Effects of A Dual-Task Intervention in Postural Control and Cognitive Performance in Adolescents

Postural Control and Muscle Activity during Dual-Task in Young Adults

In everyday life, we recurrently perform two tasks simultaneously, which is called dual-tasking. A common dual task is smartphone use while standing or walking. According to previous studies, this task can compromise postural stability. However, few studies have analyzed lower limb muscle activity during dual-tasking using smartphones. This study aimed to assess the postural sway and muscle activity during dual-tasking in young adults. Thirty-six healthy young adults (23.08 ± 3.92 years) participated in this study. They performed a single task (ST: keeping a quiet standing posture) and a dual task (DT: keeping the ST while simultaneously performing a cognitive task on their smartphone). Postural sway was assessed through the center of pressure (CoP) analysis using a force platform: total CoP displacement, CoP displacement in the anterior-posterior and medial-lateral directions, mean total velocity of the CoP, mean velocity of the CoP in the anterior-posterior and medial-lateral directions, and 95% confidence ellipse sway area. A surface electromyography system recorded the muscle activity of the lumbar spinal erector and five muscles of the lower limb (bilaterally). The results showed an increase in postural sway from the ST to the DT in all CoP variables (p < 0.05), and muscle activity in most muscles analyzed decreased from the ST to the DT (p < 0.05). In conclusion, our results reflect a decentralization of attention from motor performance once postural sway increased and muscle activity decreased in dual-task conditions.

Cognitive CAMSA: an ecological proposal to integrate cognitive performance into motor competence assessment

Purpose

To profile the participants using a system of self-organizing maps (SOM) based on their motor and cognitive performance during a dual-task version of the Canadian Agility and Movement Skill Assessment (Cognitive CAMSA).

Methods

A total of 169 secondary school students (39.3% girls) volunteered to participate. The original CAMSA, cognitive CAMSA, the Corsi and Digit Span tests were used to assess (a) motor competence, (b) motor competence with cognitive load, and (c) cognitive performance, respectively. SOMs and the k-means clustering algorithm were used to establish the adolescents' dual-task performance profiles.

Results

Including decision making based on verbal and visual cues in the original CAMSA significantly increased the participants' total scores but also the time required to complete the test, while the skill score remained unchanged. However, not all the participants showed changes in their performance in the same direction during the cognitive CAMSA. Person-centered analyses by SOMs and k-means clustering identified six performance profiles with variations in the cognitive, motor skill, and time scores (H5 = 146.15, H5 = 102.68, and H5 = 108.07, respectively; all p < 0.01).

Conclusion

The cognitive CAMSA was shown to be a feasible field-motor test for assessing motor competence with a cognitive load in an ecological setting. Some of the profiles identified in the SOM approach represented adolescents with similar motor and cognitive performance in dual-task or single-task contexts, although other participants obtained high motor competence in single and dual-tasking while their cognitive performance declined or rose more in dual-task than in single task situations. The cognitive CAMSA emerges as a tool of great potential, applicable in educational and sports environments, to know subjects' characteristics and try to individualize the interventions accordingly with their dual-task profile.

Effectiveness of executive functioning training among heterogeneous adolescent samples: A systematic review

The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. A systematic review of the literature was conducted to retrieve and consolidate findings from articles evaluating executive functioning training techniques among adolescents. A total of 26 articles were located that examined the role of executive functioning training techniques among adolescents (age 10-19 years). Articles retrieved enabled comparison across psychiatric and medical diagnoses including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as adolescents with physical health concerns. Results revealed that among typically developing adolescents, executive functioning training was non-significant or yielded small effect size improvements in executive functioning as measured by behavioral and neuroimaging tasks among 62.5% of studies reviewed. In contrast, in those with medical conditions, ASD, ADHD, and conduct disorder, all but two studies reviewed yielded a medium to large effect size, supporting the effectiveness of EF training. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.

Linking Pain and Motor Control: Conceptualization of Movement Deficits in Patients With Painful Conditions

When people experience or expect pain, they move differently. Pain-altered movement strategies, collectively described here as pain-related movement dysfunction (PRMD), may persist well after pain resolves and, ultimately, may result in altered kinematics and kinetics, future reinjury, and disability. Although PRMD may manifest as abnormal movements that are often evident in clinical assessment, the underlying mechanisms are complex, engaging sensory-perceptual, cognitive, psychological, and motor processes. Motor control theories provide a conceptual framework to determine, assess, and target processes that contribute to normal and abnormal movement and thus are important for physical therapy and rehabilitation practice. Contemporary understanding of motor control has evolved from reflex-based understanding to a more complex task-dependent interaction between cognitive and motor systems, each with distinct neuroanatomic substrates. Though experts have recognized the importance of motor control in the management of painful conditions, there is no comprehensive framework that explicates the processes engaged in the control of goal-directed actions, particularly in the presence of pain. This Perspective outlines sensory-perceptual, cognitive, psychological, and motor processes in the contemporary model of motor control, describing the neural substrates underlying each process and highlighting how pain and anticipation of pain influence motor control processes and consequently contribute to PRMD. Finally, potential lines of future inquiry-grounded in the contemporary model of motor control-are outlined to advance understanding and improve the assessment and treatment of PRMD.

IMPACT

This Perspective proposes that approaching PRMD from a contemporary motor control perspective will uncover key mechanisms, identify treatment targets, inform assessments, and innovate treatments across sensory-perceptual, cognitive, and motor domains, all of which have the potential to improve movement and functional outcomes in patients with painful conditions.

Effects of cognitive-motor dual task training on cognitive and physical performance in healthy children and adolescents: A scoping review

Simultaneous dual- or multitasking training has been used in manifold ways to improve cognitive-motor performance in different age groups. Dual task (DT) training is assumed to improve both, single task (ST) motor and cognitive performance, but particularly, performance under dual tasking conditions. Further, DT interventions have been shown to be beneficial for motor skill learning and cognitive performance as well as academic achievements in children and adolescents. The aim of this scoping review was to summarize current evidence on different cognitive-motor interventions that practice motor and cognitive performance simultaneously in children and adolescents and to identify training regimes that are most effective to improve cognitive or motor performance in this target group.

METHODS

Four electronic databases were searched (Pubmed, MEDLINE, Web of Science and APA Psycinfo) until May 2021. Following the PRISMA guidelines, title, abstract, and full-text screening as well as quality assessment was done by two independent reviewers. Studies were eligible if they (1) were published in English or German language, (2) accessible as a full-text version, (3) included at least one group of children or adolescents with a mean age of 4 to 21 years, (4) used dual-tasks as part of the intervention, (5) conducted one or more training sessions, and (6) reported at least one cognitive or motor outcome. The main outcome measures were cognitive and motor as well as cognitive-motor DT performance. Due to the heterogeneity in the characteristics of the included studies, we designed this review as a scoping review.

RESULTS

Seven studies met the inclusion criteria (n = 543, age four to 14 years, 47.1% female). One study reported two intervention experiments. Studies differed in sample size (20-189) as well as in type of training (specific or general DT training) and dose (frequency: one session/week to 110 sessions within 22 weeks). Overall, task-specific improvements in physical and cognitive functions were found, but not consistently across all interventions. Two interventions out of five interventions that measured motor performance demonstrated improvement in that domain, especially in balance. Three out of five interventions that measured cognitive functions found improved cognition. Only one study examined DT performance post training but failed to gain significant improvements in comparison to a control group. Studies only occasionally integrated training principles like individualization or progression in the design of their intervention.

DISCUSSION

The results indicate that DT training interventions may improve physical and/or cognitive functions in children and adolescents. Best practice recommendations for training regimes cannot be derived as outcomes differed a lot and were not systematically assessed across studies. Future studies should integrate more principles of training monitoring and aspects like individualization and progression to provide ideal training control and achieve better DT training results. Further, more high-quality trials are needed that adhere to the previous concepts.

PSYCINFO CLASSIFICATION

2340 Cognitive Processes 2820 Cognitive & Perceptual Development. 3720 Sports.

Comparison of postural control in older adults under different dual-task conditions: A cross-sectional study

BACKGROUND

and purpose: Performing a cognitive task while maintaining postural stability, known as "dual-task" condition, can increase the cognitive demand and reduce the postural control capacity. The inability to allocate attention to postural control under dual-task conditions may lead to balance impairments, particularly in older adults. The present study aimed to compare the effects of different dual-task conditions of backward counting (BC) and visual attention (VA) on older adults' postural balance performance.

METHODS

Twenty asymptomatic volunteers (mean age: 70.4 ± 4.1 years) were recruited. Participants stood on a foam surface placed over a force plate, and displacement and sway velocity of their center of pressure (COP) in anterior-posterior (AP) and medial-lateral (ML) directions were recorded under three conditions: BC dual-task, VA dual-task (control of center of mass with a laser pointer), and quiet stance as the control task (CT).

RESULTS

Repeated measures ANOVA showed a significant difference in AP and ML sway velocities between conditions with p-values of 0.039 and 0.042, respectively. The LSD post-hoc test revealed that the BC task significantly increased AP sway velocity compared to the CT (p = 0.013), and the VA task significantly increased ML sway velocity compared to the CT (p = 0.034) and the BC tasks (p = 0.026). There were no statistically significant differences between conditions for ML (p = 0.058) and AP (p = 0.350) displacements and total sway velocity (p = 0.051).

CONCLUSION

Older adults' postural stability can be impaired under dual-task conditions and the present study revealed that various dual tasks increase postural sway in different directions.

Impact of Visual Biofeedback of Trunk Sway Smoothness on Motor Learning during Unipedal Stance

The assessment of trunk sway smoothness using an accelerometer sensor embedded in a smartphone could be a biomarker for tracking motor learning. This study aimed to determine the reliability of trunk sway smoothness and the effect of visual biofeedback of sway smoothness on motor learning in healthy people during unipedal stance training using an iPhone 5 measurement system. In the first experiment, trunk sway smoothness in the reliability group (n = 11) was assessed on two days, separated by one week. In the second, the biofeedback group (n = 12) and no-biofeedback group (n = 12) were compared during 7 days of unipedal stance test training and one more day of retention (without biofeedback). The intraclass correlation coefficient score 0.98 (0.93–0.99) showed that this method has excellent test–retest reliability. Based on the power law of practice, the biofeedback group showed greater improvement during training days (p = 0.003). Two-way mixed analysis of variance indicates a significant difference between groups (p < 0.001) and between days (p < 0.001), as well as significant interaction (p < 0.001). Post hoc analysis shows better performance in the biofeedback group from training days 2 and 7, as well as on the retention day (p < 0.001). Motor learning objectification through visual biofeedback of trunk sway smoothness enhances postural control learning and is useful and reliable for assessing motor learning.