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Song F, Ding K, Sun M, Xia R. Effect of 12-week head-down strong abdominal breathing on cognitive function in patients with stable chronic obstructive pulmonary disease: a single-centre randomised controlled trial protocol. Trials 2024; 25:351. [PMID: 38816733 PMCID: PMC11140949 DOI: 10.1186/s13063-024-08193-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/23/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) often suffer from a combination of mild cognitive impairment (MCI) and a significant reduction in their quality of life. In the exercise programme of pulmonary rehabilitation (PR), pulmonary rehabilitation intervention is often carried out by enhancing respiratory function. Strong abdominal breathing is a kind of breathing method, through which the diaphragm can be exercised, thereby enhancing the deflection distance of the diaphragm during breathing and improving respiratory function. The inversion trainer can meet the different angles of head-down training and also has the characteristics of low cost, easy to operate, and use a wide range of scenarios. According to currently available data, strong abdominal breathing in combination with head-down position has not yet been used in pulmonary rehabilitation in this type of rehabilitation programme. It is valuable to use this device to study PR of cognitive function in patients with COPD. METHODS This study was a 12-week single-centre randomised controlled trial and blinding the assessors and data processors of the test. Recruitment is planned for January 1, 2024. It is expected that 81 patients with stable COPD combined with MCI will be recruited and randomly assigned to the head-down strong abdominal breathing group (HG), the fitness qigong eight-duanjin group (BDJ), and the control group (CG) in a 1:1:1 ratio. Using fNIRS (functional near-infrared spectroscopy) to assess brain oxygen availability before and after pulmonary rehabilitation in three periods: before, during and after the intervention. Cognitive functioning is also assessed using the Overall Cognitive Assessment Scale, the Specific Cognitive Functioning Assessment Scale and the Cognitive Behavioural Ability Test. TRIAL REGISTRATION The Specialised Committee on Scientific Research and Academic Ethics of the Academic Committee of Anqing Normal University approved the project (ANU2023001). China Clinical Trial Registry approved the study (ChiCTR2300075400) with a registration date of 2023/09/04. DISCUSSION The aim of this study was to explore novel exercise rehabilitation methods to improve cognitive function in COPD patients. It results in a lower financial burden and higher participation in pulmonary rehabilitation and improves the quality of survival of patients with COPD.
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Affiliation(s)
- Feiyun Song
- Department of Sports Rehabilitation, School of Physical Education, Anqing Normal University, Anhui, China
| | - Kexin Ding
- Department of Sports Rehabilitation, School of Physical Education, Anqing Normal University, Anhui, China
| | - Mingyun Sun
- Department of Sports Rehabilitation, School of Physical Education, Anqing Normal University, Anhui, China.
| | - Rui Xia
- School of Physical Education of Chaohu University, Anhui, China.
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Nedović N, Eminović F, Marković V, Stanković I, Radovanović S. Gait Characteristics during Dual-Task Walking in Elderly Subjects of Different Ages. Brain Sci 2024; 14:148. [PMID: 38391723 PMCID: PMC10886897 DOI: 10.3390/brainsci14020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/14/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND In older age, walking ability gradually decreases due to factors including impaired balance, reduced muscle strength, and impaired vision and proprioception. Further, cognitive functions play a key role during walking and gradually decline with age. There is greater variability in gait parameters when the demands during walking increase, in dual- and multiple-task situations. The aim of this study was to analyze gait parameters while performing a demanding cognitive and motor dual task in three different age-related healthy elderly subject groups. METHOD A total of 132 healthy individuals (54 males, 78 females) were divided into three groups-55 to 65, 66 to 75, and 76 to 85 years. The subjects performed a basic walking task, dual motor task, dual mental task, and combined motor and mental task while walking. The gait parameters cycle time, stride length, swing time, and double support time were noted, as well as the variability of those parameters. RESULTS Cycle time was longer and stride length was shorter in the >76-year-old group than in the 51-65-year-old group in all test conditions. A comparison of all three groups did not show a significant difference in swing time, while double support time was increased in the same group. CONCLUSIONS Changes are observed when gait is performed simultaneously with an additional motor or cognitive task. Early detection of gait disorders can help identify elderly people at increased risk of falls. Employing a dual-task paradigm during gait assessment in healthy elderly subjects may help identify cognitive impairment early in the course of the disturbance.
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Affiliation(s)
- Nenad Nedović
- College of Health Sciences, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia
| | - Fadilj Eminović
- Faculty of Special Education and Rehabilitation, University of Belgrade, 11000 Belgrade, Serbia
| | - Vladana Marković
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Iva Stanković
- Neurology Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Saša Radovanović
- Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
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Arpaia P, Cuocolo R, Fullin A, Gargiulo L, Mancino F, Moccaldi N, Vallefuoco E, De Blasiis P. Executive Functions Assessment Based on Wireless EEG and 3D Gait Analysis During Dual-Task: A Feasibility Study. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2024; 12:268-278. [PMID: 38410182 PMCID: PMC10896422 DOI: 10.1109/jtehm.2024.3357287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/28/2024]
Abstract
Executive functions (EFs) are neurocognitive processes planning and regulating daily life actions. Performance of two simultaneous tasks, requiring the same cognitive resources, lead to a cognitive fatigue. Several studies investigated cognitive-motor task and the interference during walking, highlighting an increasing risk of falls especially in elderly and people with neurological diseases. A few studies instrumentally explored relationship between activation-no-activation of two EFs (working memory and inhibition) and spatial-temporal gait parameters. Aim of our study was to detect activation of inhibition and working memory during progressive difficulty levels of cognitive tasks and spontaneous walking using, respectively, wireless electroencephalography (EEG) and 3D-gait analysis. Thirteen healthy subjects were recruited. Two cognitive tasks were performed, activating inhibition (Go-NoGo) and working memory (N-back). EEG features (absolute and relative power in different bands) and kinematic parameters (7 spatial-temporal ones and Gait Variable Score for 9 range of motion of lower limbs) were analyzed. A significant decrease of stride length and an increase of external-rotation of foot progression were found during dual task with Go-NoGo. Moreover, a significant correlation was found between the relative power in the delta band at channels Fz, C4 and progressive difficulty levels of Go-NoGo (activating inhibition) during walking, whereas working memory showed no correlation. This study reinforces the hypothesis of the prevalent involvement of inhibition with respect to working memory during dual task walking and reveals specific kinematic adaptations. The foundations for EEG-based monitoring of cognitive processes involved in gait are laid. Clinical and Translational Impact Statement: Clinical and instrumental evaluation and training of executive functions (as inhibition), during cognitive-motor task, could be useful for rehabilitation treatment of gait disorder in elderly and people with neurological disease.
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Affiliation(s)
- Pasquale Arpaia
- Department of Electrical Engineering and Information TechnologiesUniversity of Naples Federico II 80138 Naples Italy
| | - Renato Cuocolo
- Department of Medicine, Surgery, and DentistryScuola Medica SalernitanaUniversity of Salerno 84084 Salerno Italy
| | - Allegra Fullin
- Department of Mental and Physical Health and Preventive MedicineSection of Human AnatomyUniversity of Campania Luigi Vanvitelli Caserta 81100 Naples Italy
- Department of Advanced Biomedical SciencesUniversity of Naples Federico II 80138 Naples Italy
| | - Ludovica Gargiulo
- Department of Electrical Engineering and Information TechnologiesUniversity of Naples Federico II 80138 Naples Italy
| | - Francesca Mancino
- Department of Electrical Engineering and Information TechnologiesUniversity of Naples Federico II 80138 Naples Italy
| | - Nicola Moccaldi
- Department of Electrical Engineering and Information TechnologiesUniversity of Naples Federico II 80138 Naples Italy
| | - Ersilia Vallefuoco
- Department of Psychology and Cognitive ScienceUniversity of Trento 38122 Rovereto Italy
| | - Paolo De Blasiis
- Department of Mental and Physical Health and Preventive MedicineSection of Human AnatomyUniversity of Campania Luigi Vanvitelli Caserta 81100 Naples Italy
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4
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Helfer KS, van Emmerik R, Freyman RL, Banks JJ. An Exploratory Study of Walking, Listening, and Remembering in Younger and Middle-Aged Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4052-4065. [PMID: 37672796 PMCID: PMC10713016 DOI: 10.1044/2023_jslhr-23-00198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE The purpose of this study was to assess how needing to listen and remember information while walking affects speech perception, memory task performance, and gait in younger and middle-aged adults. METHOD Four gait parameters (stride duration, step variability, whole-body center of mass acceleration, and mediolateral head acceleration) were measured when younger and middle-aged participants stood or walked on a treadmill while they simultaneously completed a speech-on-speech perception task and a preload memory task, singly and in combination. RESULTS Speech perception was significantly poorer for middle-aged than for younger participants. Performance on the speech perception measure did not differ significantly between walking and standing for either group of participants, but the additional cognitive load of the memory task reduced performance on the speech perception task. Memory task performance was significantly poorer when combined with the speech perception task than when measured in isolation for both participant groups, but no further declines were noted when participants were also walking. Mediolateral head acceleration, which has been linked to loss of balance, was significantly greater during multitask trials, as compared to when participants were only walking without being required to listen or remember. Post hoc analysis showed that dual- and multitask influences on mediolateral head acceleration were more prominent for middle-aged than for younger participants. Stride duration was longer in the multitask condition than when participants were only walking. CONCLUSIONS Results of this exploratory study indicate that gait may be impacted when individuals (both younger and middle-aged) are listening and remembering while walking. Data also substantiate prior findings of early age-related declines in the perception of speech in the presence of understandable speech maskers.
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Affiliation(s)
- Karen S. Helfer
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | | | - Richard L. Freyman
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | - Jacob J. Banks
- Department of Kinesiology, University of Massachusetts Amherst
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Guess TM, Bliss R, Hall JB, Kiselica AM. Comparison of Azure Kinect overground gait spatiotemporal parameters to marker based optical motion capture. Gait Posture 2022; 96:130-136. [PMID: 35635988 DOI: 10.1016/j.gaitpost.2022.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Instrumented measurement of spatiotemporal parameters during walking can provide valuable information on an individual's overall function and health. Efficient, inexpensive, and accurate measurement of overground walking spatiotemporal parameters would be a critical component of providing point-of-care assessments of gait function, concussion recovery, fall-risk, and cognitive decline. Depth cameras combined with skeleton pose tracking algorithms, such as the Microsoft Kinect with body tracking software, have been used to measure walking spatiotemporal parameters. However, the ability of the latest generation Microsoft Kinect sensor, the Azure Kinect, to accurately measure overground walking spatiotemporal parameters has not been evaluated in the literature. RESEARCH QUESTION The purpose of this work was to compare overground walking spatiotemporal parameters measurements from a 12 camera Vicon optical motion capture system to measurements of a single Azure Kinect with body tracking SDK (software development kit). METHODS Spatiotemporal parameters of overground walking were simultaneously collected on twenty young healthy participants. Stride length, stride time, step length and step width were derived from ankle joint center locations and measurements from the two instruments were compared using descriptive statistics, scatter plots, Pearson correlation analyses, and Bland-Altman analyses. RESULTS Pearson correlation coefficients were greater than 0.87 for all spatiotemporal parameters with most parameters demonstrating very strong (> 0.9) agreement. The mean of the differences for stride length between measurements was 35.6 mm for the left limb and 39.1 mm for the right limb, both of which are less than 3% of average stride length. Mean of the differences for step width and stride time were less than 2% and 1% of their averages respectively. SIGNIFICANCE A single Microsoft Azure Kinect with body tracking SDK can provide clinically relevant measurement of walking spatiotemporal parameters, providing accessible and objective measurements that can improve clinical decision making across a variety of patient populations.
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Affiliation(s)
- Trent M Guess
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA; Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
| | - Rebecca Bliss
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Jamie B Hall
- Department of Physical Therapy, University of Missouri, Columbia, MO, USA
| | - Andrew M Kiselica
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
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Task-prioritization and balance recovery strategies used by young healthy adults during dual-task walking. Gait Posture 2022; 95:115-120. [PMID: 35472735 DOI: 10.1016/j.gaitpost.2022.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 03/30/2022] [Accepted: 04/13/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Maintaining dynamic balance is an essential task during walking, with foot-placement playing a critical role. Dual-task studies analyzing steady-state walking with cognitive loads have found healthy adults prioritize cognitive task performance at the expense of maintaining control of their balance. However, few studies have focused on the influence of cognitive loads on more difficult motor tasks, such as walking with unexpected foot-placement perturbations. Individuals often recover from a loss of balance using an ankle or hip strategy; however, how cognitive loads affect these balance recovery strategies remains unknown. RESEARCH QUESTION How do individuals prioritize cognitive resources and does the balance recovery strategy used change following mediolateral foot-placement perturbations during steady-state walking when performing cognitive tasks of increasing difficulty? METHODS Fifteen young healthy adults walked during unperturbed and perturbed conditions with increasing cognitive loads (no cognitive load, attentive listening, spelling short words backwards and spelling long words backwards). No specific task-prioritization instructions were given. Medial and lateral foot-placement perturbations were applied prior to heel-strike during random steps. RESULTS Cognitive performance decreased between the unperturbed and perturbed conditions. While balance control decreased during perturbed relative to unperturbed walking, the additional cognitive load had little effect on balance control during the perturbations. Lastly, the balance recovery strategy used, as measured by peak joint moments at the ankle and hip, was unaffected by the additional cognitive loads. SIGNIFICANCE Individuals appear to prioritize their balance control over cognitive performance when experiencing foot-placement perturbations and do not change their balance recovery strategy with the addition of a cognitive load. These results highlight the flexibility of task-prioritization in young adults and provide a foundation for future studies analyzing neurologically impaired populations.
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7
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Loss of Neural Automaticity Contributes to Slower Walking in COPD Patients. Cells 2022; 11:cells11101606. [PMID: 35626645 PMCID: PMC9139263 DOI: 10.3390/cells11101606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 02/05/2023] Open
Abstract
The physical impairments (e.g., slower walking speed) in patients with chronic obstructive pulmonary disease (COPD) have been attributed to peripheral characteristics (e.g., muscle atrophy). However, cognitive impairment may compromise motor control including walking automaticity. The objective of this study was to investigate PFC neural activity, evaluated using changes in oxygenated hemoglobin (ΔO2Hb), during preferred paced walking (PPW) in COPD patients and age-matched controls. The ΔO2Hb from the left and right dorsolateral PFC was measured using functional near-infrared spectroscopy. Fifteen COPD patients (age: 71 ± 8) and twenty age-matched controls (69 ± 7 years) participated. Two-way mixed ANOVA demonstrated that O2Hb in both groups decreased during PPW from the start (quintile 1; Q1) to the end (quintile 5; Q5) in the left dorsolateral and medial PFC. Q1 was comprised of the data during the first 20% of the task, while Q5 included data collected in the last 20% of the task duration. PPW duration ranged between 30.0 and 61.4 s in the control group and between 28.6 and 73.0 s in COPD patients. COPD patients demonstrated a higher O2Hb in Q5 compared to the negative O2Hb in controls in the right medial and dorsolateral PFC during PPW. PPW velocity was lower in COPD patients compared to controls (1.02 ± 0.22 vs. 1.22 ± 0.14 m/s, p = 0.005). Healthy older controls exhibited automaticity during walking unlike patients with COPD. The lesser decrease in O2Hb in COPD patients may be attributed to increased executive demands or affect-related cues (e.g., pain or dyspnea) during walking.
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Hassan SA, Bonetti LV, Kasawara KT, Beal DS, Rozenberg D, Reid WD. Decreased automaticity contributes to dual task decrements in older compared to younger adults. Eur J Appl Physiol 2022; 122:965-974. [PMID: 35084541 DOI: 10.1007/s00421-022-04891-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/09/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE To contrast older and younger adults' prefrontal cortex (PFC) neural activity (through changes in oxygenated hemoglobin) during single and dual tasks, and to compare decrements in task performance. METHODS Changes in oxygenated hemoglobin of dorsolateral PFC were monitored using functional near-infrared spectroscopy during single tasks of spelling backwards (cognitive task) and 30 m preferred paced walk; and a dual task combining both. Gait velocity was measured by a pressure sensitive mat. RESULTS Twenty sex-matched younger (27.6 ± 3.5 years) and 17 older adults (71.2 ± 4.9 years) were recruited. The left PFC oxygenated hemoglobin decreased from start (1st quintile) to the end (5th quintile) of the walking task in younger adults ( - 0.03 ± 0.03 to - 0.72 ± 0.20 µM; p < .05) unlike the non-significant change in older adults (0.03 ± 0.06 to - 0.41 ± 0.32 µM, p > .05). Overall, oxygenation increased bilaterally during dual versus single walk task in older adults (Left PFC: 0.22 ± 0.16 vs. - 0.23 ± 0.21 µM, respectively; Right PFC: 0.17 ± 0.18 vs. - 0.33 ± 0.22 µM, respectively), but only in right PFC in younger adults ( - 0.02 ± 0.15 vs. - 0.47 ± 0.13 µM). Older adults exhibited lower velocity during the dual task compared to younger adults (1.03 ± 0.16 vs. 1.20 ± 0.17 m/s, respectively). Older age was associated with dual task cost on velocity during walking after adjusting for confounding variables. CONCLUSIONS Age-related cognitive decline in older adults may increase neural activity for cognitive tasks and diminish walking automaticity that may lead to decrements during dual tasking; the greater PFC increases in the oxygenated hemoglobin and lower velocity may be due to increased cognitive load and limited attentional resources.
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Affiliation(s)
- S Ahmed Hassan
- Physical Therapy, University of Toronto, Toronto, ON, Canada.
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON, Canada.
| | - Leandro Viçosa Bonetti
- Physical Therapy, University of Toronto, Toronto, ON, Canada
- Post-Graduation Program in Health Sciences, Universidade de Caxias Do Sul, Caxias Do Sul, Rio Grande do Sul, Brazil
- Department of Physical Therapy, Universidade de Caxias Do Sul, Caxias Do Sul, Rio Grande do Sul, Brazil
| | | | - Deryk S Beal
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Dmitry Rozenberg
- Temerty Faculty of Medicine, Division of Respirology, University Health Network, Toronto, ON, Canada
- Toronto General Hospital Research Institute, Toronto, ON, Canada
| | - W Darlene Reid
- Physical Therapy, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehab-University Health Network, Toronto, ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
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Sasaki K, Ooi T, Yokota A, Azuma T, Asano K, Ooizumi S, Kimura T. Effects of cognitive tasks on center-of-foot pressure displacements and brain activity during single leg stance: comparison in community-dwelling healthy older and young people. J Phys Ther Sci 2022; 34:177-182. [PMID: 35291478 PMCID: PMC8918108 DOI: 10.1589/jpts.34.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022] Open
Abstract
[Purpose] This study aimed to investigate the effect of cognitive tasks on the
center-of-foot pressure (COP) displacements and brain activity during single leg stance
(SLS) in older people. [Participants and Methods] This study included 25 healthy older
(age, 68.8 ± 4.9 years) and 25 young (age, 21.0 ± 0.9 years) participants. Participants
performed SLS for 35 s under a single-task (ST) and three dual-tasks (DTs), namely verbal,
subtraction, and recall tasks. We measured the total length of COP
(COP_TL) and change in oxygenated hemoglobin
(HbO2) levels during SLS under four tasks. [Results] There were no
differences in COP_TL and HbO2 levels in the young
group, whereas COP_TL in the recall task was significantly
longer than in ST in the older group. In the comparisons of the DTc (the relative change
of DT to ST), no differences were found among three DTs in the young group, whereas the
DTc of COP_TL in the recall task was significantly higher than
that in the verbal task in the older group. Regarding HbO2, no differences were
observed among the four tasks in both groups. [Conclusion] These results suggest that SLS
combined with a recall task may be useful for fall risk screening in healthy older
individuals.
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Affiliation(s)
- Kentaro Sasaki
- Graduate School of Health Sciences, Kinjo University: 1200 Kasama, Hakusan city, Ishikawa 924-8511, Japan
| | - Takafumi Ooi
- Department of Medical Technology Rehabilitation Center, Kaga Medical Center, Japan
| | - Ayako Yokota
- Department of Physical Therapy, Kinjo University, Japan
| | - Toshiki Azuma
- Department of Rehabilitation, Yawata Medical Center, Japan
| | - Keisuke Asano
- Department of Physical Therapy, Keiju Kanazawa Hospital, Japan
| | - Shinichi Ooizumi
- Department of Medical Technology Rehabilitation Center, Kaga Medical Center, Japan
| | - Tsuyoshi Kimura
- Department of Social Welfare, Faculty of Social Welfare, Kinjo University, Japan
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Tandon R, Javid P, Di Giulio I. Mobile phone use is detrimental for gait stability in young adults. Gait Posture 2021; 88:37-41. [PMID: 33990000 DOI: 10.1016/j.gaitpost.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/29/2021] [Accepted: 05/02/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human walking is a highly automated motor task, however if the individual's attention is divided, gait can be negatively affected. Although the effect of divided attention has been usually tested with standardised cognitive tasks, the common task of walking while talking on the phone may represent an ecological dual task scenario. RESEARCH QUESTION What is the effect of divided attention on locomotion when using a mobile phone? METHODS Thirty-seven healthy participants were asked to walk while performing different cognitive tasks: counting and spelling backwards, talking on the phone (handset by the ear and hands-free), and texting. As a control, extra postural conditions were tested: holding the phone by the ear (without talking) and carrying the phone as in the texting task. These tasks were compared with normal walking (no other cognitive or postural task). Twenty participants also performed the same tasks with the addition of an obstacle halfway through the walkway. Gait performance was measured using non-invasive inertial sensors. Step time and mediolateral acceleration range were calculated. RESULTS Step time increased when counting (mean ± standard error 0.63 ± 0.02 s, p < 0.001), spelling backwards (0.67 ± 0.03 s, p < 0.001) and texting (0.61 ± 0.02 s, p = 0.005) compared to normal walking (0.56 ± 0.02 s). Compared to normal walking (8.03 ± 0.58 m/s2), mediolateral acceleration decreased when counting (6.43 ± 0.39 m/s2, p < 0.001), spelling backwards (6.67 ± 0.44 m/s2, p < 0.001), when talking on the phone while holding the phone (7.28 ± 0.48 m/s2, p = 0.003), or hands-free (7.28 ± 0.40 m/s2, p = 0.004), or texting (6.71 ± 0.50 m/s2, p < 0.001). Introducing an obstacle confirmed these results. SIGNIFICANCE This study shows that even in young and healthy individuals, gait is affected by divided attention. Furthermore, the results show that common and ecological cognitive tasks, such as phone use, could induce measurable worsening of gait performance. Individuals should be careful when walking and performing other tasks that could distract them, by dividing their attention.
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Affiliation(s)
- Radhika Tandon
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King's College London, Guys Campus, Great Maze Pond, London, SE1 9RT England, UK
| | - Pernia Javid
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King's College London, Guys Campus, Great Maze Pond, London, SE1 9RT England, UK
| | - Irene Di Giulio
- School of Basic and Medical Biosciences, Faculty of Life Science and Medicine, King's College London, Guys Campus, Great Maze Pond, London, SE1 9RT England, UK.
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11
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Laatar R, Ben Waer F, Rebai H, Sahli S. Caffeine consumption improves motor and cognitive performances during dual tasking in middle-aged women. Behav Brain Res 2021; 412:113437. [PMID: 34182008 DOI: 10.1016/j.bbr.2021.113437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/27/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to explore the effect of caffeine consumption (CC) on cognitive motor interference while walking and maintaining balance in middle-aged women. Twenty middle-aged women (52 ± 2.0 years; height 158 ± 2.0 cm; body mass 77 ± 14.9 kg; body mass index ±3.4 kg/m2, mean ± SD) participated in this study. Participants completed measures of a single task (ST) cognitive, a ST motor and a dual task (DT) cognitive-motor tests before and after either caffeine (100 mg) or placebo ingestion. Results showed that before CC, both motor (P < 0.0005) and cognitive (P < 0.05) performances decreased in the DT condition compared to the ST one. After CC, no significant difference in the motor performances between ST and DT conditions was observed. In fact, both standing and walking DT performances were improved as indicated by a significant (P < 0.05) decrease in the dual task cost (DTC) of motor performances. In conclusion, middle-aged women showed difficulties to manage DT situations in which a cognitive and a motor task must be performed concurrently. Caffeine is an effective ergogenic aid to improve both cognitive and motor performances during DT conditions and could be an alternative to nullify the deteriorating effect of DT when maintaining balance and walking in middle-aged women. These enhancements could offer great potential for everyday functioning.
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Affiliation(s)
- Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Fatma Ben Waer
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Haithem Rebai
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
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12
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Small GH, Brough LG, Neptune RR. The influence of cognitive load on balance control during steady-state walking. J Biomech 2021; 122:110466. [PMID: 33962328 DOI: 10.1016/j.jbiomech.2021.110466] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
For an individual to successfully walk, they must maintain control of their dynamic balance. However, situations that require increased cognitive attention may impair an individual's ability to actively control their balance. While dual-task studies have analyzed walking-while-talking conditions, few studies have focused specifically on the influence of cognitive load on balance control. The purpose of this study was to assess how individuals prioritize their cognitive resources and control dynamic balance during dual-task conditions of varying difficulty. Young healthy adults (n = 15) performed two single-task conditions (spelling-while-standing and treadmill walking with no cognitive load) and three dual-task conditions (treadmill walking with increasing cognitive load: attentive listening and spelling short and long words backwards). Cognitive performance did not change between the single- and dual-task as measured by spelling percent error and response rate (p = 0.300). Balance control, assessed using the range of whole-body angular momentum, did not change between the no load and listening conditions, but decreased during the short and long spelling conditions (p < 0.001). These results highlight that in young adults balance control decreases during dual-task treadmill walking with increased cognitive loads, but their cognitive performance does not change. The decrease in balance control suggests that participants prioritized cognitive performance over balance control during these dual-task walking conditions. This work offers additional insight into the automaticity of walking and task-prioritization in healthy young individuals and provides the basis for future studies to determine differences in neurologically impaired populations.
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Affiliation(s)
- Gabriella H Small
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Lydia G Brough
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Richard R Neptune
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA.
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13
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Su D, Liu Z, Jiang X, Zhang F, Yu W, Ma H, Wang C, Wang Z, Wang X, Hu W, Manor B, Feng T, Zhou J. Simple Smartphone-Based Assessment of Gait Characteristics in Parkinson Disease: Validation Study. JMIR Mhealth Uhealth 2021; 9:e25451. [PMID: 33605894 PMCID: PMC7935653 DOI: 10.2196/25451] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/08/2020] [Accepted: 01/20/2021] [Indexed: 01/14/2023] Open
Abstract
Background Parkinson disease (PD) is a common movement disorder. Patients with PD have multiple gait impairments that result in an increased risk of falls and diminished quality of life. Therefore, gait measurement is important for the management of PD. Objective We previously developed a smartphone-based dual-task gait assessment that was validated in healthy adults. The aim of this study was to test the validity of this gait assessment in people with PD, and to examine the association between app-derived gait metrics and the clinical and functional characteristics of PD. Methods Fifty-two participants with clinically diagnosed PD completed assessments of walking, Movement Disorder Society Unified Parkinson Disease Rating Scale III (UPDRS III), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety (HAM-A), and Hamilton Depression (HAM-D) rating scale tests. Participants followed multimedia instructions provided by the app to complete two 20-meter trials each of walking normally (single task) and walking while performing a serial subtraction dual task (dual task). Gait data were simultaneously collected with the app and gold-standard wearable motion sensors. Stride times and stride time variability were derived from the acceleration and angular velocity signal acquired from the internal motion sensor of the phone and from the wearable sensor system. Results High correlations were observed between the stride time and stride time variability derived from the app and from the gold-standard system (r=0.98-0.99, P<.001), revealing excellent validity of the app-based gait assessment in PD. Compared with those from the single-task condition, the stride time (F1,103=14.1, P<.001) and stride time variability (F1,103=6.8, P=.008) in the dual-task condition were significantly greater. Participants who walked with greater stride time variability exhibited a greater UPDRS III total score (single task: β=.39, P<.001; dual task: β=.37, P=.01), HAM-A (single-task: β=.49, P=.007; dual-task: β=.48, P=.009), and HAM-D (single task: β=.44, P=.01; dual task: β=.49, P=.009). Moreover, those with greater dual-task stride time variability (β=.48, P=.001) or dual-task cost of stride time variability (β=.44, P=.004) exhibited lower MoCA scores. Conclusions A smartphone-based gait assessment can be used to provide meaningful metrics of single- and dual-task gait that are associated with disease severity and functional outcomes in individuals with PD.
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Affiliation(s)
- Dongning Su
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Zhu Liu
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Xin Jiang
- The Second Clinical Medical College, Jinan University, Guangzhou, China.,Department of Geriatrics, Shenzhen People's Hospital, Shenzhen, Guangdong, China.,The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Fangzhao Zhang
- Department of Computer Science, The University of British Columbia, Vancouver, BC, Canada
| | - Wanting Yu
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States
| | - Huizi Ma
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Chunxue Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Zhan Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Xuemei Wang
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Wanli Hu
- Department of Hematology and Oncology, Jingxi Campus, Capital Medical University, Beijing ChaoYang Hospital, Beijing, China
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States.,Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Tao Feng
- Department of Neurology, Beijing Tiantan Hospital, Beijing, China
| | - Junhong Zhou
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States.,Beth Israel Deaconess Medical Center, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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14
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Hoffmann R, Brodowski H, Steinhage A, Grzegorzek M. Detecting Walking Challenges in Gait Patterns Using a Capacitive Sensor Floor and Recurrent Neural Networks. SENSORS 2021; 21:s21041086. [PMID: 33562548 PMCID: PMC7914733 DOI: 10.3390/s21041086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
Gait patterns are a result of the complex kinematics that enable human two-legged locomotion, and they can reveal a lot about a person’s state and health. Analysing them is useful for researchers to get new insights into the course of diseases, and for physicians to track the progress after healing from injuries. When a person walks and is interfered with in any way, the resulting disturbance can show up and be found in the gait patterns. This paper describes an experimental setup for capturing gait patterns with a capacitive sensor floor, which can detect the time and position of foot contacts on the floor. With this setup, a dataset was recorded where 42 participants walked over a sensor floor in different modes, inter alia, normal pace, closed eyes, and dual-task. A recurrent neural network based on Long Short-Term Memory units was trained and evaluated for the classification task of recognising the walking mode solely from the floor sensor data. Furthermore, participants were asked to do the Unilateral Heel-Rise Test, and their gait was recorded before and after doing the test. Another neural network instance was trained to predict the number of repetitions participants were able to do on the test. As the results of the classification tasks turned out to be promising, the combination of this sensor floor and the recurrent neural network architecture seems like a good system for further investigation leading to applications in health and care.
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Affiliation(s)
- Raoul Hoffmann
- SensProtect GmbH, 85635 Höhenkirchen-Siegertsbrunn, Germany;
- Institute of Medical Informatics, University of Lübeck, 23538 Lübeck, Germany;
- Correspondence:
| | - Hanna Brodowski
- Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Lübeck (P.E.R.L.), University of Lübeck, 23538 Lübeck, Germany;
- Geriatrics Research Group, Charité-Universitätsmedizin Berlin, 13347 Berlin, Germany
| | - Axel Steinhage
- SensProtect GmbH, 85635 Höhenkirchen-Siegertsbrunn, Germany;
| | - Marcin Grzegorzek
- Institute of Medical Informatics, University of Lübeck, 23538 Lübeck, Germany;
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15
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Roostaei M, Raji P, Morone G, Razi B, Khademi-Kalantari K. The effect of dual-task conditions on gait and balance performance in children with cerebral palsy: A systematic review and meta-analysis of observational studies. J Bodyw Mov Ther 2020; 26:448-462. [PMID: 33992282 DOI: 10.1016/j.jbmt.2020.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 10/29/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
Dual-task conditions are commonly experienced in daily routines. The aim of the present systematic review is to investigate the effect of dual-task conditions on gait and balance performance in children with cerebral palsy (CP) and to perform meta-analyses where applicable. Five databases, "ProQuest", "PubMed", "OTSeeker", "Scopus", and "PEDro" from the incipient date of databases up to Aug 24, 2020 were searched for studies focusing on the effects of dual-task conditions on gait and balance performance in children with CP. After removing irrelevant articles and applying inclusion and exclusion criteria, nine articles were included in the present systematic review and meta-analysis. The results of the meta-analysis showed that walking speed was slower during dual-task conditions compared to single-task conditions in children with CP (WMD = -0.29 m/s, 95% CI = -0.34, -0.24, P ≤ 0.001) and walking speed decreased in children with CP during dual-task conditions in comparison with the typical development (TD) control group (WMD = -0.19 m/s, 95% CI = -0.23 to -0.15, P ≤ 0.001). The results of subgroup analysis based on the type of task indicated that adding concurrent tasks to walking degrades walking speed under varied dual-task conditions. Additionally, theoretical synthesis of the literature demonstrated that other gait and balance variables are changed by performing cognitive and motor secondary tasks differently. Although these changes may be compensatory strategies to retain their stability, there was not sufficient evidence to reach a firm conclusion. Research gaps and recommendations for future studies are discussed.
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Affiliation(s)
- Meysam Roostaei
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Parvin Raji
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Bahman Razi
- Department of Hematology, School of Medicine, Tarbiat Modares University, Tehran, Iran.
| | - Khosro Khademi-Kalantari
- Department of Physiotherapy, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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