognitive and physical frailty. Further studies are needed to elucidate this complex relation to improve the outcomes of frailty.
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Affiliation(s)
- M Halil
- Muhammet Cemal Kizilarslanoglu, MD, Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, 06100 Ankara, Turkey, Tel: +903123053071, Fax: +903123097620, e-mail:
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610
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Wrightson JG, Twomey R, Ross EZ, Smeeton NJ. The effect of transcranial direct current stimulation on task processing and prioritisation during dual-task gait. Exp Brain Res 2015; 233:1575-83. [DOI: 10.1007/s00221-015-4232-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/14/2015] [Indexed: 10/23/2022]
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611
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Vallabhajosula S, Tan CW, Mukherjee M, Davidson AJ, Stergiou N. Biomechanical analyses of stair-climbing while dual-tasking. J Biomech 2015; 48:921-9. [PMID: 25773590 DOI: 10.1016/j.jbiomech.2015.02.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 02/05/2015] [Accepted: 02/15/2015] [Indexed: 11/19/2022]
Abstract
Stair-climbing while doing a concurrent task like talking or holding an object is a common activity of daily living which poses high risk for falls. While biomechanical analyses of overground walking during dual-tasking have been studied extensively, little is known on the biomechanics of stair-climbing while dual-tasking. We sought to determine the impact of performing a concurrent cognitive or motor task during stair-climbing. We hypothesized that a concurrent cognitive task will have a greater impact on stair climbing performance compared to a concurrent motor task and that this impact will be greater on a higher-level step. Ten healthy young adults performed 10 trials of stair-climbing each under four conditions: stair ascending only, stair ascending and performing subtraction of serial sevens from a three-digit number, stair ascending and carrying an empty opaque box and stair ascending, performing subtraction of serial sevens from a random three-digit number and carrying an empty opaque box. Kinematics (lower extremity joint angles and minimum toe clearance) and kinetics (ground reaction forces and joint moments and powers) data were collected. We found that a concurrent cognitive task impacted kinetics but not kinematics of stair-climbing. The effect of dual-tasking during stair ascent also seemed to vary based on the different phases of stair ascent stance and seem to have greater impact as one climbs higher. Overall, the results of the current study suggest that the association between the executive functioning and motor task (like gait) becomes stronger as the level of complexity of the motor task increases.
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Affiliation(s)
- Srikant Vallabhajosula
- Department of Physical Therapy Education, School of Health Sciences, Elon University, Elon, NC, United States.
| | - Chi Wei Tan
- Biomechanics Research Building, School of Health, Physical Education and Recreation, College of Education, University of Nebraska at Omaha, Omaha, NE, United States
| | - Mukul Mukherjee
- Biomechanics Research Building, School of Health, Physical Education and Recreation, College of Education, University of Nebraska at Omaha, Omaha, NE, United States
| | - Austin J Davidson
- Biomechanics Research Building, School of Health, Physical Education and Recreation, College of Education, University of Nebraska at Omaha, Omaha, NE, United States
| | - Nicholas Stergiou
- Biomechanics Research Building, School of Health, Physical Education and Recreation, College of Education, University of Nebraska at Omaha, Omaha, NE, United States; College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
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612
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Pereira HM, Spears VC, Schlinder-Delap B, Yoon T, Nielson KA, Hunter SK. Age and sex differences in steadiness of elbow flexor muscles with imposed cognitive demand. Eur J Appl Physiol 2015; 115:1367-79. [PMID: 25633070 DOI: 10.1007/s00421-015-3113-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/14/2015] [Indexed: 01/25/2023]
Abstract
PURPOSE These studies determined (1) age- and sex-related differences in steadiness of isometric contractions when high cognitive demand was imposed across a range of forces with the elbow flexor muscles (study 1) and; (2) sex differences in steadiness among older adults when low cognitive demand was imposed (study 2). METHODS 36 young adults (18-25 years; 18 women) and 30 older adults (60-82 years; 17 women) performed isometric contractions at 5, 30 and 40 % of maximum voluntary contraction (MVC). Study 1 involved a high-cognitive demand session (serial subtractions by 13 during the contraction) and a control session (no mental math). Study 2 (older adults only) involved a low-cognitive demand session (subtracting by 1s). RESULTS Older individuals exhibited greater increases in force fluctuations (coefficient of variation of force, CV) with high cognitive demand than young adults, with the largest age difference at 5 % MVC (P = 0.01). Older adults had greater agonist EMG activity with high-cognitive demand and women had greater coactivation than men (P < 0.05). In study 2, CV of force increased with low cognitive demand for the older women but not for the older men (P = 0.03). CONCLUSION Older adults had reduced steadiness and increased muscle activation when high cognitive demand was imposed while low cognitive demand induced increased force fluctuations in older women but not older men. These findings have implications for daily and work-related tasks that involve cognitive demand performed simultaneously during submaximal isometric contractions in an aging workforce.
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Affiliation(s)
- Hugo M Pereira
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Milwaukee, WI, 53201, USA
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613
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Knaepen K, Marusic U, Crea S, Rodríguez Guerrero CD, Vitiello N, Pattyn N, Mairesse O, Lefeber D, Meeusen R. Psychophysiological response to cognitive workload during symmetrical, asymmetrical and dual-task walking. Hum Mov Sci 2015; 40:248-63. [PMID: 25617994 DOI: 10.1016/j.humov.2015.01.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/31/2014] [Accepted: 01/02/2015] [Indexed: 12/11/2022]
Abstract
Walking with a lower limb prosthesis comes at a high cognitive workload for amputees, possibly affecting their mobility, safety and independency. A biocooperative prosthesis which is able to reduce the cognitive workload of walking could offer a solution. Therefore, we wanted to investigate whether different levels of cognitive workload can be assessed during symmetrical, asymmetrical and dual-task walking and to identify which parameters are the most sensitive. Twenty-four healthy subjects participated in this study. Cognitive workload was assessed through psychophysiological responses, physical and cognitive performance and subjective ratings. The results showed that breathing frequency and heart rate significantly increased, and heart rate variability significantly decreased with increasing cognitive workload during walking (p<.05). Performance measures (e.g., cadence) only changed under high cognitive workload. As a result, psychophysiological measures are the most sensitive to identify changes in cognitive workload during walking. These parameters reflect the cognitive effort necessary to maintain performance during complex walking and can easily be assessed regardless of the task. This makes them excellent candidates to feed to the control loop of a biocooperative prosthesis in order to detect the cognitive workload. This information can then be used to adapt the robotic assistance to the patient's cognitive abilities.
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Affiliation(s)
- Kristel Knaepen
- Department of Human Physiology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Advanced Rehabilitation Technology and Science Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre of Koper, University of Primorska, Titovtrg 4, 6000 Koper, Slovenia.
| | - Simona Crea
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56026 Pisa, Italy.
| | - Carlos D Rodríguez Guerrero
- Advanced Rehabilitation Technology and Science Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Robotics and Multibody Mechanics Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Nicola Vitiello
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale Rinaldo Piaggio 34, 56026 Pisa, Italy; Don Carlo Gnocchi Foundation, Via Di Scandicci 269, 50143 Firenze, Italy.
| | - Nathalie Pattyn
- Department of Human Physiology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Vital Signs and Performance Monitoring Research Group, Belgian Royal Military Academy, Hobbemastraat 8, 1000 Brussels, Belgium; Department of Biological Psychology, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Olivier Mairesse
- Vital Signs and Performance Monitoring Research Group, Belgian Royal Military Academy, Hobbemastraat 8, 1000 Brussels, Belgium; Department of Biological Psychology, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Dirk Lefeber
- Advanced Rehabilitation Technology and Science Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Robotics and Multibody Mechanics Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Romain Meeusen
- Department of Human Physiology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; Advanced Rehabilitation Technology and Science Research Group, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
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614
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Borges SDM, Radanovic M, Forlenza OV. Functional mobility in a divided attention task in older adults with cognitive impairment. J Mot Behav 2015; 47:378-85. [PMID: 25610990 DOI: 10.1080/00222895.2014.998331] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Motor disorders may occur in mild cognitive impairment (MCI) and at early stages of Alzheimer's disease (AD), particularly under divided attention conditions. We examined functional mobility in 104 older adults (42 with MCI, 26 with mild AD, and 36 cognitively healthy) using the Timed Up and Go test (TUG) under 4 experimental conditions: TUG single task, TUG plus a cognitive task, TUG plus a manual task, and TUG plus a cognitive and a manual task. Statistically significant differences in mean time of execution were found in all four experimental conditions when comparing MCI and controls (p < .001), and when comparing MCI and AD patients (p < .05). Receiver-operating characteristic curve analyses showed that all four testing conditions could differentiate the three groups (area under the curve > .8, p < .001 for MCI vs. controls; area under the curve > .7, p < .001 for MCI vs. AD). The authors conclude that functional motor deficits occurring in MCI can be assessed by the TUG test, in single or dual task modality.
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Affiliation(s)
- Sheila de Melo Borges
- a Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo , Brazil
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615
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Wang XQ, Pi YL, Chen BL, Chen PJ, Liu Y, Wang R, Li X, Waddington G. Cognitive motor interference for gait and balance in stroke: a systematic review and meta-analysis. Eur J Neurol 2015; 22:555-e37. [PMID: 25560629 PMCID: PMC4342759 DOI: 10.1111/ene.12616] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/07/2014] [Indexed: 11/30/2022]
Abstract
Background and purpose An increasing interest in the potential benefits of cognitive motor interference (CMI) for stroke has recently been observed, but the efficacy of CMI for gait and balance is controversial. A systematic review and meta-analysis of randomized controlled trials was performed to estimate the effect of CMI on gait and balance in patients with stroke. Methods Articles in Medline, EMBASE, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc were searched from 1970 to July 2014. Only randomized controlled trials examining the effects of CMI for patients with stroke were included, and no language restrictions were applied. Main outcome measures included gait and balance function. Results A total of 15 studies composed of 395 participants met the inclusion criteria, and 13 studies of 363 participants were used as data sources for the meta-analysis. Pooling revealed that CMI was superior to the control group for gait speed [mean difference (MD) 0.19 m/s, 95% confidence interval (CI) (0.06, 0.31), P = 0.003], stride length [MD 12.53 cm, 95% CI (4.07, 20.99), P = 0.004], cadence [MD 10.44 steps/min, 95% CI (4.17, 16.71), P = 0.001], centre of pressure sway area [MD −1.05, 95% CI (−1.85, −0.26), P = 0.01] and Berg balance scale [MD 2.87, 95% CI (0.54, 5.21), P = 0.02] in the short term. Conclusion Cognitive motor interference is effective for improving gait and balance function for stroke in the short term. However, only little evidence supports assumptions regarding CMI's long-term benefits.
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Affiliation(s)
- X-Q Wang
- Sport Medicine and Rehabilitation Centre, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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616
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Cho KH, Kim MK, Lee HJ, Lee WH. Virtual Reality Training with Cognitive Load Improves Walking Function in Chronic Stroke Patients. TOHOKU J EXP MED 2015; 236:273-80. [PMID: 26228205 DOI: 10.1620/tjem.236.273] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Ki Hun Cho
- Department of Rehabilitative and Assistive Technology, Korea National Rehabilitation Research Institute
| | - Min Kyu Kim
- Department of Physical Therapy, Sahmyook University, College of Health Science
- Department of Physical Therapy, Myongji Choonhey Rehabilitation Hospital
| | - Hwang-Jae Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention & Rehabilitation, Heart Vascular and Stroke, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Wan Hee Lee
- Department of Physical Therapy, Sahmyook University, College of Health Science
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617
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Nascimbeni A, Minchillo M, Salatino A, Morabito U, Ricci R. Gait attentional load at different walking speeds. Gait Posture 2015; 41:304-6. [PMID: 25270327 DOI: 10.1016/j.gaitpost.2014.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 09/02/2014] [Accepted: 09/13/2014] [Indexed: 02/02/2023]
Abstract
Gait is an attention-demanding task even in healthy young adults. However, scant evidence exists about the attentional load required at various walking speeds. The aim of this study was to investigate motor-cognitive interference while walking at spontaneous, slow and very slow speed on a treadmill while carrying out a backward counting task, in a group (n = 22) of healthy young participants. Cognitive performance was also assessed while sitting. Higher DT cost on the cognitive task was found at spontaneous and very slow walking speed, while at slow walking speed the cognitive task was prioritized with higher DT cost on the motor task. The attentional allocation during DT depends on walking speed with gait prioritization at spontaneous and very slow speed that likely represent more challenging motor conditions.
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Affiliation(s)
- Alberto Nascimbeni
- Rehabilitation Unit, S. Croce Hospital Moncalieri, Via Vittime di Bologna 20, 10024 Moncalieri, Turin, Italy.
| | - Marco Minchillo
- Rehabilitation Unit, S. Croce Hospital Moncalieri, Via Vittime di Bologna 20, 10024 Moncalieri, Turin, Italy.
| | - Adriana Salatino
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy.
| | - Ursula Morabito
- Rehabilitation Unit, S. Croce Hospital Moncalieri, Via Vittime di Bologna 20, 10024 Moncalieri, Turin, Italy.
| | - Raffaella Ricci
- Department of Psychology, University of Turin, Via Po 14, 10123 Turin, Italy.
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618
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Alhasani R, Nayak A, Szturm T, Nankar M, Boreskie S, Brousseau G. The Feasibility of a Novel Dual-Task Exercise Program Which Integrates Balance, Gaze, Mobility and Cognition in Community Dwelling Older Adults: Protocol for a Randomized Clinical Pilot Trial. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/aar.2015.43012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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619
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Szturm T, Sakhalkar V, Boreskie S, Marotta JJ, Wu C, Kanitkar A. Integrated testing of standing balance and cognition: test-retest reliability and construct validity. Gait Posture 2015; 41:146-52. [PMID: 25455701 DOI: 10.1016/j.gaitpost.2014.09.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 02/02/2023]
Abstract
Balance and cognitive impairments which are common with aging often coexist, are prognostic of future adverse health events, including fall injuries. Consequently, dual-task assessment programs that simultaneously address both stability and cognition are important to consider in rehabilitation and benefit healthy aging. The objective of this study was to establish test-retest reliability and construct validity of a dual-task computer game-based platform (TGP) that integrates head tracking and cognitive tasks with balance activities. Thirty healthy, community-dwelling individuals median age 64 (range 60-67) were recruited from a certified Medical Fitness Facility. Participants performed a series of computerized head tracking and cognitive game tasks while standing on fixed and sponge surfaces. Testing was conducted on two occasions, one week apart. Moderate to high test retest reliability (ICC values of 0.55-0.75) was observed for all outcome measures representing balance, gaze performance, cognition, and dual-task performance. A significant increase in center of foot pressure (COP) excursion was observed during both head tracking and cognitive dual-task conditions. The results demonstrate the system's ability to reliably detect changes related to specific and integrated aspects of balance, gaze, and cognitive performance.
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Affiliation(s)
- Tony Szturm
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | - Vedant Sakhalkar
- School of Medical Rehabilitation, University of Manitoba, Canada.
| | | | | | - Christine Wu
- Department of Mechanical Engineering, University of Manitoba, Canada; Department of Manufacturing Engineering, University of Manitoba, Canada.
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620
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The effect of different types of walking on dual-task performance and task prioritization among community-dwelling older adults. ScientificWorldJournal 2014; 2014:259547. [PMID: 25506610 PMCID: PMC4258915 DOI: 10.1155/2014/259547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 11/05/2014] [Accepted: 11/10/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The ability to safely conduct different types of walking concurrently with a cognitive task (i.e., dual task) is crucial for daily life. The contribution of different walking types to dual-task performance has not yet been determined, nor is there agreement on the strategies that older adults use to divide their attention between two tasks (task prioritization). OBJECTIVES To compare the effect of walking in three different directions (forward, backward, and sideways) on dual-task performance and to explore the strategies of older adults to allocate their attention in response to different motor task demands. DESIGN A cross-sectional study. SUBJECTS Thirty-two (22 female) community-dwelling older adults (aged 72.7±5.7 years). METHODS Subjects randomly conducted single and dual task: walking to three directions separately, cognitive tasks separately, and combination of the two. RESULTS Walking forward was the least demanding task, during single (FW < BW, SW) (P < .001) and dual tasks (FW < BW < SW) (P < .001). The calculation of DTC revealed the same pattern (P < .001). DTC of the cognitive tasks was not significantly different among the three walking types. CONCLUSIONS The decline mainly in the motor performance during dual task indicates that participants prioritized the cognitive task. These findings challenge the "posture first" paradigm for task prioritization.
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621
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Leow LA, Parrott T, Grahn JA. Individual differences in beat perception affect gait responses to low- and high-groove music. Front Hum Neurosci 2014; 8:811. [PMID: 25374521 PMCID: PMC4205839 DOI: 10.3389/fnhum.2014.00811] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 09/23/2014] [Indexed: 11/13/2022] Open
Abstract
Slowed gait in patients with Parkinson's disease (PD) can be improved when patients synchronize footsteps to isochronous metronome cues, but limited retention of such improvements suggest that permanent cueing regimes are needed for long-term improvements. If so, music might make permanent cueing regimes more pleasant, improving adherence; however, music cueing requires patients to synchronize movements to the "beat," which might be difficult for patients with PD who tend to show weak beat perception. One solution may be to use high-groove music, which has high beat salience that may facilitate synchronization, and affective properties, which may improve motivation to move. As a first step to understanding how beat perception affects gait in complex neurological disorders, we examined how beat perception ability affected gait in neurotypical adults. Synchronization performance and gait parameters were assessed as healthy young adults with strong or weak beat perception synchronized to low-groove music, high-groove music, and metronome cues. High-groove music was predicted to elicit better synchronization than low-groove music, due to its higher beat salience. Two musical tempi, or rates, were used: (1) preferred tempo: beat rate matched to preferred step rate and (2) faster tempo: beat rate adjusted to 22.5% faster than preferred step rate. For both strong and weak beat-perceivers, synchronization performance was best with metronome cues, followed by high-groove music, and worst with low-groove music. In addition, high-groove music elicited longer and faster steps than low-groove music, both at preferred tempo and at faster tempo. Low-groove music was particularly detrimental to gait in weak beat-perceivers, who showed slower and shorter steps compared to uncued walking. The findings show that individual differences in beat perception affect gait when synchronizing footsteps to music, and have implications for using music in gait rehabilitation.
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Affiliation(s)
- Li-Ann Leow
- The Brain and Mind Institute, University of Western Ontario , London, ON , Canada
| | - Taylor Parrott
- The Brain and Mind Institute, University of Western Ontario , London, ON , Canada
| | - Jessica A Grahn
- The Brain and Mind Institute, University of Western Ontario , London, ON , Canada
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622
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Bergamin M, Gobbo S, Zanotto T, Sieverdes JC, Alberton CL, Zaccaria M, Ermolao A. Influence of age on postural sway during different dual-task conditions. Front Aging Neurosci 2014; 6:271. [PMID: 25374539 PMCID: PMC4205805 DOI: 10.3389/fnagi.2014.00271] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 09/19/2014] [Indexed: 11/13/2022] Open
Abstract
Dual-task performance assessments of competing parallel tasks and postural outcomes are growing in importance for geriatricians, as it is associated with predicting fall risk in older adults. This study aims to evaluate the postural stability during different dual-task conditions including visual (SMBT), verbal (CBAT) and cognitive (MAT) tasks in comparison with the standard Romberg's open eyes position (OE). Furthermore, these conditions were investigated in a sample of young adults and a group of older healthy subjects to examine a potential interaction between type of secondary task and age status. To compare these groups across the four conditions, a within-between mixed model ANOVA was applied. Thus, a stabilometric platform has been used to measure center of pressure velocity (CoPV), sway area (SA), antero-posterior (AP) and medio-lateral (ML) oscillations as extents of postural sway. Tests of within-subjects effects indicated that different four conditions influenced the static balance for CoPV (p < 0.001), SA (p < 0.001). Post-hoc analyses indicated that CBAT task induced the worst balance condition on CoPV and resulted in significantly worse scores than OE (-11.4%; p < 0.05), SMBT (-17.8%; p < 0.01) and MAT (-17.8%; p < 0.01) conditions; the largest SA was found in OE, and it was statistically larger than SMBT (-27.0%; p < 0.01) and MAT (-23.1%; p < 0.01). The between-subjects analysis indicated a general lower balance control in the group of elderly subjects (CoPV p < 0.001, SA p < 0.002), while, the mixed model ANOVA did not detect any interaction effect between types of secondary task and groups in any parameters (CoPV p = 0.154, SA p = 0.125). Postural sway during dual-task assessments was also found to decrease with advancing age, however, no interactions between aging and types of secondary tasks were found. Overall, these results indicated that the secondary task which most influenced the length of sway path, as measured by postural stability was a simple verbal assignment.
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Affiliation(s)
- Marco Bergamin
- Sport and Exercise Medicine Division, Department of Medicine, University of PadovaPadova, Italy
| | - Stefano Gobbo
- Sport and Exercise Medicine Division, Department of Medicine, University of PadovaPadova, Italy
| | - Tobia Zanotto
- Sport and Exercise Medicine Division, Department of Medicine, University of PadovaPadova, Italy
| | - John C. Sieverdes
- College of Nursing, Medical University of South CarolinaCharleston, SC, USA
| | | | - Marco Zaccaria
- Sport and Exercise Medicine Division, Department of Medicine, University of PadovaPadova, Italy
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of PadovaPadova, Italy
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623
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Schaefer S. The ecological approach to cognitive-motor dual-tasking: findings on the effects of expertise and age. Front Psychol 2014; 5:1167. [PMID: 25352820 PMCID: PMC4196472 DOI: 10.3389/fpsyg.2014.01167] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/25/2014] [Indexed: 11/13/2022] Open
Abstract
The underlying assumption of studies on cognitive-motor dual-tasking is that resources are limited, and when they have to be shared between a cognitive and a motor task, performances will suffer. Resource competition should therefore be particularly pronounced in children, older adults, or people who are just acquiring a new motor skill. The current review summarizes expertise and age comparative studies that have combined a cognitive and a motor task. Expertise studies have often assessed sports performances (e.g., golf putting, soccer dribbling, rugby drills) and have shown that experts are more successful than novices to keep up their performances in dual-task situations. The review also presents age-comparative studies that have used walking (on narrow tracks or on a treadmill) as the motor task. Older adults often show higher costs than young adults, and they tend to prioritize the motor domain. These findings are discussed in relation to the ecological approach to dual-task research originally introduced by Li et al. (2005). The approach proposes to study ecologically valid dual-task situations, and always to investigate dual-task costs for both domains (cognitive and motor performance) in order to assess potential tradeoffs. In addition, task difficulties should be individually adjusted, and differential-emphasis instructions should be included in the study design.
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Affiliation(s)
- Sabine Schaefer
- Center for Lifespan Psychology, Max Planck Institute for Human Development Berlin, Germany
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624
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Guedes RC, Dias RC, Pereira LSM, Silva SLA, Lustosa LP, Dias JMD. Influence of dual task and frailty on gait parameters of older community-dwelling individuals. Braz J Phys Ther 2014; 18:445-52. [PMID: 25372007 PMCID: PMC4228630 DOI: 10.1590/bjpt-rbf.2014.0034] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 05/05/2014] [Indexed: 11/21/2022] Open
Abstract
Background: Gait parameters such as gait speed (GS) are important indicators of functional
capacity. Frailty Syndrome is closely related to GS and is also capable of
predicting adverse outcomes. The cognitive demand of gait control is usually
explored with dual-task (DT) methodology. Objective: To investigate the effect of DT and frailty on the spatio-temporal parameters of
gait in older people and identify which variables relate to GS. Method: The presence of frailty was verified by Fried's Frailty Criteria. Cognitive
function was evaluated with the Mini-Mental State Exam (MMSE) and gait parameters
were analyzed through the GAITRite(r) system in the single-task and DT
conditions. The Kolmogorov-Smirnov, ANOVA, and Pearson's Correlation tests were
administered. Results: The participants were assigned to the groups frail (FG), pre-frail (PFG), and
non-frail (NFG). During the DT, the three groups showed a decrease in GS, cadence,
and stride length and an increase in stride time (p<0.001). The reduction in
the GS of the FG during the DT showed a positive correlation with the MMSE scores
(r=730; p=0.001) and with grip strength (r=681; p=0.001). Conclusions: Gait parameters are more affected by the DT, especially in the frail older
subjects. The reduction in GS in the FG is associated with lower grip strength and
lower scores in the MMSE. The GS was able to discriminate the older adults in the
three levels of frailty, being an important measure of the functional capacity in
this population.
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Affiliation(s)
- Rita C Guedes
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rosângela C Dias
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Sílvia L A Silva
- Departamento de Fisioterapia, Universidade Federal de Alfenas, Alfenas, MG, Brazil
| | - Lygia P Lustosa
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - João M D Dias
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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625
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Caçola PM, Pant MD. Using a generalized linear mixed model approach to explore the role of age, motor proficiency, and cognitive styles in children's reach estimation accuracy. Percept Mot Skills 2014; 119:530-49. [PMID: 25202996 DOI: 10.2466/27.10.pms.119c21z0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose was to use a multi-level statistical technique to analyze how children's age, motor proficiency, and cognitive styles interact to affect accuracy on reach estimation tasks via Motor Imagery and Visual Imagery. Results from the Generalized Linear Mixed Model analysis (GLMM) indicated that only the 7-year-old age group had significant random intercepts for both tasks. Motor proficiency predicted accuracy in reach tasks, and cognitive styles (object scale) predicted accuracy in the motor imagery task. GLMM analysis is suitable to explore age and other parameters of development. In this case, it allowed an assessment of motor proficiency interacting with age to shape how children represent, plan, and act on the environment.
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626
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Hollands KL, Agnihotri D, Tyson SF. Effects of dual task on turning ability in stroke survivors and older adults. Gait Posture 2014; 40:564-9. [PMID: 25086799 DOI: 10.1016/j.gaitpost.2014.06.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 03/14/2014] [Accepted: 06/30/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Turning is an integral component of independent mobility in which stroke survivors frequently fall. OBJECTIVE This study sought to measure the effects of competing cognitive demands on the stepping patterns of stroke survivors, compared to healthy age-match adults, during turning as a putative mechanism for falls. METHODS Walking and turning (90°) was assessed under single (walking and turning alone) and dual task (subtracting serial 3s while walking and turning) conditions using an electronic, pressure-sensitive walkway. Dependent measures were time to turn, variability in time to turn, step length, step width and single support time during three steps of the turn. Turning ability in single and dual task conditions was compared between stroke survivors (n=17, mean ± SD: 59 ± 113 months post-stroke, 64 ± 10 years of age) and age-matched healthy counterparts (n=15). RESULTS Both groups took longer, were more variable, tended to widen the second step and, crucially, increased single support time on the inside leg of the turn while turning and distracted. CONCLUSIONS Increased single support time during turning may represent biomechanical mechanism, within stepping patterns of turning under distraction, for increased risk of falls for both stroke survivors and older adults.
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Affiliation(s)
- K L Hollands
- School of Health Sciences, University of Salford, Manchester, UK.
| | - D Agnihotri
- School of Health Sciences, University of Salford, Manchester, UK
| | - S F Tyson
- Stroke & Vascular Research Centre, School of Nursing, Midwifery & Social Work, University of Manchester, UK
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627
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Leone C, Patti F, Feys P. Measuring the cost of cognitive-motor dual tasking during walking in multiple sclerosis. Mult Scler 2014; 21:123-31. [DOI: 10.1177/1352458514547408] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purposeful, safe locomotion requires higher-level cortical processes, to meet the real-life demands of walking while performing concurrent cognitive tasks (e.g. recalling a shopping list or attending to a conversation). The assessment of walking and a secondary cognitive task under these ‘dual tasking’ conditions may represent a more valid outcome measure in multiple sclerosis (MS), by examining the occurrence and magnitude of the cognitive-motor interference of walking. This topical review provides a state-of-the-art overview of research into dual-tasking during walking in persons with MS, based on 14 recent papers. Studies consistently demonstrate a slowing of ambulation under dual tasking, regardless of the cognitive task demand, the stage of the disease and the disability level. The reciprocal effect of walking on the cognitive tasks was rarely assessed. We present our main findings, highlight the different factors contributing to dual-task deficits, identify methodological shortcomings and offer recommendations for constructing dual-tasking paradigms useful in clinical practice and research.
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Affiliation(s)
- Carmela Leone
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - Francesco Patti
- Section of Neurosciences University of Catania, Catania, Italy
| | - Peter Feys
- REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Hasselt University, Hasselt, Belgium
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628
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Abbruzzese LD, Rao AK, Bellows R, Figueroa K, Levy J, Lim E, Puccio L. Effects of manual task complexity on gait parameters in school-aged children and adults. Gait Posture 2014; 40:658-63. [PMID: 25168911 DOI: 10.1016/j.gaitpost.2014.07.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 06/26/2014] [Accepted: 07/21/2014] [Indexed: 02/02/2023]
Abstract
This study examined the dual-task interference effects of complexity (simple vs. complex), type of task (carrying a pitcher vs. tray), and age (young adults vs. 7-10 year old children) on temporal-spatial and variability measures of gait. All participants first walked on the GAITRite walkway without any concurrent task, followed by four dual-task gait conditions. The group of children had a more variable step length and step time than adults across all walking conditions. They also slowed down, took fewer, smaller steps and spent more time in double limb support than adults in the complex dual task conditions. Gait in healthy young adults and school aged children was relatively unaffected by concurrent performance of simple versions of the manual tasks. Our overall analysis suggests that dual-task gait in school aged children is still developing and has not yet reached adult capacity. This study also highlights the critical role of task demand and complexity in dual-task interference.
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Affiliation(s)
- Laurel D Abbruzzese
- Program in Physical Therapy, Department of Rehabilitation and Regenerative Medicine Columbia University College of Physicians and Surgeons, New York, USA.
| | - Ashwini K Rao
- Program in Physical Therapy, Department of Rehabilitation and Regenerative Medicine Columbia University College of Physicians and Surgeons, New York, USA; G.H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, USA
| | | | | | | | - Esther Lim
- Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Lauren Puccio
- St. Mary's Hospital for Children, Bayside, New York, USA
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629
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Menant JC, Schoene D, Sarofim M, Lord SR. Single and dual task tests of gait speed are equivalent in the prediction of falls in older people: a systematic review and meta-analysis. Ageing Res Rev 2014; 16:83-104. [PMID: 24915643 DOI: 10.1016/j.arr.2014.06.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/26/2014] [Accepted: 06/02/2014] [Indexed: 11/19/2022]
Abstract
Although simple assessments of gait speed have been shown to predict falls as well as hospitalisation, functional decline and mortality in older people, dual task gait speed paradigms have been increasingly evaluated with respect to fall prediction. Some studies have found that dual task walking paradigms can predict falls in older people. A systematic review and meta-analysis was conducted to determine whether dual task walking paradigms involving a secondary cognitive task have greater ability to predict falls than single walking tasks. The meta-analytic findings indicate single and dual task tests of gait speed are equivalent in the prediction of falls in older people and sub-group analyses revealed similar findings for studies that included only cognitively impaired participants, slow walkers or used secondary mental-tracking or verbal fluency tasks.
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Affiliation(s)
- Jasmine C Menant
- Falls and Balance Research Group, Neuroscience Research Australia, P.O. Box 1165, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney 2052, Australia
| | - Daniel Schoene
- Falls and Balance Research Group, Neuroscience Research Australia, P.O. Box 1165, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney 2052, Australia
| | - Mina Sarofim
- School of Medicine, University of New South Wales (UNSW), Sydney 2052, Australia
| | - Stephen R Lord
- Falls and Balance Research Group, Neuroscience Research Australia, P.O. Box 1165, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney 2052, Australia.
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630
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Radovanović S, Jovičić M, Marić NP, Kostić V. Gait characteristics in patients with major depression performing cognitive and motor tasks while walking. Psychiatry Res 2014; 217:39-46. [PMID: 24613201 DOI: 10.1016/j.psychres.2014.02.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 01/26/2014] [Accepted: 02/01/2014] [Indexed: 11/30/2022]
Abstract
Depressed patients demonstrate alterations in motor and cognitive functioning that can affect their adjustments to the variations in everyday life environment. The objective was to explore gait parameters and variability of patients with major depressive disorder in dual task walking situations. Eight patients and 20 healthy controls performed motor, mental and combined motor+mental tasks while walking. Calculated parameters were cycle time, stride length, swing time, double support time and their coefficients of variation (CV). Patients demonstrated greater gait variability (swing time CV) than controls during baseline walk (t(26)=2.64, p<0.05) and motor dual task (t(26)=3.68, p<0.05). Moreover, the transition from mental to combined task decreased stride length (M=126.48±15.35 and M=121.19±13.55, p<0.001) and increased double support time (M=0.266±0.072 and M=0.287±0.076, p<0.01) only in controls. Also, gait variability increased in controls during the combined task, while remaining the same or decreasing in patients. Tasks that required greater cognitive involvement affected gait variability in patients more than controls, but only up to a certain level, after which patients׳ stability appeared unaffected by the increase of cognitive demand. This could be explained by a tendency of patients to neglect complex cognitive tasks while walking in order to preserve stability and prevent possible falls.
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Affiliation(s)
- Saša Radovanović
- Institute for Medical Research, University of Belgrade, Dr Subotića 4, 11129 Belgrade, Serbia.
| | | | - Nadja P Marić
- Clinic for Psychiatry, School of Medicine, University of Belgrade, Serbia
| | - Vladimir Kostić
- Clinic for Neurology, School of Medicine, University of Belgrade, Serbia
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Radovanović S, Milićev M, Perić S, Basta I, Kostić V, Stević Z. Gait in amyotrophic lateral sclerosis: Is gait pattern differently affected in spinal and bulbar onset of the disease during dual task walking? Amyotroph Lateral Scler Frontotemporal Degener 2014; 15:488-93. [PMID: 24918304 DOI: 10.3109/21678421.2014.918148] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by weakness, fatigue, loss of balance and coordination. The purpose of the study was to examine gait in ALS patients. Gait was compared in ALS with spinal and bulbar onset, while performing dual mental and motor tasks. Dual-task walking was performed by 27 ALS patients, 13 with spinal- and 14 with bulbar-onset disease. Twenty-nine healthy subjects were used as a control group. The subjects performed a basic, simple walking task, dual-motor task, dual-mental task, and combined motor and mental tasks. Results showed that dual-task paradigm has an effect on gait in ALS patients. Gait was differently affected in spinal and bulbar onset of ALS by some of the given tasks. Mental tasks had a larger effect than motor tasks in all gait parameters. In conclusion, both ALS forms have impaired gait in dual tasks. Simple walk in patients with spinal onset shows higher variability of certain gait parameters compared to bulbar-onset patients and controls. Differences in gait could also indicate postural instability and possible falls in complex walking situations.
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632
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MacAulay RK, Brouillette RM, Foil HC, Bruce-Keller AJ, Keller JN. A longitudinal study on dual-tasking effects on gait: cognitive change predicts gait variance in the elderly. PLoS One 2014; 9:e99436. [PMID: 24905590 PMCID: PMC4048284 DOI: 10.1371/journal.pone.0099436] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/14/2014] [Indexed: 11/19/2022] Open
Abstract
Neuropsychological abilities have found to explain a large proportion of variance in objective measures of walking gait that predict both dementia and falling within the elderly. However, to this date there has been little research on the interplay between changes in these neuropsychological processes and walking gait overtime. To our knowledge, the present study is the first to investigate intra-individual changes in neurocognitive test performance and gait step time at two-time points across a one-year span. Neuropsychological test scores from 440 elderly individuals deemed cognitively normal at Year One were analyzed via repeated measures t-tests to assess for decline in cognitive performance at Year Two. 34 of these 440 individuals neuropsychological test performance significantly declined at Year Two; whereas the "non-decliners" displayed improved memory, working memory, attention/processing speed test performance. Neuropsychological test scores were also submitted to factor analysis at both time points for data reduction purposes and to assess the factor stability overtime. Results at Year One yielded a three-factor solution: Language/Memory, Executive Attention/Processing Speed, and Working Memory. Year Two's test scores also generated a three-factor solution (Working Memory, Language/Executive Attention/Processing Speed, and Memory). Notably, language measures loaded on Executive Attention/Processing Speed rather than on the Memory factor at Year Two. Hierarchal multiple regression revealed that both Executive Attention/Processing Speed and sex significantly predicted variance in dual task step time at both time points. Remarkably, in the "decliners", the magnitude of the contribution of the neuropsychological characteristics to gait variance significantly increased at Year Two. In summary, this study provides longitudinal evidence of the dynamic relationship between intra-individual cognitive change and its influence on dual task gait step time. These results also indicate that the failure to show improved test performance (particularly, on memory tests) with repeated administrations might prove to be useful of indicator of early cognitive decline.
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Affiliation(s)
- Rebecca K. MacAulay
- Louisiana State University, Department of Psychology. Baton Rouge, Louisiana, United States of America
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Robert M. Brouillette
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Heather C. Foil
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | | | - Jeffrey N. Keller
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
- * E-mail:
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633
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Beurskens R, Helmich I, Rein R, Bock O. Age-related changes in prefrontal activity during walking in dual-task situations: A fNIRS study. Int J Psychophysiol 2014; 92:122-8. [DOI: 10.1016/j.ijpsycho.2014.03.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/10/2014] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
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634
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Corp DT, Lum JA, Tooley GA, Pearce AJ. Corticospinal activity during dual tasking: A systematic review and meta-analysis of TMS literature from 1995 to 2013. Neurosci Biobehav Rev 2014; 43:74-87. [DOI: 10.1016/j.neubiorev.2014.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/08/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
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635
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Pothier K, Benguigui N, Kulpa R, Chavoix C. Multiple Object Tracking While Walking: Similarities and Differences Between Young, Young-Old, and Old-Old Adults. J Gerontol B Psychol Sci Soc Sci 2014; 70:840-9. [PMID: 24859224 DOI: 10.1093/geronb/gbu047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 03/23/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Walking while simultaneously engaged in another activity becomes more difficult as one grows older. Here, we address the issue of changes in dual-task behavior at different stages of life, particularly in the latter stages. METHODS We developed a dual task that combined walking along an 8-m walkway with a multiple object tracking (MOT) task of increasing difficulty. This secondary cognitive task imitates visuospatial daily activities and provides reliable quantitative measurements. Our dual-task paradigm was tested on 27 young adults (23.85 ± 2.09 years old) and two groups of older adults (18 young-old and 18 old-old adults, aged 63.89 ± 3.32 and 80.83 ± 3.84 years, respectively). RESULTS Significant decrease in tracking performance with increasing complexity of the MOT task was found in all three groups. An age-related decrease in MOT and gait performance was also found. However, young-old adults performed as well as young adults under low attentional load conditions (in the MOT task and simple walking), whereas their performance was as impaired as those of old-old adults under high attentional load conditions (in the MOT task and walking under dual-task condition). DISCUSSION These different profiles between the two groups of older participants could be explained in terms of compensation strategies and risk of falling.
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Affiliation(s)
- Kristell Pothier
- Institut national de la santé et de la recherche médicale, U1075 COMETE, Caen, France. Normandie University, School of Medicine, Caen, France. University of Caen Basse-Normandie, COMETE Laboratory (Mobilités: Orientation, Attention et Chronobiologie), Caen, France. Department of Rheumatology, CHU (Centre Hospitalier Universitaire) de Caen, France.
| | - Nicolas Benguigui
- Normandie University, School of Medicine, Caen, France. University of Caen Basse-Normandie, CESAMS (EA 4260, Centre d'étude sport et actions motrices), Caen, France
| | - Richard Kulpa
- M2S Laboratory Mouvement, Sport, Santé, Rennes 2 University, France
| | - Chantal Chavoix
- Institut national de la santé et de la recherche médicale, U1075 COMETE, Caen, France. Normandie University, School of Medicine, Caen, France. University of Caen Basse-Normandie, COMETE Laboratory (Mobilités: Orientation, Attention et Chronobiologie), Caen, France
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636
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Amboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord 2014; 28:1520-33. [PMID: 24132840 DOI: 10.1002/mds.25674] [Citation(s) in RCA: 328] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/15/2013] [Accepted: 08/19/2013] [Indexed: 12/18/2022] Open
Abstract
Dementia and gait impairments often coexist in older adults and patients with neurodegenerative disease. Both conditions represent independent risk factors for falls. The relationship between cognitive function and gait has recently received increasing attention. Gait is no longer considered merely automated motor activity but rather an activity that requires executive function and attention as well as judgment of external and internal cues. In this review, we intend to: (1) summarize and synthesize the experimental, neuropsychological, and neuroimaging evidence that supports the role played by cognition in the control of gait; and (2) briefly discuss the implications deriving from the interplay between cognition and gait. In recent years, the dual task paradigm has been widely used as an experimental method to explore the interplay between gait and cognition. Several neuropsychological investigations have also demonstrated that walking relies on the use of several cognitive domains, including executive-attentional function, visuospatial abilities, and even memory resources. A number of morphological and functional neuroimaging studies have offered additional evidence supporting the relationship between gait and cognitive resources. Based on the findings from 3 lines of studies, it appears that a growing body of evidence indicates a pivotal role of cognition in gait control and fall prevention. The interplay between higher-order neural function and gait has a number of clinical implications, ranging from integrated assessment tools to possible innovative lines of interventions, including cognitive therapy for falls prevention on one hand and walking program for reducing dementia risk on the other.
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Affiliation(s)
- Marianna Amboni
- Isituto di Diagnosi e Cura Hermitage-Capodimonte, Naples, Italy; Neurodegenerative Diseases Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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637
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Mirelman A, Maidan I, Bernad-Elazari H, Nieuwhof F, Reelick M, Giladi N, Hausdorff JM. Increased frontal brain activation during walking while dual tasking: an fNIRS study in healthy young adults. J Neuroeng Rehabil 2014; 11:85. [PMID: 24886198 PMCID: PMC4055254 DOI: 10.1186/1743-0003-11-85] [Citation(s) in RCA: 166] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/25/2014] [Indexed: 11/10/2022] Open
Abstract
Background Accumulating evidence suggests that gait is influenced by higher order cognitive and cortical control mechanisms. Recently, several studies used functional near infrared spectroscopy (fNIRS) to examine brain activity during walking, demonstrating increased oxygenated hemoglobin (HbO2) levels in the frontal cortex during walking while subjects completed a verbal cognitive task. It is, however, still unclear whether this increase in activation was related to verbalization, if the response was specific to gait, or if it would also be observed during standing, a different motor control task. The aim of this study was to investigate whether an increase in frontal activation is specific to dual tasking during walking. Methods Twenty-three healthy young adults (mean 30.9 ± 3.7 yrs, 13 females) were assessed using an electronic walkway. Frontal brain activation was assessed using an fNIRS system consisting of two probes placed on the forehead of the subjects. Assessments included: walking in a self-selected speed; walking while counting forward; walking while serially subtracting 7s (Walking+S7); and standing while serially subtracting 7s (Standing+S7). Data was collected from 5 walks of 30 meters in each condition. Twenty seconds of quiet standing before each walk served as baseline frontal lobe activity. Repeated Measures Analysis of Variance (RM ANOVA) tested for differences between the conditions. Results Significant differences were observed in HbO2 levels between all conditions (p = 0.007). HbO2 levels appeared to be graded; walking alone demonstrated the lowest levels of HbO2 followed by walking+counting condition (p = 0.03) followed by Walking+S7 condition significantly increased compared to the two other walking conditions (p < 0.01). No significant differences in HbO2 levels were observed between usual walking and the standing condition (p = 0.38) or between standing with or without serial subtraction (p = 0.76). Conclusions This study provides direct evidence that dual tasking during walking is associated with frontal brain activation in healthy young adults. The observed changes are apparently not a response to the verbalization of words and are related to the cognitive load during gait.
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Affiliation(s)
- Anat Mirelman
- Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel.
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638
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Kline JE, Poggensee K, Ferris DP. Your brain on speed: cognitive performance of a spatial working memory task is not affected by walking speed. Front Hum Neurosci 2014; 8:288. [PMID: 24847239 PMCID: PMC4021146 DOI: 10.3389/fnhum.2014.00288] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 04/18/2014] [Indexed: 11/13/2022] Open
Abstract
When humans walk in everyday life, they typically perform a range of cognitive tasks while they are on the move. Past studies examining performance changes in dual cognitive-motor tasks during walking have produced a variety of results. These discrepancies may be related to the type of cognitive task chosen, differences in the walking speeds studied, or lack of controlling for walking speed. The goal of this study was to determine how young, healthy subjects performed a spatial working memory task over a range of walking speeds. We used high-density electroencephalography to determine if electrocortical activity mirrored changes in cognitive performance across speeds. Subjects stood (0.0 m/s) and walked (0.4, 0.8, 1.2, and 1.6 m/s) with and without performing a Brooks spatial working memory task. We hypothesized that performance of the spatial working memory task and the associated electrocortical activity would decrease significantly with walking speed. Across speeds, the spatial working memory task caused subjects to step more widely compared with walking without the task. This is typically a sign that humans are adapting their gait dynamics to increase gait stability. Several cortical areas exhibited power fluctuations time-locked to memory encoding during the cognitive task. In the somatosensory association cortex, alpha power increased prior to stimulus presentation and decreased during memory encoding. There were small significant reductions in theta power in the right superior parietal lobule and the posterior cingulate cortex around memory encoding. However, the subjects did not show a significant change in cognitive task performance or electrocortical activity with walking speed. These findings indicate that in young, healthy subjects walking speed does not affect performance of a spatial working memory task. These subjects can devote adequate cortical resources to spatial cognition when needed, regardless of walking speed.
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Affiliation(s)
- Julia E Kline
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, USA
| | | | - Daniel P Ferris
- Department of Biomedical Engineering, University of Michigan Ann Arbor, MI, USA ; School of Kinesiology, University of Michigan Ann Arbor, MI, USA
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639
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Doi T, Shimada H, Makizako H, Tsutsumimoto K, Uemura K, Anan Y, Suzuki T. Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. BMC Neurol 2014; 14:67. [PMID: 24694100 PMCID: PMC3994221 DOI: 10.1186/1471-2377-14-67] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/26/2014] [Indexed: 11/10/2022] Open
Abstract
Background Gait ability and cognitive function are interrelated during both normal walking (NW) and dual-task walking (DTW), and gait ability is thus adversely affected by cognitive impairment in both situations. However, this association is insufficiently understood in people with mild cognitive impairment (MCI). Here, we conducted a study with MCI participants, to examine whether the association depends on walking conditions and MCI subtypes. Methods We classified 389 elderly adults into amnestic MCI (n = 191) and non-amnestic MCI (n = 198), assessed their cognitive functions, and administered gait experiments under NW and DTW conditions. Gait ability was defined as gait speed. Five aspects of cognitive function were assessed: processing speed, executive function, working memory, verbal memory, and visual memory. Results Regression analysis adjusted for covariates showed a significant association between cognitive functions and gait speed. Processing speed and executive function correlated with gait speed during both NW and DTW (p < .05). Gait speed during DTW was also significantly associated with working memory (p < .001). Visual memory was associated during NW and DTW, particularly for amnestic MCI participants (p < .05). Conclusions Our findings support the idea that the association between gait speed and cognitive function depends on walking condition and MCI subtypes. Additional studies are necessary to determine the neural basis for the disruption in gait control in older adults with MCI.
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Affiliation(s)
- Takehiko Doi
- Section for Health Promotion, Department for Research and Development to Support Independent Life of Elderly, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka, Obu, Aichi 474-8511, Japan.
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640
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Strouwen C, Molenaar EALM, Keus SHJ, Münks L, Munneke M, Vandenberghe W, Bloem BR, Nieuwboer A. Protocol for a randomized comparison of integrated versus consecutive dual task practice in Parkinson's disease: the DUALITY trial. BMC Neurol 2014; 14:61. [PMID: 24674594 PMCID: PMC3974198 DOI: 10.1186/1471-2377-14-61] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/24/2014] [Indexed: 02/02/2023] Open
Abstract
Background Multiple tasking is an integral part of daily mobility. Patients with Parkinson’s disease have dual tasking difficulties due to their combined motor and cognitive deficits. Two contrasting physiotherapy interventions have been proposed to alleviate dual tasking difficulties: either to discourage simultaneous execution of dual tasks (consecutive training); or to practice their concurrent use (integrated training). It is currently unclear which of these training methods should be adopted to achieve safe and consolidated dual task performance in daily life. Therefore, the proposed randomized controlled trial will compare the effects of integrated versus consecutive training of dual tasking (tested by combining walking with cognitive exercises). Methods and design Hundred and twenty patients with Parkinson’s disease will be recruited to participate in this multi-centered, single blind, randomized controlled trial. Patients in Hoehn & Yahr stage II-III, with or without freezing of gait, and who report dual task difficulties will be included. All patients will undergo a six-week control period without intervention after which they will be randomized to integrated or consecutive task practice. Training will consist of standardized walking and cognitive exercises delivered at home four times a week during six weeks. Treatment is guided by a physiotherapist twice a week and consists of two sessions of self-practice using an MP3 player. Blinded testers will assess patients before and after the control period, after the intervention period and after a 12-week follow-up period. The primary outcome measure is dual task gait velocity, i.e. walking combined with a novel untrained cognitive task to evaluate the consolidation of learning. Secondary outcomes include several single and dual task gait and cognitive measures, functional outcomes and a quality of life scale. Falling will be recorded as a possible adverse event using a weekly phone call for the entire study period. Discussion This randomized study will evaluate the effectiveness and safety of integrated versus consecutive task training in patients with Parkinson’s disease. The study will also highlight whether dual task gait training leads to robust motor learning effects, and whether these can be retained and carried-over to untrained dual tasks and functional mobility. Trial registration Clinicaltrials.gov NCT01375413.
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Affiliation(s)
| | | | | | | | | | | | | | - Alice Nieuwboer
- Department of Rehabilitation Sciences, KU Leuven, Faculty of Kinesiology and Rehabilitation, Tervuursevest 101 bus 1501, Leuven 3001, Belgium.
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641
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Przekoracka-Krawczyk A, Nawrot P, Czaińska M, Michalak KP. Impaired body balance control in adults with strabismus. Vision Res 2014; 98:35-45. [PMID: 24680877 DOI: 10.1016/j.visres.2014.03.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 03/03/2014] [Accepted: 03/11/2014] [Indexed: 11/25/2022]
Abstract
Previous studies revealed that people with binocular vision disorders have poor postural stability. However, most of the research was performed only on children and under binocular viewing condition, that could negatively affect the results. The aim of the current study was to investigate the influence of extra-ocular proprioceptive signals on postural stability in young adults with binocular vision disorders. Moreover, additional mental task was introduced to detect any postural compensation which could possibly hide the real influence of afferent extra-ocular signals. 21 Subjects, aged 18-45 yrs, with horizontal strabismus, were qualified to binocular vision disorders (BVD) group. 41 subjects, aged 19-45 yrs, with no strabismus formed the normal binocular vision (NBV) group. Posturography data were collected in 2 separate parts: (1) quiet standing (Single-Task), and (2) performance of a mental task while standing (Dual-Task). Each part consisted of three 60-s viewing conditions, with: (1) dominant/fellow eye (DE), (2) non-dominant/strabismic eye (NDE), and with (3) both eyes closed (EC). Subjects were looking at X located at the distance of 150 cm. Generally, BVD group showed elevated body balance during quiet stance compared to NBV group. Interestingly, better stabilization in BVD group occurred under NDE viewing. Surprisingly, additional mental task improved the postural stability in BVD group almost to the level of NBV group. These findings emphasize the role of the eye-muscle signals in postural control and suggest that suitable vision therapy can be the appropriate way to improve body balance/motor functions in people with binocular vision disorders.
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Affiliation(s)
- Anna Przekoracka-Krawczyk
- Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University in Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Paweł Nawrot
- Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University in Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Monika Czaińska
- Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University in Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Krzysztof Piotr Michalak
- Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University in Poznań, Umultowska 85, 61-614 Poznań, Poland.
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642
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Agmon M, Belza B, Nguyen HQ, Logsdon RG, Kelly VE. A systematic review of interventions conducted in clinical or community settings to improve dual-task postural control in older adults. Clin Interv Aging 2014; 9:477-92. [PMID: 24741296 PMCID: PMC3970921 DOI: 10.2147/cia.s54978] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Injury due to falls is a major problem among older adults. Decrements in dual-task postural control performance (simultaneously performing two tasks, at least one of which requires postural control) have been associated with an increased risk of falling. Evidence-based interventions that can be used in clinical or community settings to improve dual-task postural control may help to reduce this risk. Purpose The aims of this systematic review are: 1) to identify clinical or community-based interventions that improved dual-task postural control among older adults; and 2) to identify the key elements of those interventions. Data sources Studies were obtained from a search conducted through October 2013 of the following electronic databases: PubMed, CINAHL, PsycINFO, and Web of Science. Study selection Randomized and nonrandomized controlled studies examining the effects of interventions aimed at improving dual-task postural control among community-dwelling older adults were selected. Data extraction All studies were evaluated based on methodological quality. Intervention characteristics including study purpose, study design, and sample size were identified, and effects of dual-task interventions on various postural control and cognitive outcomes were noted. Data synthesis Twenty-two studies fulfilled the selection criteria and were summarized in this review to identify characteristics of successful interventions. Limitations The ability to synthesize data was limited by the heterogeneity in participant characteristics, study designs, and outcome measures. Conclusion Dual-task postural control can be modified by specific training. There was little evidence that single-task training transferred to dual-task postural control performance. Further investigation of dual-task training using standardized outcome measurements is needed.
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Affiliation(s)
- Maayan Agmon
- The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Israel
| | - Basia Belza
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Huong Q Nguyen
- School of Nursing, University of Washington, Seattle, WA, USA ; Department of Research and Evaluation, Kaiser Permanente, CA, USA
| | | | - Valerie E Kelly
- School of Medicine, University of Washington, Seattle, WA, USA
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643
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Shin SS, An DH. The Effect of Motor Dual-task Balance Training on Balance and Gait of Elderly Women. J Phys Ther Sci 2014; 26:359-61. [PMID: 24707083 PMCID: PMC3976002 DOI: 10.1589/jpts.26.359] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 09/22/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effect of a motor dual-task balance program on balance and gait of elderly women to suggest a more effective balance exercise method. [Subjects] Twenty elderly Korean women who could walk independently were recruited from the community dwelling. [Methods] The motor dual-task balance training (experimental) group stood on an Aero-step, and performed gym ball bouncing, catching, and throwing, while the simple task balance training (control) group merely stood on the Aero-step. Participants performed 45 minutes of training, 2 times a week for 6 weeks. Balance (fall index) was measured using a TETRAX. Gait variables were recorded on a GAITRite walkway at self-determined walking speed. [Results] The fall index of the experimental group was significantly lower than that of the control group. Step length, stride length, velocity, and cadence of the experimental group improved significantly more than those of control group. [Conclusions] We found that motor dual-task balance training improved balance and walking ability more than simple balance training. Further studies should investigate motor dual-task training with kinematic and kinetic data, and muscle activation based on motor strategies.
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Affiliation(s)
- Sun-Shil Shin
- Department of Rehabilitation Science, Graduate School, Inje University, Republic of Korea
| | - Duk-Hyun An
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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644
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De Sanctis P, Butler JS, Malcolm BR, Foxe JJ. Recalibration of inhibitory control systems during walking-related dual-task interference: a mobile brain-body imaging (MOBI) study. Neuroimage 2014; 94:55-64. [PMID: 24642283 DOI: 10.1016/j.neuroimage.2014.03.016] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/06/2014] [Accepted: 03/09/2014] [Indexed: 10/25/2022] Open
Abstract
Walking while simultaneously performing cognitively demanding tasks such as talking or texting are typical complex behaviors in our daily routines. Little is known about neural mechanisms underlying cortical resource allocation during such mobile actions, largely due to portability limitations of conventional neuroimaging technologies. We applied an EEG-based Mobile Brain-Body Imaging (MOBI) system that integrates high-density event-related potential (ERP) recordings with simultaneously acquired foot-force sensor data to monitor gait patterns and brain activity. We compared behavioral and ERP measures associated with performing a Go/NoGo response-inhibition task under conditions where participants (N=18) sat in a stationary way, walked deliberately or walked briskly. This allowed for assessment of effects of increasing dual-task load (i.e. walking speed) on neural indices of inhibitory control. Stride time and variability were also measured during inhibitory task performance and compared to stride parameters without task performance, thereby assessing reciprocal dual-task effects on gait parameters. There were no task performance differences between sitting and either walking condition, indicating that participants could perform both tasks simultaneously without suffering dual-task costs. However, participants took longer strides under dual-task load, likely indicating an adaptive mechanism to reduce inter-task competition for cortical resources. We found robust differences in amplitude, latency and topography of ERP components (N2 and P3) associated with inhibitory control between the sitting and walking conditions. Considering that participants showed no dual-task performance costs, we suggest that observed neural alterations under increasing task-load represent adaptive recalibration of the inhibitory network towards a more controlled and effortful processing mode, thereby optimizing performance under dual-task situations.
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Affiliation(s)
- Pierfilippo De Sanctis
- The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Neuroscience, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Psychology, 138th Street & Convent Ave., New York, NY 10031, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Biology, 138th Street & Convent Ave., New York, NY 10031, USA.
| | - John S Butler
- The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Neuroscience, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA
| | - Brenda R Malcolm
- The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Neuroscience, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Psychology, 138th Street & Convent Ave., New York, NY 10031, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Biology, 138th Street & Convent Ave., New York, NY 10031, USA
| | - John J Foxe
- The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Pediatrics, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; The Sheryl & Daniel R. Tishman Cognitive Neurophysiology Laboratory, Children's Evaluation and Rehabilitation Center (CERC), Department of Neuroscience, Albert Einstein College of Medicine, Van Etten Building - Wing 1C, 1225 Morris Park Avenue, Bronx, New York 10461, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Psychology, 138th Street & Convent Ave., New York, NY 10031, USA; Program in Cognitive Neuroscience, City College of the City University of New York, Department of Biology, 138th Street & Convent Ave., New York, NY 10031, USA.
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645
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Tang PF, Yang HJ, Peng YC, Chen HY. Motor dual-task Timed Up & Go test better identifies prefrailty individuals than single-task Timed Up & Go test. Geriatr Gerontol Int 2014; 15:204-10. [PMID: 24571496 DOI: 10.1111/ggi.12258] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2013] [Indexed: 01/11/2023]
Abstract
AIM The present study investigated whether dual-task Timed Up & Go tests (TUG) could identify prefrail individuals more sensitively than the single-task TUG (TUGsingle ) in community-dwelling middle-aged and older adults. METHODS This cross-sectional study recruited adults aged 50 years and older who actively participated in local community programs. Time taken to complete single-task TUG and dual-task TUG, carrying a cup of water (TUGmanual ) or carrying out serial-3 subtraction (TUGcognitive ) while executing TUG, was measured. Prefrailty status was defined based on Fried's phenotypic definition. RESULTS Of the 65 participants (mean age 71.5±8.1 years), 33.3% of the 12 middle-aged (50-64 years) and 62.3% of the 53 older (≥65 years) adults were prefrail, mainly as a result of weak grip strength. The receiver operating characteristic curve analyses for differentiating prefrailty from non-frailty showed that the area under the curve (AUC) for TUGmanual (0.73, 95% CI 0.60-0.86) was better than that for TUGsingle (0.67, 95% CI 0.54-0.80), whereas the AUC value was not significant for TUGcognitive (0.60, 95% CI 0.46-0.74). The optimal cut-off points for detecting prefrailty using TUGsingle , TUGmanual and TUGcognitive were 7.7 s (sensitivity 68%), 8.2 s (sensitivity 83%), and 14.3 s (sensitivity 29%), respectively. After adjusting for age, logistic regression analyses showed that individuals with TUGmanual 8.2 s or slower were 7.2-fold more likely to have prefrailty than those with TUGmanual faster than 8.2 s. CONCLUSION TUGmanual is more valid and sensitive than TUGsingle in identifying prefrail individuals. The TUGmanual thus could serve as a screening tool for early detection of individuals with prefrailty in community-dwelling middle-aged and older adults.
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Affiliation(s)
- Pei-Fang Tang
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University Hospital, Taipei, Taiwan; Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
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646
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Meester D, Al-Yahya E, Dawes H, Martin-Fagg P, Piñon C. Associations between prefrontal cortex activation and H-reflex modulation during dual task gait. Front Hum Neurosci 2014; 8:78. [PMID: 24600375 PMCID: PMC3926984 DOI: 10.3389/fnhum.2014.00078] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 01/31/2014] [Indexed: 11/16/2022] Open
Abstract
Walking, although a largely automatic process, is controlled by the cortex and the spinal cord with corrective reflexes modulated through integration of neural signals from central and peripheral inputs at supraspinal level throughout the gait cycle. In this study we used an additional cognitive task to interfere with the automatic processing during walking in order to explore the neural mechanisms involved in healthy young adults. Participants were asked to walk on a treadmill at two speeds, both with and without additional cognitive load. We evaluated the impact of speed and cognitive load by analyzing activity of the prefrontal cortex (PFC) using functional Near-Infrared Spectroscopy (fNIRS) alongside spinal cord reflex activity measured by soleus H-reflex amplitude and gait changes obtained by using an inertial measuring unit. Repeated measures ANOVA revealed that fNIRS Oxy-Hb concentrations significantly increased in the PFC with dual task (walking while performing a cognitive task) compared to a single task (walking only; p < 0.05). PFC activity was unaffected by increases of walking speed. H-reflex amplitude and gait variables did not change in response to either dual task or increases in walking speed. When walking under additional cognitive load participants adapted by using greater activity in the PFC, but this adaptation did not detrimentally affect H-reflex amplitude or gait variables. Our findings suggest that in a healthy young population central mechanisms (PFC) are activated in response to cognitive loads but that H-reflex activity and gait performance can successfully be maintained. This study provides insights into the mechanisms behind healthy individuals safely performing dual task walking.
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Affiliation(s)
- Daan Meester
- Movement Science Group, Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington, Oxford UK
| | - Emad Al-Yahya
- Movement Science Group, Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington, Oxford UK ; Department of Physiotherapy, Faculty of Rehabilitation, The University of Jordan Amman, Jordan
| | - Helen Dawes
- Movement Science Group, Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington, Oxford UK
| | - Penny Martin-Fagg
- Movement Science Group, Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington, Oxford UK
| | - Carmen Piñon
- Movement Science Group, Department of Sport and Health Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington, Oxford UK
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647
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Caçola P, Gabbard C, Spessato B. An age-related view of the role of object and spatial cognitive styles in distance estimation. JOURNAL OF COGNITIVE PSYCHOLOGY 2014. [DOI: 10.1080/20445911.2013.876028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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648
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Patel P, Lamar M, Bhatt T. Effect of type of cognitive task and walking speed on cognitive-motor interference during dual-task walking. Neuroscience 2014; 260:140-8. [DOI: 10.1016/j.neuroscience.2013.12.016] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/09/2013] [Accepted: 12/09/2013] [Indexed: 11/24/2022]
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649
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Shin S, Chung HR, Fitschen PJ, Kistler BM, Woo Park H, Wilund KR, Sosonff JJ. Postural control in hemodialysis patients. Gait Posture 2014; 39:723-7. [PMID: 24189110 PMCID: PMC3946821 DOI: 10.1016/j.gaitpost.2013.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/12/2013] [Accepted: 10/08/2013] [Indexed: 02/02/2023]
Abstract
The current investigation examined whether patients undergoing hemodialysis (HD) have reduced standing postural control performance during simultaneous cognitive task performance (i.e. dual task cost (DTC)) compared to age-gender matched controls. 19 persons undergoing HD and 19 age, gender, and body mass index (BMI) matched controls participated in the investigation. All participants performed 2 trials of quiet standing balance and 2 postural trials in which they performed a cognitive task. Postural control was indexed with various measures of the center of pressure (COP) trajectory. The change in postural control with a cognitive task (e.g. dual task cost DTC) was quantified as a change in the center of COP parameters of postural control from quiet standing to the cognitive condition. The primary observations were that (1) HD patients had significantly greater postural sway than age, gender, BMI matched controls (p's < 0.05); (2) HD patients had a greater DTC than the controls during quiet standing (p's < 0.05). The observations highlight that HD participants have poor postural control that is further exacerbated by a simultaneous performance of a cognitive task. It is possible that this impaired postural control places HD participants at elevated fall risk. Further study is necessary to determine contributing factors to an increased DTC in this population and whether targeted interventions such as exercise can reduce DTC.
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Affiliation(s)
- Sunghoon Shin
- Department of Biomedical Engineering, Kyung Hee Univeristy, Yongin, Korea
| | - Hae Ryong Chung
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, US
| | - Peter J. Fitschen
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, US
| | - Brandon M. Kistler
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, US
| | - Hyun Woo Park
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, US
| | - Kenneth R. Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, US
| | - Jacob J Sosonff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, US
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650
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Callisaya ML, Beare R, Phan TG, Chen J, Srikanth VK. Global and regional associations of smaller cerebral gray and white matter volumes with gait in older people. PLoS One 2014; 9:e84909. [PMID: 24416309 PMCID: PMC3885624 DOI: 10.1371/journal.pone.0084909] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 11/27/2013] [Indexed: 11/18/2022] Open
Abstract
Background Gait impairments increase with advancing age and can lead to falls and loss of independence. Brain atrophy also occurs in older age and may contribute to gait decline. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people. Methods In a population-based study, participants aged >60 years without Parkinson's disease or brain infarcts underwent magnetic resonance imaging and gait measurements using a computerized walkway. Linear regression was used to study associations of total gray and white matter volumes with gait, adjusting for each other, age, sex, height and white matter hyperintensity volume. Other covariates considered in analyses included weight and vascular disease history. Voxel-based morphometry was used to study regional relationships of gray and white matter with gait. Results There were 305 participants, mean age 71.4 (6.9) years, 54% male, mean gait speed 1.16 (0.22) m/s. Smaller total gray matter volume was independently associated with poorer gait speed (p = 0.001) and step length (p<0.001), but not cadence. Smaller volumes of cortical and subcortical gray matter in bilateral regions important for motor control, vision, perception and memory were independently associated with slower gait speed and shorter steps. No global or regional associations were observed between white matter volume and gait independent of gray matter volume, white matter hyperintensity volume and other covariates. Conclusion Smaller gray matter volume in bilaterally distributed brain networks serving motor control was associated with slower gait speed and step length, but not cadence.
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Affiliation(s)
- Michele L. Callisaya
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Clayton, Victoria, Australia
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
- * E-mail:
| | - Richard Beare
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Clayton, Victoria, Australia
| | - Thanh G. Phan
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Clayton, Victoria, Australia
| | - Jian Chen
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Clayton, Victoria, Australia
| | - Velandai K. Srikanth
- Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Clayton, Victoria, Australia
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
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