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Nada N, El-Gohary MM, Essawy WM. The effect of increased listening effort on the balance performance of patients with compensated vestibular lesion. Auris Nasus Larynx 2024; 51:492-500. [PMID: 38522352 DOI: 10.1016/j.anl.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 03/26/2024]
Abstract
OBJECTIVES This study investigated the effects of listening effort (LE) on balance in patients with compensated vestibular deficits compared to healthy peers. METHODS The subjects included two main groups: a control group of 15 healthy subjects and a study group of 19 patients with compensated vestibular pathology. The computerized dynamic posturography test (CDP) was conducted without the speech-in-noise task as a baseline, then the participant was subjected to a dual task in which the auditory task (speech-in-noise sentences) was given as the primary task, and the balance function test was the secondary task. RESULTS WITHIN-GROUP ANALYSIS: The study group showed statistically significantly worse values of all body balance parameters under dual-task than the baseline in all conditions. These differences were much higher under the compliant platform conditions. However, these findings were not statistically significant in the control group. BETWEEN-GROUP ANALYSIS The study group showed a statistically significant decline in body balance reactions compared to the control group under dual-task with increased listening effort and the compliant platform. Study subgroup analysis revealed statistically significant differences between patients with unilateral vestibular loss (UVL) and those with bilateral vestibular loss (BVL) in the unstable platform condition. CONCLUSION Our study regarding implementing a dual-tasking paradigm as a measure of LE during the evaluation of chronic vestibular patients with CDP demonstrated how dual-tasking with increased LE affects postural stability. Because of this, patients will probably be more prone to tripping and falling in multitasking situations, as found in real-world settings. This fact should be taken into consideration while testing patients with chronic vertigo and compensated states at VNG. A dual-task paradigm helps uncover the unrevealed pathology.
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Affiliation(s)
- Nashwa Nada
- Department of Otolaryngology/Head and Neck Surgery, Audiovestibular Unit, Faculty of Medicine, Tanta University Hospital, El-Geish Street, Tanta, El-Gharbia 31511, Egypt.
| | | | - Wessam Mostafa Essawy
- Department of Otolaryngology/Head and Neck Surgery, Audiovestibular Unit, Faculty of Medicine, Tanta University Hospital, El-Geish Street, Tanta, El-Gharbia 31511, Egypt
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2
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Pitman J, Shannon J, MacLellan MJ, Vallis LA. Visual cue spatial context affects performance of anticipatory postural adjustments. Hum Mov Sci 2024; 95:103210. [PMID: 38531224 DOI: 10.1016/j.humov.2024.103210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/29/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
Past research indicates that anticipatory postural adjustment (APA) errors may be due to the incorrect selection of responses to visual stimuli. In the current study we used the Simon task as a methodological tool to challenge the response selection stage of processing by presenting visual cues with conflicting spatial context; in this case generating a step response to a left pointing arrow which appears to the participant's right side or vice versa. We expected greater mediolateral APA errors, delayed APA and step onset times, and greater lateral CoP displacement prior to stepping for visual cues with incongruent spatial contexts compared to cues with congruent. Thirteen healthy young adults completed step initiation trials (n = 40) from a force platform while whole-body kinematic motion was tracked. Participants were presented with arrows pointing to the left or right, indicating to step with the left or right limb, respectively. These arrows were presented on the same side as the desired step direction (congruent) or the opposite side (incongruent). Results revealed that incongruent trials resulted in significantly more incidences of mediolateral APA errors and greater mediolateral CoP deviations during the APA compared to congruent visual cue context trials. No effects were observed for the temporal outcomes, suggesting that young adults can maintain temporal execution of steps despite these motor control errors. This study demonstrates that the spatial context of visual information significantly impacts the success of response selection processes during step initiation, furthering our knowledge of how humans integrate visual information to initiate whole body movement.
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Affiliation(s)
- Jenna Pitman
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Julia Shannon
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Michael J MacLellan
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Lori Ann Vallis
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada.
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3
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Van Humbeeck N, Van Wilderode M, Kliegl R, van Wieringen A, Krampe RT. Multitasking across the lifespan in different task contexts. Sci Rep 2024; 14:11817. [PMID: 38783047 PMCID: PMC11116417 DOI: 10.1038/s41598-024-61859-w] [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: 12/06/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
We assessed lifespan development of multitasking in a sample of 187 individuals aged 8-82 years. Participants performed a visuo-spatial working memory (VSWM) task together with either postural control or reaction time (RT) tasks. Using criterion-referenced testing we individually adjusted difficulty levels for the VSWM task to control for single-task differences. Age-differences in single-task performances followed U-shaped patterns with young adults outperforming children and older adults. Multitasking manipulations yielded robust performance decrements in VSWM, postural control and RT tasks. Presumably due to our adjustment of VSWM challenges, costs in this task were small and similar across age groups suggesting that age-differential costs found in earlier studies largely reflected differences already present during single-task performance. Age-differences in multitasking costs for concurrent tasks depended on specific combinations. For VSWM and RT task combinations increases in RT were the smallest for children but pronounced in adults highlighting the role of cognitive control processes. Stabilogram diffusion analysis of postural control demonstrated that long-term control mechanisms were affected by concurrent VSWM demands. This interference was pronounced in older adults supporting concepts of compensation or increased cognitive involvement in sensorimotor processes at older age. Our study demonstrates how a lifespan approach can delineate the explanatory scope of models of human multitasking.
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Affiliation(s)
| | - Mira Van Wilderode
- Research Group Experimental Oto-Rhino-Laryngology, University of Leuven (KU Leuven), Leuven, Belgium
| | - Reinhold Kliegl
- Division of Training and Movement Sciences, University of Potsdam, Potsdam, Germany
| | - Astrid van Wieringen
- Research Group Experimental Oto-Rhino-Laryngology, University of Leuven (KU Leuven), Leuven, Belgium
- Dept of Special Needs Education, University of Oslo, Oslo, Norway
| | - Ralf T Krampe
- Brain & Cognition Group, University of Leuven (KU Leuven), Leuven, Belgium.
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4
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Winesett SP, Chatterjee SA, Borgia B, Cox BA, Hawkins KA, Miles JW, Swanson CW, Choi JT, Seidler RD, Fox EJ, Clark DJ. Visuospatial cognition predicts performance on an obstructed vision obstacle walking task in older adults. Exp Gerontol 2024; 189:112403. [PMID: 38490285 DOI: 10.1016/j.exger.2024.112403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024]
Abstract
Walking performance and cognitive function demonstrate strong associations in older adults, with both declining with advancing age. Walking requires the use of cognitive resources, particularly in complex environments like stepping over obstacles. A commonly implemented approach for measuring the cognitive control of walking is a dual-task walking assessment, in which walking is combined with a second task. However, dual-task assessments have shortcomings, including issues with scaling the task difficulty and controlling for task prioritization. Here we present a new assessment designed to be less susceptible to these shortcomings while still challenging cognitive control of walking: the Obstructed Vision Obstacle (OBVIO) task. During the task, participants hold a lightweight tray at waist level obstructing their view of upcoming foam blocks, which are intermittently spaced along a 10 m walkway. This forces the participants to use cognitive resources (e.g., attention and working memory) to remember the exact placement of upcoming obstacles to facilitate successful crossing. The results demonstrate that adding the obstructed vision board significantly slowed walking speed by an average of 0.26 m/s and increased the number of obstacle strikes by 8-fold in healthy older adults (n = 74). Additionally, OBVIO walking performance (a score based on both speed and number of obstacle strikes) significantly correlated with computer-based assessments of visuospatial working memory, attention, and verbal working memory. These results provide initial support that the OBVIO task is a feasible walking test that demands cognitive resources. This study lays the groundwork for using the OBVIO task in future assessment and intervention studies.
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Affiliation(s)
- Steven P Winesett
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
| | - Sudeshna A Chatterjee
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, USA
| | - Brianne Borgia
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA; Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Brigette A Cox
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Kelly A Hawkins
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA
| | - Jon W Miles
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Clayton W Swanson
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Julia T Choi
- Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Rachael D Seidler
- Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Emily J Fox
- Department of Physical Therapy, University of Florida, Gainesville, FL, USA; Brooks Rehabilitation, Jacksonville, FL, USA
| | - David J Clark
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Department of Neurology, University of Florida, Gainesville, FL, USA
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5
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Riedel N, Herzog M, Stein T, Deml B. Cognitive-motor interference during walking with modified leg mechanics: a dual-task walking study. Front Psychol 2024; 15:1375029. [PMID: 38699569 PMCID: PMC11063364 DOI: 10.3389/fpsyg.2024.1375029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/25/2024] [Indexed: 05/05/2024] Open
Abstract
Background The use of mobile exoskeletons as assistive walking devices has the potential to affect the biomechanics of the musculoskeletal system due to their weight and restricted range of motion. This may result in physical and cognitive load for the user. Understanding how lower extremity loading affects cognitive-motor interference is crucial for the design of wearable devices, including powered exoskeletons, and the development of effective training interventions. Objective This study aims to examine the effects of modified leg mechanics on cognitive-motor interference in dual-task walking. Gait variability, as an indicator of motor control, was analyzed to investigate its relation to cognitive task difficulty and to determine whether lower extremity loading modifies this relationship. Additionally, the impact on the gait pattern, as represented by the mean values of spatio-temporal gait parameters were investigated. Method Fifteen healthy young adults walked on a treadmill with and without weight cuffs bilaterally attached to their thighs and shanks while performing a visual-verbal Stroop test (simple task) and a serial subtraction task (difficult task). Dependent variables include mean values and variability (coefficients of variation) of step length, step width, stride time and double support time. Additionally, secondary task performance as correct response rates and perceived workload were assessed. Results Double support time variability decreased during dual-task walking, but not during walking with modified leg mechanics while performing the difficult secondary task. Walking with modified leg mechanics resulted in increased gait variability compared to normal walking, regardless of cognitive load. During walking with modified leg mechanics, step length, step width, and stride time increased, while double support time decreased. The secondary tasks did not affect the gait pattern. Conclusion The interplay between an external focus of attention and competition for attentional resources may influence the variability of double support time. The findings suggest that walking with modified leg mechanics could increase cognitive-motor interference for healthy young adults in demanding dual-task situations. Therefore, it is important to analyze the underlying mechanisms of cognitive-motor interference in the context of human-exoskeleton interaction.
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Affiliation(s)
- Norman Riedel
- Institute of Human and Industrial Engineering, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Michael Herzog
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Barbara Deml
- Institute of Human and Industrial Engineering, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Jackson KM, Thayer SC, Simpson KL, Shaw TH, McKnight PE, Helton WS. Swimming with a head-mounted display: dual-task costs. ERGONOMICS 2024:1-10. [PMID: 38613402 DOI: 10.1080/00140139.2024.2339436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/31/2024] [Indexed: 04/14/2024]
Abstract
Head-up displays (HUDs) have the potential to change work in operation environments by providing hands-free information to wearers. However, these benefits may be accompanied by trade-offs, primarily by increasing cognitive load due to dividing attention. Previous studies have attempted to understand the trade-offs of HUD usage; however, all of which were focused on land-based tasks. A gap in understanding exists when examining HUD use in aquatic environments as immersion introduces unique environmental and physiological factors that could affect multitasking. In this study, we investigated multitasking performance associated with swimming with a HUD. Eighteen participants completed three tasks: swimming only, a HUD-administered word recall task, and a dual-task combining both tasks. Results revealed significant dual-task interference in both tasks, though possibly less pronounced than in land-based tasks. These findings enhance not only help characterise dual-task performance, but also offer valuable insights for HUD design for aquatic settings.
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Affiliation(s)
- Kenneth M Jackson
- Department of Psychology, George Mason University, Fairfax, VA, USA
- Health and Human-Machine Systems Group, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA
| | - Sean C Thayer
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | | | - Tyler H Shaw
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | | | - William S Helton
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Boebinger S, Payne A, Martino G, Kerr K, Mirdamadi J, McKay JL, Borich M, Ting L. Precise cortical contributions to sensorimotor feedback control during reactive balance. PLoS Comput Biol 2024; 20:e1011562. [PMID: 38630803 PMCID: PMC11057980 DOI: 10.1371/journal.pcbi.1011562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/29/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
The role of the cortex in shaping automatic whole-body motor behaviors such as walking and balance is poorly understood. Gait and balance are typically mediated through subcortical circuits, with the cortex becoming engaged as needed on an individual basis by task difficulty and complexity. However, we lack a mechanistic understanding of how increased cortical contribution to whole-body movements shapes motor output. Here we use reactive balance recovery as a paradigm to identify relationships between hierarchical control mechanisms and their engagement across balance tasks of increasing difficulty in young adults. We hypothesize that parallel sensorimotor feedback loops engaging subcortical and cortical circuits contribute to balance-correcting muscle activity, and that the involvement of cortical circuits increases with balance challenge. We decomposed balance-correcting muscle activity based on hypothesized subcortically- and cortically-mediated feedback components driven by similar sensory information, but with different loop delays. The initial balance-correcting muscle activity was engaged at all levels of balance difficulty. Its onset latency was consistent with subcortical sensorimotor loops observed in the lower limb. An even later, presumed, cortically-mediated burst of muscle activity became additionally engaged as balance task difficulty increased, at latencies consistent with longer transcortical sensorimotor loops. We further demonstrate that evoked cortical activity in central midline areas measured using electroencephalography (EEG) can be explained by a similar sensory transformation as muscle activity but at a delay consistent with its role in a transcortical loop driving later cortical contributions to balance-correcting muscle activity. These results demonstrate that a neuromechanical model of muscle activity can be used to infer cortical contributions to muscle activity without recording brain activity. Our model may provide a useful framework for evaluating changes in cortical contributions to balance that are associated with falls in older adults and in neurological disorders such as Parkinson's disease.
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Affiliation(s)
- Scott Boebinger
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, United States of America
| | - Aiden Payne
- Department of Psychology, Florida State University, Tallahassee, Florida, United States of America
| | - Giovanni Martino
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Kennedy Kerr
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, United States of America
| | - Jasmine Mirdamadi
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States of America
| | - J. Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, United States of America
- Departments of Biomedical Informatics and Neurology, Emory University, Atlanta, Georgia, United States of America
| | - Michael Borich
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, United States of America
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Lena Ting
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, United States of America
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia, United States of America
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Benjamin RS, Cushing SL, Blakeman AW, Campos JL, Papsin BC, Gordon KA. Effects of the BalanCI on Working Memory and Balance in Children and Young Adults With Cochleovestibular Dysfunction. Ear Hear 2024; 45:378-389. [PMID: 37759357 DOI: 10.1097/aud.0000000000001433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
OBJECTIVES This study aimed to: (1) determine the interaction between cognitive load and balance in children and young adults with bilateral cochleovestibular dysfunction who use bilateral cochlear implants (CIs) and (2) determine the effect of an auditory balance prosthesis (the BalanCI) on this interaction. Many (20 to 70%) children with sensorineural hearing loss experience some degree of vestibular loss, leading to poorer balance. Poor balance could have effects on cognitive resource allocation which might be alleviated by the BalanCI as it translates head-referenced cues into electrical pulses delivered through the CI. It is hypothesized that children and young adults with cochleovestibular dysfunction will demonstrate greater dual-task costs than typically-developing children during dual balance-cognition tasks, and that BalanCI use will improve performance on these tasks. DESIGN Study participants were 15 typically-developing children (control group: mean age ± SD = 13.6 ± 2.75 years, 6 females) and 10 children and young adults who use bilateral CIs and have vestibular dysfunction (CI-V group: mean age ± SD=20.6 ± 5.36 years, 7 females). Participants completed two working memory tasks (backward auditory verbal digit span task and backward visuospatial dot matrix task) during three balance conditions: seated, standing in tandem stance with the BalanCI off, and standing in tandem stance with the BalanCI on. Working memory performance was quantified as total number of correct trials achieved. Postural stability was quantified as translational and rotational path length of motion capture markers worn on the head, upper body, pelvis, and feet, normalized by trial time. RESULTS Relative to the control group, children and young adults in the CI-V group exhibited poorer overall working memory across all balance conditions ( p = 0.03), poorer translational postural stability (larger translational path length) during both verbal and visuospatial working memory tasks ( p < 0.001), and poorer rotational stability (larger rotational path length) during the verbal working memory task ( p = 0.026). The CI-V group also exhibited poorer translational ( p = 0.004) and rotational ( p < 0.001) postural stability during the backward verbal digit span task than backward visuospatial dot matrix task; BalanCI use reduced this stability difference between verbal and visuospatial working memory tasks for translational stability overall ( p > 0.9), as well as for rotational stability during the maximum working memory span (highest load) participants achieved in each task ( p = 0.91). CONCLUSIONS Balance and working memory were impaired in the CI-V group compared with the control group. The BalanCI offered subtle improvements in stability in the CI-V group during a backward verbal working memory task, without producing a negative effect on working memory outcomes. This study supports the feasibility of the BalanCI as a balance prosthesis for individuals with cochleovestibular impairments.
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Affiliation(s)
- Rebecca S Benjamin
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Cushing
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Alan W Blakeman
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer L Campos
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Blake C Papsin
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Karen A Gordon
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
- Archie's Cochlear Implant Laboratory, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Communication Disorders, Hospital for Sick Children, Toronto, Ontario, Canada
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Van Criekinge T, Sahu U, Bhatt T. Effect of Explicit Prioritization on Dual Tasks During Standing and Walking in People With Neurologic and Neurocognitive Disorders: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2024:S0003-9993(24)00824-4. [PMID: 38401769 DOI: 10.1016/j.apmr.2024.02.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVES To examine the effectiveness of explicit task (ie, equal, motor or cognitive) prioritization during dual tasking (DT) in adults with neurologic and neurocognitive disorders (stroke, Parkinson disease [PD], multiple sclerosis, dementia, Alzheimer disease, and mild cognitive impairment). DATA SOURCE A systematic search in 4 databases (PubMed, Web of Science, Embase, and Cochrane Central) yielded 1138 unique studies published up to 2023. STUDY SELECTION Forty-one experimental studies were selected that assessed the effect of explicit prioritization instructions on both motor and cognitive performance during dual-tasks related to standing and walking in selected populations. Primary outcome measures were walking speed and response accuracy. Availability of data allowed us to perform a meta-analysis on 27 of the 41 articles by using inverse variance with a random effects model. DATA EXTRACTION The data including design, subject characteristics, motor and cognitive tasks, prioritization, motor and cognitive outcomes, instructions, and key findings were extracted. Two assessors rated the selected studies for risk of bias and quality using the Quality Assessment Tools of the National Institutes of Health. DATA SYNTHESIS This study examined 1535 adults who were asked to perform motor-cognitive DT in standing or walking, including 381 adults with stroke, 526 with PD, 617 with multiple sclerosis, 10 with dementia, 9 with Alzheimer disease, and 8 with mild cognitive impairment. During all prioritization instructions, participants slowed down during DT (standardized mean difference (SMD)equal=0.43; SMDmotor=0.78; SMDcognitive=0.69, P<.03) while maintaining similar response accuracy (SMDequal=0.12; SMDmotor=0.23; SMDcognitive=-.01, P>.05). However, considerable between-group heterogeneity was observed resulting in different motor and cognitive responses between pathologies. CONCLUSION Motor prioritization was achieved in adults with PD and stroke, unlike adults with neurocognitive disorders who were negatively affected by any type DT prioritizing. The reported within-group heterogeneity revealed that effects of explicit task prioritization are dependent on motor and cognitive task complexity, and the type of instructions. Recommendations are provided to ensure accurate use of instructions during DT paradigms.
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Affiliation(s)
| | - Upasana Sahu
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL
| | - Tanvi Bhatt
- Department of Physical Therapy, College of Applied Health and Sciences, University of Illinois at Chicago, Chicago, IL.
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Emami F, Negahban H, Sinaei E, Mostafaee N, Shahtahmassebi B, Ebrahimzadeh MH, Mehravar M. The Effects of Various Cognitive Tasks Including Working Memory, Visuospatial, and Executive Function on Postural Control in Patients With Anterior Cruciate Ligament Injury. Motor Control 2024:1-17. [PMID: 38253046 DOI: 10.1123/mc.2023-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
Anterior cruciate ligament (ACL) rupture can impair balance performance, particularly during cognitive motor dual-tasks. This study aimed to determine the effects of various modalities of cognitive load (working memory, and visuospatial and executive function) on postural control parameters in individuals with ACL injury. Twenty-seven ACL-injured and 27 healthy participants were evaluated doing different cognitive tasks (silent backward counting, Benton's judgment of line orientation, and Stroop color-word test) while standing on a rigid surface or a foam. Each task was repeated three times and then averaged. Center of pressure variables used to measure postural performance included sway area and sway velocity in anterior-posterior and medial-lateral directions. Cognitive performance was also assessed by calculating errors and the score of cognitive tasks. A mixed model analysis of variance for center of pressure parameters indicated that patients had more sways than the healthy group. The interaction of group by postural difficulty by cognitive tasks was statistically significant for cognitive errors (p < .01), and patients with ACL injury indicated more cognitive errors compared to healthy controls while standing on the foam. The main effect of cognitive task was statistically significant for all postural parameters, representing reduced postural sways in both groups with all cognitive tasks. However, ACL-injured patients showed more cognitive errors in difficult postural conditions, suggesting that individuals with ACL injury may prioritize postural control over cognitive task accuracy and adopt the posture-first strategy to maintain balance under dual-task conditions.
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Affiliation(s)
- Fatemeh Emami
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Sinaei
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Mostafaee
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behnaz Shahtahmassebi
- Sport Injuries and Corrective Movements Department, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Mohammad Mehravar
- Musculoskeletal Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Noll WP, Phan V, Lee H. Modern smartphone usage can negatively impact postural balance while standing on dynamically challenging grounds. Gait Posture 2024; 107:233-239. [PMID: 37852884 DOI: 10.1016/j.gaitpost.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 04/16/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND While several studies have explored the impacts of smartphone usage on postural balance, their tasks are limited to texting or calling, and the studies were performed on rigid ground. RESEARCH QUESTIONS METHODS: Sixteen healthy young adults were recruited to perform two smartphone tasks: taking selfies and posting statuses on social media; participants were standing on four different grounds: rigid, foam-based compliant, robot-simulated compliant, and robot-simulated oscillatory grounds. The center-of-pressure (CoP) under each foot was recorded via force plates and the net CoP was calculated. Temporal, spatial, and control aspects of postural balance were analyzed by virtual time-to-contact (VTC), CoP path length (PL) and sway area (SA), and switching rate (SR), respectively. Two-way repeated measures analysis of variance (ANOVA) tests were performed for each dependent variable to compare the mean differences between smartphone tasks and ground conditions and their interaction effect. Paired t-tests with Bonferroni correction were used to determine significant differences in post-hoc analyses. RESULTS VTC decreased significantly whereas CoP PL and SA increased significantly during smartphone usage (all p-values <0.001). Interaction effects between task and ground condition (all p-values <0.001) were observed in all measures but SR, implying that the effect of smartphone usage on postural balance can significantly change depending on the ground condition. SIGNIFICANCE These results highlight the potential fall risks due to the impact of modern smartphone usage on standing balance. Understanding the effect of smartphone usage on standing balance and the interaction effect with various ground conditions opens the door for potential balance assistive devices and mobile phone applications to minimize falls.
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Affiliation(s)
- William P Noll
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, USA
| | - Vu Phan
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Hyunglae Lee
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA.
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12
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Rafiee Manesh V, Inanlu M, Yekaninejad MS, Khanmohammadi R. The effect of different types of cognitive tasks on postural sway fluctuations in older and younger adults: A nonlinear study. J Bodyw Mov Ther 2024; 37:63-69. [PMID: 38432843 DOI: 10.1016/j.jbmt.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/25/2023] [Accepted: 11/11/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND There are numerous types of cognitive tasks classified as mental tracking (MT), working memory (WM), reaction time (RT), discrimination and decision-making and verbal fluency (VF). However, limited studies have investigated the effects of cognitive task type on postural control in older adults. PURPOSE s: The aim of this study was to investigate the effect of aging and several types of cognitive tasks on postural control in terms of nonlinear analysis. METHOD Postural control was investigated under 6 conditions (single task and dual-task with RT; easy and difficult VF; easy and difficult WM; easy and difficult MT. Outcome measurements were the max Lyapunov, entropy, and correlation dimension at anteroposterior (AP) and mediolateral (ML) directions. RESULTS The results revealed that within the older group, the AP & ML max Lyapunov at dual-task with difficult WM and MT was significantly higher than all other conditions. In addition, the older group had lower AP entropy at dual-task with easy VF, difficult WM, and easy as well as difficult MT. CONCLUSION The results can be useful to understand the postural control mechanisms and to detect the alterations following aging and applying different types of cognitive tasks. In addition, the investigated parameters can be a basis for identifying postural control deficiencies.
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Affiliation(s)
- Vahid Rafiee Manesh
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Inanlu
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Khanmohammadi
- Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
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13
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Atakanova A, Laurentius T, Bollheimer C, Hildebrand F, Siebers HL. Does listening to audiobooks affect gait behavior? BMC Sports Sci Med Rehabil 2023; 15:159. [PMID: 38001528 PMCID: PMC10675893 DOI: 10.1186/s13102-023-00773-6] [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: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The effect of listening to audiobooks, podcasts, and other audio files while walking on gait performance has not been well studied. Although the number of audio users is growing annually. Evidence suggests that a posture-first strategy contributes to gait stability in healthy individuals during dual-task conditions, but this effect may be diminished when the cognitive task is consciously prioritized. OBJECTIVES To study the effect of listening to an audiobook while walking, as a daily life-like dual-task, on spatiotemporal gait parameters. METHODS Forty young healthy (24.05 ± 3.66) subjects participated in the study. Spatiotemporal gait parameters were measured for 5 min on a treadmill once without (single-task) and once while listening to an audiobook through over-ear headphones (dual-task). Measured parameters included spatiotemporal parameters, gait phases, maximum pressure, and dual-task cost. Data were statistically analyzed using SPSS software. RESULTS There were no significant differences in any of the studied parameters between the single- and dual-task conditions, even though the subjective cognitive load of listening to audiobooks while walking was high. However, participants with different habits had significant differences in gait phases and maximum pressure. Rare listeners had a shorter stance phase, a longer swing phase, and a higher maximum pressure on the dominant heel. They also had significant differences in dual-task costs. CONCLUSION No differences in the spatiotemporal gait parameters for walking with and without listening to audiobooks, as a daily life-like dual-task, were observed. However, the difference between participants who listened rarely and participants who listened often may confirm the "posture first" strategy in young healthy people. TRIAL REGISTRATION DRKS00025837, retrospectively registered on 23.11.2021.
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Affiliation(s)
- Aisuluu Atakanova
- Department of Geriatric Medicine, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Thea Laurentius
- Department of Geriatric Medicine, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Cornelius Bollheimer
- Department of Geriatric Medicine, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, Aachen, Germany
| | - Hannah Lena Siebers
- Department of Orthopedics, Trauma and Reconstructive Surgery, Uniklinik RWTH Aachen, Aachen, Germany
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14
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Hume PA, Lewis GN, Brown SR, Rashid U, Theadom A, Taylor D. NZ-RugbyHealth Study: Current Postural Control Ability of Former Rugby Union and Non-contact Sport Players. Sports Med 2023; 53:2257-2266. [PMID: 37209367 DOI: 10.1007/s40279-023-01864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Players in contact sports frequently experience mild traumatic brain (concussion) injuries (TBI). While there are known disruptions to balance following acute head trauma, it is uncertain if sport-related concussion injuries have a lasting impact on postural control. AIM To assess postural control in retired rugby players in comparison to retired non-contact sport players, and to evaluate any association with self-reported sport-related concussion history. METHODS Using a cross-sectional design, 75 players in the NZ-RugbyHealth study from three sports groups (44 ± 8 years; 24 elite rugby, 30 community rugby, 21 non-contact sport) took part in this study. The SMART EquiTest® Balance Master was used to assess participant's ability to make effective use of visual, vestibular and proprioceptive information using standardised tests. Postural sway was also quantified using centre of pressure (COP) path length. The relationship among sports group, sport-related concussion history and postural control was evaluated using mixed regression models while controlling for age and body mass index. RESULTS Limited significant differences in balance metrics were found between the sports groups. A statistically significant (p < 0.001) interaction indicated a relationship between COP path length and sport-related concussion history in the most challenging balance condition, such that path length increased as the number of previous sport-related concussions increased. CONCLUSION There was some evidence for a relationship between sport-related concussion recurrence in sports players and postural stability in challenging balance conditions. There was no evidence of impaired balance ability in retired rugby players compared with non-contact sport athletes.
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Affiliation(s)
- Patria A Hume
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
- Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand.
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
- Minderoo Tech & Policy Lab, The University of Western Australia, Perth, Australia.
| | - Gwyn N Lewis
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Scott R Brown
- Sports Performance Research Institute New Zealand, School of Sport and Recreation, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand
- Department of Kinesiology, Aquinas College, Grand Rapids, MI, USA
| | - Usman Rashid
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Alice Theadom
- Traumatic Brain Injury Network, Auckland University of Technology, Auckland, New Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
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15
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Azadian E, Dadgar SA, Majlesi M, Jafarnezhadgero AA, Jalilvand M, Bijarchian MH. The effects of cognitive intervention on inter-joint coordination during walking in the older adults with balance impairment. Gait Posture 2023; 106:72-79. [PMID: 37672966 DOI: 10.1016/j.gaitpost.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 04/07/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Cognitive interventions are among the effective training-on-gait parameters; however, the effects of such trainings on inter-joints coordination has not been much considered. RESEARCH QUESTION Can dual task and executive function training affect inter-joint coordination during walking in elderly with poor balance? METHODS Thirty elderly men were purposefully divided into three groups: 1) dual-task training group (DTG), 2) executive function training group (EFG) and 3) control group. After the pre-test, the experimental groups participated in 24 training sessions while the control group were required to do their normal daily tasks. VICON three-dimensional motion analysis system with four T20 series cameras was used to evaluate inter-joints coordination during the experiment. Participants had to walk a 12-meter path while kinematics of their joints was recorded. The inter-joint coordination at the sagittal plane and in four phases were assessed using the vector coding technique. RESULTS The findings of this study showed that the greatest effect of the intervention on the coordination between the joints was in the loading and mid-stance phases (p < 0.05). Also, the variability in the coupling angle showed a significant decrease in most phases (p < 0.05). SIGNIFICANCE Based on the obtained results, it can be argued that the loading and mid-stance are more involved in postural control and balance because the center of gravity is transferred between the legs and the person is normally on single-leg stance in these phases.
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Affiliation(s)
- Elaheh Azadian
- Department of Motor Behavior, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
| | | | - Mahdi Majlesi
- Department of Sport Biomechanics, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
| | - Amir Ali Jafarnezhadgero
- Department of Sport Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Mohammad Jalilvand
- Department of Motor Behavior, Hamedan Branch, Islamic Azad University, Hamedan, Iran.
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Nicoli G, Pavon G, Grayson A, Emerson A, Mitra S. Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities. Front Integr Neurosci 2023; 17:1181025. [PMID: 37600233 PMCID: PMC10434793 DOI: 10.3389/fnint.2023.1181025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.
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Affiliation(s)
- Giovanni Nicoli
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Giulia Pavon
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Andrew Grayson
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Anne Emerson
- Faculty of Social Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Suvobrata Mitra
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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Terry ME, Shulman D, Vallis LA. What Is the Role of Sustained Visual Attention in the Maintenance of Postural Control in Young Adults? Exp Psychol 2023; 70:232-240. [PMID: 37946454 DOI: 10.1027/1618-3169/a000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Dual tasks requiring sustained visual attention and upright stance are common, yet their impact on standing balance is not well understood. We investigated the role of visual attention in the maintenance of postural control, using the multiple-object tracking (MOT) task. Healthy young adults (n = 12) performed the MOT task at three object movement speeds while seated or standing. MOT performance was assessed using tracking capacity (k). Metrics calculated to assess mediolateral (ML) and anterior-posterior (AP) postural control included: maximum difference between CoM and CoP position (CoM-CoP Max), root mean square distance for center of pressure and center of mass position (CoP and CoM RMS distance), and correlation between CoM and CoP time series signals (CoM/CoP correlation). As predicted, k decreased significantly as object movement speed increased for both standing and seated conditions. Object movement speed also significantly affected AP CoM-CoP Max in seated conditions (p = .021) and AP CoM/CoP correlation for standing conditions (p = .002). The results demonstrate utility of the MOT task in understanding the role of visual attention in postural control, even though healthy young adults were able to compensate for the addition of a sustained visual attention task, with minimal deficits to postural control.
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Affiliation(s)
- Mallory E Terry
- Department of Psychology, University of Guelph, Ontario, Canada
| | - David Shulman
- Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, Canada
| | - Lori Ann Vallis
- Department of Human Health and Nutritional Sciences, University of Guelph, Ontario, Canada
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18
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Borji R, Laatar R, Zarrouk N, Sahli S, Rebai H. Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104562. [PMID: 37379660 DOI: 10.1016/j.ridd.2023.104562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AIMS This study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). METHODS AND PROCEDURES Fifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. OUTCOMES AND RESULTS In the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. CONCLUSION Adolescents with DS are more prone to DT effects on postural balance than those with TD.
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Affiliation(s)
- Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - 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
| | - Nidhal Zarrouk
- 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
| | - Haithem Rebai
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
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Blakely MJ, Smith SL, Russell PN, Helton WS. Dual-task effects between tone counting and mathematical calculations. APPLIED ERGONOMICS 2023; 111:104052. [PMID: 37216771 DOI: 10.1016/j.apergo.2023.104052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023]
Abstract
We examined the impact of performing a tone counting task of varying cognitive loads and mathematical calculations simultaneously, compared to performance on the same tasks done individually. Participants performed continuous mathematical calculations, performed a high and a low cognitive load tone counting task, and also performed the math and counting tasks simultaneously. Performing the two tasks together resulted in significant dual-task interference. We also compared these results to previous studies employing the tone counting tasks with physically demanding tasks (climbing, kayaking and running). The interference between tone counting and mathematical calculations was worse than the interference between tone counting and running and kayaking. For climbing, the difference in interference was more nuanced with evidence indicating climbing uniquely asserts task prioritization. These findings have implications for operations requiring dual or multi-tasking.
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Affiliation(s)
- Megan J Blakely
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.
| | - Samantha L Smith
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, MI, USA
| | - Paul N Russell
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand
| | - William S Helton
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand; Department of Psychology, George Mason University, Fairfax, VA, USA.
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20
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Li Y, Yu N, Zhang C, Song Q, Wang J, Sun W. Test-retest reliability of kinematic and kinetic parameters during dual-task stair walking in the elderly. Front Physiol 2023; 14:1177159. [PMID: 37228826 PMCID: PMC10203527 DOI: 10.3389/fphys.2023.1177159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/13/2023] [Indexed: 05/27/2023] Open
Abstract
Objective: This study aims to evaluate the test-retest reliability of kinematics and kinetics during single and dual-task stair walking in the elderly. Methods: Fifteen healthy elderly adults were recruited. Kinematic and kinetic parameters were measured using an infrared motion analysis system (Vicon, Oxford Metrics Ltd., Oxford, United Kingdom) and force platforms (Switzerland, Kistler 9287BA and 9281CA). Participants were tested under single-task and dual-task (serial 3 subtractions or carrying a cup of water) conditions. Each participant completed two sessions on two separate days with a 1-week interval. Intraclass correlation coefficients (ICC), Pearson correlation coefficient (r), and Bland-Altman plot were used to assess the reliability of stair walking. Results: When ascending stairs, the ICC of kinematics and kinetics ranged from fair to excellent (ICC = 0.500-0.979) in the single and dual tasks, except for step length (ICC = 0.394) in the single task. The r value of kinematics and kinetics ranged from 0.704 to 0.999. When descending stairs, the ICC of kinematics and kinetics ranged from good to excellent (ICC = 0.661-0.963), except for min hip moment (ICC = 0.133) and min ankle moment (ICC = 0.057) in the manual task. The r value of kinematics and kinetics ranged from 0.773 to 0.960 in the single and dual tasks. In the Bland-Altman plots, all the zero values and most of the dots fell in the 95% confidence interval, and the mean difference was found to be close to zero for all the parameters during stair walking. Conclusion: These results obtained from this study show the good test-retest reliability of step cadence, step speed, and step width during single- and dual-task stair walking in the elderly, and the poor reliability of step length during ascending stairs. All the kinetic parameters, including min hip moment, max knee moment, and min ankle moment, had good test-retest reliability during single- and dual-task stair walking, but min hip moment and min ankle moment had poor reliability during manual-task descending stair. These results may help researchers in the assessment of biomechanics of dual-task stair walking in the elderly and to interpret the effect of interventions in this population.
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Affiliation(s)
- Yue Li
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Ning Yu
- School of Science, Shandong Jianzhu University, Jinan, China
| | - Cui Zhang
- Shandong Institute of Sports Science, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Jiangna Wang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
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21
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Laatar R, Kachouri H, Borji R, Ben Waer F, Rebai H, Sahli S. Dual-task affects postural balance performance in children with intellectual disability. Somatosens Mot Res 2023; 40:33-38. [PMID: 36524595 DOI: 10.1080/08990220.2022.2157389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Dual-task designs have been used to study the degree of automatic and controlled processing involved in postural balance. The aim of the present study was to explore postural balance performance during dual-task condition in children with intellectual disability compared to those with typical development. METHODS Fifteen children with intellectual disability aged from 7 to 12 years old and fifteen age-matched children with typical development participated in this study. Participants were asked to maintain static balance on a force platform during a baseline condition (single task) and while performing the Picture Recognition Memory Test (dual-task condition). RESULTS The results showed that dual-task similarly affects postural performance of both typically developing children and those with intellectual disability (p < .001). CONCLUSIONS Children with intellectual disability and children with typical development have difficulties in maintaining their balance when carrying out a concurrent cognitive task. Intellectual disability did not lead to a more strongly compromised balance performance in dual-task situation.
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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
| | - Hiba Kachouri
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Rihab Borji
- 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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Nikitas C, Kontogianni E, Papadopoulou S, Tsoukatos M, Kikidis D. Can vigilance predict the status of safe functional gait and risk of falls in patients with peripheral vestibular disorders? A cross-sectional study. J Neurol Sci 2023; 445:120547. [PMID: 36634581 DOI: 10.1016/j.jns.2023.120547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Peripheral vestibular disorders except from reflexes dysfunction correspond also to cognitive decline. The objectives of this cross-sectional study were to a) identify correlations among variables of functional gait, cognitive function, and perceived dizziness and b) explore variables that could be used as prognostic factors of functional gait in people with peripheral vestibular deficits. METHODS We recruited 154 people with peripheral vestibular deficits. The participants presented with moderate disability in terms of the Dizziness Handicap Inventory questionnaire (mean: 48.00, 95% confidence interval: 45.24-50.75), deficits in the Functional Gait Assessment test (mean: 22.75, 95% confidence interval: 22.13-23.40) and indication of mild cognitive impairment based on Montreal Cognitive Assessment tool (mean: 25.18, 95% confidence interval: 24.75-25.60). RESULTS Statistically significant correlations found among functional gait and gender, age, educational level, perceived level of disability and the total score of the Montreal Cognitive Assessment tool. Several components of the cognitive screening test (executive function, vigilance, language skills, verbal fluency) also correlated statistically significant with functional gait. Linear regression models revealed that age, perceived level of disability and vigilance significantly predicted functional gait variability (R2 = 0.350; p < 0.001) as well as high risk of falling, as indicated by a score on Functional Gait Assessment test <22/30 (R2 = 0.380). CONCLUSIONS Cognitive impairments affect functional gait in people with peripheral vestibular disorders. Thus, the integration of cognitive functional assessment must be considered as a prerequisite for functional assessment and designing rehabilitation programs that will include dual task training.
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Affiliation(s)
- Christos Nikitas
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece.
| | - Evangelia Kontogianni
- 1(st) Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Papadopoulou
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Michalis Tsoukatos
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Dimitris Kikidis
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
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Šömen MM, Peskar M, Wollesen B, Gramann K, Marusic U. Does Standing Up Enhance Performance on the Stroop Task in Healthy Young Adults? A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2319. [PMID: 36767687 PMCID: PMC9915369 DOI: 10.3390/ijerph20032319] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Understanding the changes in cognitive processing that accompany changes in posture can expand our understanding of embodied cognition and open new avenues for applications in (neuro)ergonomics. Recent studies have challenged the question of whether standing up alters cognitive performance. An electronic database search for randomized controlled trials was performed using Academic Search Complete, CINAHL Ultimate, MEDLINE, PubMed, and Web of Science following PRISMA guidelines, PICOS framework, and standard quality assessment criteria (SQAC). We pooled data from a total of 603 healthy young adults for incongruent and 578 for congruent stimuli and Stroop effect (mean age = 24 years). Using random-effects results, no difference was found between sitting and standing for the Stroop effect (Hedges' g = 0.13, 95% CI = -0.04 to 0.29, p = 0.134), even when comparing congruent (Hedges' g = 0.10; 95% CI: -0.132 to 0.339; Z = 0.86; p = 0.389) and incongruent (Hedges' g = 0.18; 95% CI: -0.072 to 0.422; Z = 1.39; p = 0.164) stimuli separately. Importantly, these results imply that changing from a seated to a standing posture in healthy young adults is unlikely to have detrimental effects on selective attention and cognitive control. To gain a full understanding of this phenomenon, further research should examine this effect in a population of healthy older adults, as well as in a population with pathology.
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Affiliation(s)
- Maja Maša Šömen
- Department of Psychology, Faculty of Arts, University of Ljubljana, Aškerčeva Cesta 2, 1000 Ljubljana, Slovenia
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva Ulica 1, 6000 Koper, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva Ulica 1, 6000 Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
| | - Bettina Wollesen
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
- Human Movement and Training Science, Institute of Human Movement Science, Psychology and Human Movement, University Hamburg, Turmweg 2, 20146 Hamburg, Germany
| | - Klaus Gramann
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Garibaldijeva Ulica 1, 6000 Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea—ECM, Slovenska Ulica 17, 2000 Maribor, Slovenia
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Mack M, Stojan R, Bock O, Voelcker-Rehage C. The association of executive functions and physical fitness with cognitive-motor multitasking in a street crossing scenario. Sci Rep 2023; 13:697. [PMID: 36639402 PMCID: PMC9839686 DOI: 10.1038/s41598-022-26438-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023] Open
Abstract
Age-related decline in cognitive-motor multitasking performance has been attributed to declines in executive functions and physical fitness (motor coordinative fitness and cardiovascular fitness). It has been suggested that those cognitive and physical resources strongly depend on lifestyle factors such as long-term regular physical activity and cognitive engagement. Although research suggests that there is covariation between components of executive functions and physical fitness, the interdependence between these components for cognitive-motor multitasking performance is not yet clear. The aim of the study was to examine the contribution and interrelationship between executive functions, motor coordinative fitness, and cardiovascular fitness on street crossing while multitasking. We used the more ecologically valid scenario to obtain results that might be directly transferable to daily life situation. Data from 50 healthy older adults (65-75 years, 17 females, recruited in two different cities in Germany) were analyzed. Participants' executive functions (composite score including six tests), motor coordinative fitness (composite score including five tests), and cardiovascular fitness (spiroergometry), as well as their street crossing performance while multitasking were assessed. Street crossing was tested under single-task (crossing a two-line road), and multitask conditions (crossing a two-line road while typing numbers on a keypad as simulation of mobile phone use). Street crossing performance was assessed by use of cognitive outcomes (typing, crossing failures) and motor outcomes (stay time, crossing speed). Linear mixed-effects models showed beneficial main effects of executive functions for typing (p = 0.004) and crossing failures (p = 0.023), and a beneficial main effect of motor coordinative fitness for stay time (p = 0.043). Commonality analysis revealed that the proportion of variance commonly explained by executive functions, motor coordinative fitness, and cardiovascular fitness was small for all street crossing outcomes. For typing and crossing failures (cognitive outcomes), the results further showed a higher relative contribution of executive functions compared to motor coordinative fitness and cardiovascular fitness. For stay time (motor outcome), the results correspondingly revealed a higher relative contribution of motor coordinative fitness compared to executive functions and cardiovascular fitness. The findings suggest that during cognitive-motor multitasking in everyday life, task performance is determined by the components of executive functions and physical fitness related to the specific task demands. Since multitasking in everyday life includes cognitive and motor tasks, it seems to be important to maintain both executive functions and physical fitness for independent living up to old age.
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Affiliation(s)
- Melanie Mack
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany
| | - Robert Stojan
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany.,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany
| | - Otmar Bock
- Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.,Institute of Exercise Training and Sport Informatics, German Sport University, Am Sportpark Muengersdorf 6, 50927, Cologne, Germany
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149, Muenster, Germany. .,Institute of Human Movement Science and Health, Chemnitz University of Technology, Thueringer Weg 11, 09126, Chemnitz, Germany.
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Jackson KM, Shaw TH, Helton WS. Evaluating the dual-task decrement within a simulated environment: Word recall and visual search. APPLIED ERGONOMICS 2023; 106:103861. [PMID: 35998391 DOI: 10.1016/j.apergo.2022.103861] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
Simulated environments have become better able to replicate the real world and can be used for a variety of purposes, such as testing new technology without any of the costs or risks associated with working in the real world. Because of this, it is now possible to gain a better understanding of cognitive demands when working in operational environments, where individuals are often required to multitask. Multitasking often results in performance decrements, where adding more tasks can cause a decrease in performance in each of the individual tasks. However, little research investigated multitasking performance in simulated environments. In the current study we examined how multitasking affects performance in simulated environments. Forty-eight participants performed a dual visual search and word memory task where participants were navigated through a simulated environment while being presented with words. Performance was then compared to single-task performance (visual search and word memory alone). Results showed that participants experienced significant dual-task interference when comparing the dual-tasks to the single-tasks and subjective measures confirmed these findings. These results could provide useful insight for the design of technology in operational environments, but also serve as an evaluation of MRT in simulated environments.
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Affiliation(s)
- Kenneth M Jackson
- Department of Psychology, George Mason University, Fairfax, VA, USA.
| | - Tyler H Shaw
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - William S Helton
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Salzman T, Tobón DP, Perreault H, Farhat F, Fraser S. Using Cognitive-Motor Dual-Tasks and Functional Near-Infrared Spectroscopy to Characterize Older Adults with and without Subjective Cognitive Decline. J Alzheimers Dis 2023; 95:1497-1508. [PMID: 37718810 DOI: 10.3233/jad-230469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) refers to individuals who report persistent cognitive deficits but perform normally on neuropsychological tests. Performance may be facilitated by increased prefrontal cortex activation, known as neural compensation, and could be used to differentiate between older adults with and without SCD. OBJECTIVE This cross-sectional pilot study measured changes in the hemodynamic response (ΔHbO2) using functional near-infrared spectroscopy (fNIRS) as well as cognitive and motor performance during fine and gross motor dual-tasks in older adults with and without SCD. METHODS Twenty older adults over 60 years old with (n = 10) and without (n = 10) SCD were recruited. Two experiments were conducted using 1) gross motor walking and 2) fine motor finger tapping tasks that were paired with an n-back working memory task. Participants also completed neuropsychological assessments and questionnaires on everyday functioning. RESULTS Repeated measures ANOVAs demonstrated slower response times during dual-task gait compared to the single task (p = 0.032) and in the non-SCD group, slower gait speed was also observed in the dual compared to single task (p = 0.044). Response times during dual-task finger tapping were slower than the single task (p = 0.049) and greater ΔHbO2 was observed overall in the SCD compared to non-SCD group (p = 0.002). CONCLUSIONS Examining neural and performance outcomes revealed differences between SCD and non-SCD groups and single and dual-tasks. Greater brain activation during dual-task finger tapping may reflect neural compensation, which should be examined in a larger sample and longitudinally to better characterize SCD.
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Affiliation(s)
- Talia Salzman
- School of Human Kinetics University of Ottawa, Ottawa, Canada
| | - Diana P Tobón
- Electronics and Telecommunications Engineering Department, Universidad de Medellín, Medellín, Colombia
| | - Hannah Perreault
- Interdisciplinary School of Health Sciences University of Ottawa, Ottawa, Canada
| | - Farah Farhat
- Interdisciplinary School of Health Sciences University of Ottawa, Ottawa, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences University of Ottawa, Ottawa, Canada
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Chepisheva MK. Spatial orientation, postural control and the vestibular system in healthy elderly and Alzheimer's dementia. PeerJ 2023; 11:e15040. [PMID: 37151287 PMCID: PMC10162042 DOI: 10.7717/peerj.15040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/21/2023] [Indexed: 05/09/2023] Open
Abstract
Background While extensive research has been advancing our understanding of the spatial and postural decline in healthy elderly (HE) and Alzheimer's disease (AD), much less is known about how the vestibular system contributes to the spatial and postural processing in these two populations. This is especially relevant during turning movements in the dark, such as while walking in our garden or at home at night, where the vestibular signal becomes central. As the prevention of falls and disorientation are of serious concern for the medical service, more vestibular-driven knowledge is necessary to decrease the burden for HE and AD patients with vestibular disabilities. Overview of the article The review briefly presents the current "non-vestibular based" knowledge (i.e. knowledge based on research that does not mention the "vestibular system" as a contributor or does not investigate its effects) about spatial navigation and postural control during normal healthy ageing and AD pathology. Then, it concentrates on the critical sense of the vestibular system and explores the current expertise about the aspects of spatial orientation and postural control from a vestibular system point of view. The norm is set by first looking at how healthy elderly change with age with respect to their vestibular-guided navigation and balance, followed by the AD patients and the difficulties they experience in maintaining their balance or during navigation. Conclusion Vestibular spatial and vestibular postural deficits present a considerable disadvantage and are felt not only on a physical but also on a psychological level by all those affected. Still, there is a clear need for more (central) vestibular-driven spatial and postural knowledge in healthy and pathological ageing, which can better facilitate our understanding of the aetiology of these dysfunctions. A possible change can start with the more frequent implementation of the "vestibular system examination/rehabilitation/therapy" in the clinic, which can then lead to an improvement of future prognostication and disease outcome for the patients.
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Abstract
The effect of different human body part stimuli in mental rotation tasks (MRTs) on postural stability was investigated in two dual-task experiments. There were significant differences within egocentric MRTs (Experiment 1, N = 46): Hand and foot stimuli tended to cause more body sway than whole-body figures and showed increased body sway for higher rotation angles in the MRTs. In object-based MRTs (Experiment 2, N = 109) different stimuli did not evoke different levels of body sway, but higher rotation angles led to higher body sway. Both experiments showed a stabilizing effect of MRTs compared to the control condition. Exploratorily analyses identified reaction time in MRTs as a significant predictor of body sway. The results suggest a heterogeneous impact of mental rotation on postural stability.
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Affiliation(s)
- Philipp Hofmann
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Leonardo Jost
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Petra Jansen
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
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Jackson KM, Shaw TH, Helton WS. The effects of dual-task interference on visual search and verbal memory. ERGONOMICS 2023; 66:125-135. [PMID: 35361042 DOI: 10.1080/00140139.2022.2061053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
The operational costs of multitasking are more pressing given the increase in wearable technologies (head-up displays; HUDs) that facilitate multitasking. Often multitasking comes with performance costs, where the addition of more tasks impairs the performance of the tasks. The current study explored the extent to which multitasking interference can be characterised in simulated environments, as opposed to risky and harsh environments in real operational contexts. Forty-eight participants completed several trials where they performed a visual search task while navigating a simulated environment. There were three conditions: a standalone memory task, a standalone search task, and both tasks simultaneously. Results revealed significant dual-task interference when comparing the dual-task to each of the single-tasks. Results were corroborated by subjective workload and stress metrics. The results could prove useful for designing systems for individuals who routinely multitask in operational environments. Specifically, by furthering the understanding of their performance capabilities and trade-offs due to multitasking.Practitioner summary: Due to the demands of multitasking in operational environments, quantifying the degree of information lost on each task individually will aid in the understanding of the deficits of multitasking performance. This study shows that deficits in multi-tasking (via a HUD) can be understood in simulated environments to a similar degree as real-world tasks.
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Affiliation(s)
| | - Tyler H Shaw
- Department of Psychology, George Mason University, Fairfax, VA, USA
| | - William S Helton
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Chen Y, Wan A, Mao M, Sun W, Song Q, Mao D. Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults. Front Aging Neurosci 2022; 14:1000427. [PMID: 36466597 PMCID: PMC9716214 DOI: 10.3389/fnagi.2022.1000427] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/31/2022] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND With aging, the cognitive function of the prefrontal cortex (PFC) declined, postural control weakened, and fall risk increased. As a mind-body exercise, regular Tai Chi practice could improve postural control and effectively prevent falls; however, underlying brain mechanisms remained unclear, which were shed light on by analyzing the effect of Tai Chi on the PFC in older adults by means of functional near-infrared spectroscopy (fNIRS). METHODS 36 healthy older adults without Tai Chi experience were divided randomly into Tai Chi group and Control group. The experiment was conducted four times per week for 16 weeks; 27 participants remained and completed the experiment. Negotiating obstacle task (NOT) and negotiating obstacle with cognitive task (NOCT) were performed pre- and post-intervention, and Brodmann area 10 (BA10) was detected using fNIRS for hemodynamic response. A three-dimensional motion capture system measured walking speed. RESULTS After intervention in the Tai Chi group under NOCT, the HbO2 concentration change value (ΔHbO2) in BA10 was significantly greater (right BA10: p = 0.002, left BA10: p = 0.001), walking speed was significantly faster (p = 0.040), and dual-task cost was significantly lower than pre-intervention (p = 0.047). ΔHbO2 in BA10 under NOCT was negatively correlated with dual-task cost (right BA10: r = -0.443, p = 0.021, left BA10: r = -0.448, p = 0.019). There were strong negative correlations between ΔHbO2 and ΔHbR under NOCT either pre-intervention (left PFC r = -0.841, p < 0.001; right PFC r = -0.795, p < 0.001) or post-intervention (left PFC r = -0.842, p < 0.001; right PFC r = -0.744, p < 0.001). CONCLUSION Tai Chi practice might increase the cognitive resources in older adults through the PFC bilateral activation to prioritize gait performance during negotiating obstacles under a dual-task condition.
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Affiliation(s)
- Yan Chen
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Aiying Wan
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Min Mao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Wei Sun
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Qipeng Song
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
| | - Dewei Mao
- College of Sport and Health, Shandong Sport University, Jinan, Shandong, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Baniasad M, Asheghan M, Ziya M, Holisaz MT. The effects of balance board on the balance parameters in five children with spastic cerebral palsy. J Pediatr Rehabil Med 2022; 16:149-156. [PMID: 36373298 DOI: 10.3233/prm-201526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study evaluated the effects of an instrumented balance board on the balance parameters in children with spastic cerebral palsy by carrying out a pilot single-group pre-post clinical trial. METHODS Five children aged 5 to 15 years with spastic diplegia and a Gross Motor Function Classification System level of I or II were included. All participants attended 20 sessions with an instrumented balance board, 45 minutes per session, 3 times a week for 7 weeks. The main outcome measures included the center of pressure excursion, velocity, and overshoot during quiet standing with open and closed eyes. The assessments were performed in the mediolateral and anteroposterior directions at pre- and one week post-intervention. RESULTS Non-parametric tests showed that the excursion did not change significantly except in the mediolateral direction with eyes closed (p < 0.05). The velocity of the center of pressure improved in both directions and eye conditions (p < 0.05). Also, the maximum velocity decreased with eyes open (mediolateral, anteroposterior, and total) (p < 0.05), while the change was not significant with the eyes closed. The overshoot measurements did not change significantly. CONCLUSION It is recommended to consider balance board training for improving balance parameters in children with cerebral palsy.
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Affiliation(s)
- Mina Baniasad
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mahsa Asheghan
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
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Effects of gender on dual-tasking and prioritization in older adults. Gait Posture 2022; 97:104-108. [PMID: 35917700 DOI: 10.1016/j.gaitpost.2022.07.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/07/2022] [Accepted: 07/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The ability to produce effective posture and balance while distracted (dual-tasking; DT), is critical for mobility. In particular, individuals implicit prioritization across posture and secondary, distracting stimuli may impact fall risk. However, the impact of gender on DT and prioritization during gait is poorly understood. RESEARCH QUESTION Does gender impact DT effects or prioritization while DT walking? METHODS One hundred older adults participated. The timed up and go (TUG) was completed with and without a secondary cognitive task (counting backwards by 3's). Gait (time to complete the TUG), and cognitive (rate of correct numbers listed) performance was recorded during both single tasks and while dual-tasking. DT effects were calculated for cognitive and gait performance. Prioritization was calculated as the difference between cognitive and gait DT effects. The effect of gender on DT and prioritization was assessed, controlling for age and cognitive ability. RESULTS Gender by condition (single vs. dual-task) interaction effects were observed (Gait: F1,96 =8.7; p = 0.004; Cognition: F1,96 =5.2; p = 0.024) such that, compared to male participants, females exhibited smaller cognitive DT effects, and larger gait DT effects. Further, females exhibited significantly larger prioritization scores (F1,95 =10.0, p = 0.002), indicating a cognitive prioritization compared to males. SIGNIFICANCE Given the link between posture-second strategies and falls, the current findings may provide some insight into previous results suggesting an increased fall-risk in older-adult women. However, this study did not investigate falls. Therefore, additional work is necessary to confirm current findings and further investigate the relationship between gender, prioritization, and falls; and its possible clinical relevance.
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Sangari M, Dehkordi PS, Shams A. Age and attentional focus instructions effects on postural and supra-postural tasks among older adults with mild cognitive impairments. Neurol Sci 2022; 43:6795-6801. [PMID: 36036296 DOI: 10.1007/s10072-022-06355-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/16/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the age and attentional focus instruction effects on the postural and supra-postural tasks among older adults with mild cognitive impairments. METHOD Forty healthy adults (mean age of 48.01 ± 5.45 years) and 40 older adults with mild cognitive impairments (mean age of 69.87 ± 4.28 years) were selected as participants. They were randomly divided into eight groups receiving internal and external attentional focus instructions for postural and supra-postural tasks. The postural status was evaluated by measuring the COP sway velocity with the Master Balance System. RESULTS The results showed that in both phases of acquisition and retention, the main effect of the attentional focus type was significant (P < 0.05). The group's postural control with external attentional instructions was better than the group's postural control with internal attentional instructions. Furthermore, the CI elderly gained benefit from the guidelines of attentional focus. Results showed that the task type was not significant in the acquisition phase. However, in the retention phase, the main effect of the attentional focus type was significant. The groups' postural function with the supra-postural task was better than the groups with the postural task. Furthermore, the older adults showed a better postural function in the supra-postural task than in the postural task. CONCLUSIONS Our results showed that the ability to allocate resources of attention may decrease with CI. These findings suggest that considering the effect of the supra-postural tasks' manipulation on postural control, it is possible to improve balance by designing training programs for directing supra-postural tasks. The findings of the present study can be a guide for educators and therapists. They can increase the balance of the patients by considering the dysfunction and the type of attentional guidelines to prevent them from falling and performing a dual task.
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Affiliation(s)
- Mandana Sangari
- Department of Physical Education, Chalous Branch, Islamic Azad University, Mazandaran, Iran
| | | | - Amir Shams
- Department of Motor Behavior, Sport Science Research Institute of Iran, Tehran, Iran
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Pinho JP, Azevedo APS, Serrão JC, Forner-Cordero A, Amadio AC, Mezêncio B. Aging effects of haptic input on postural control under a dual-task paradigm. Exp Gerontol 2022; 168:111928. [PMID: 35987475 DOI: 10.1016/j.exger.2022.111928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/27/2022] [Accepted: 08/11/2022] [Indexed: 11/15/2022]
Abstract
Postural control relies on three principal sensory systems: vision, vestibular and proprioceptive; that are affected by aging. When performing a cognitive task concomitantly with a motor task, those sensory impairments lead to even greater deleterious effects on balance. We aimed to study the effects of a sensory aid (a light touch) on a dual task paradigm and sought to understand the different responses on balance due to aging. Fifty healthy and highly physical active women were divided in two groups: young (N = 25, 24.2 ± 4.0 years) and older adults (N = 25, 67.3 ± 4.2 years). In a random and balanced order, all participants performed five tasks: Stroop test while seated (Seated); Stroop test while standing quiet (ST); Standing quiet (BL); Standing quiet with a haptic input (LT); and Stroop test with a haptic input while standing quiet (SL). In the Stroop test, older women committed more errors (50 vs 11 errors, p < 0.001) and had higher reaction time (1.001 ± 0.191 vs 0.699 ± 0.081 s, p < 0.001). The haptic input (LT) reduced all body sway parameters, in both groups, regardless the condition. This means that postural control under a dual task paradigm (ST) deleterious effect can be mitigated by a haptic input.
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Affiliation(s)
- João Pedro Pinho
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil; Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| | - Ana Paula Silva Azevedo
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Júlio Cerca Serrão
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Arturo Forner-Cordero
- Biomechatronics Laboratory, Department of Mechatronics and Mechanical Systems, Escola Politécnica of the University of São Paulo, Brazil.
| | - Alberto Carlos Amadio
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
| | - Bruno Mezêncio
- Biomechanics Laboratory, School of Physical Education and Sport, University of São Paulo, Brazil.
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Papavasileiou A, Hatzitaki V, Mademli L, Patikas DA. Temporal modulation of H-reflex in young and older people: Acute effects during Achilles tendon vibration while standing. Exp Gerontol 2022; 165:111844. [DOI: 10.1016/j.exger.2022.111844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 03/20/2022] [Accepted: 05/23/2022] [Indexed: 11/04/2022]
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Karunakaran KK, Foulds RA. Assessing the Cognitive Demand of Hand Controlled Exoskeleton Walking. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4338-4341. [PMID: 36085752 DOI: 10.1109/embc48229.2022.9871565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Individuals with spinal cord injury have motor and sensory deficits leading to ambulatory problems. Our current research is focused on developing innovative control mechanisms for wearable robotic exoskeletons to provide such users with complete control of their gait while allowing them to perform other activities (such as conversing, etc.). In this study, we evaluated the cognitive load due to using the user's hand movement to control the gait of a robot using a dual-task paradigm. The results show that there was no difference in symmetry and duty cycle between with and without a competing cognitive task, and the number of cognitive responses was similar to healthy controls walking on the treadmill. There was also no difference in obstacle navigation with and without the cognitive task. Results of this study suggest that using our control mechanisms is intuitive, easy to learn, and requires cognitive attention that is similar to normal human walking. Clinical Relevance-Initial evidence to understand the effects of the novel control mechanism on cognitive load over that of typical walking.
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Effects on intermittent postural control in people with Parkinson's due to a dual task. Hum Mov Sci 2022; 83:102947. [DOI: 10.1016/j.humov.2022.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 12/05/2021] [Accepted: 03/17/2022] [Indexed: 11/20/2022]
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Brahms M, Heinzel S, Rapp M, Mückstein M, Hortobágyi T, Stelzel C, Granacher U. The acute effects of mental fatigue on balance performance in healthy young and older adults - A systematic review and meta-analysis. Acta Psychol (Amst) 2022; 225:103540. [PMID: 35245722 DOI: 10.1016/j.actpsy.2022.103540] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/29/2022] [Accepted: 02/17/2022] [Indexed: 12/26/2022] Open
Abstract
Cognitive resources contribute to balance control. There is evidence that mental fatigue reduces cognitive resources and impairs balance performance, particularly in older adults and when balance tasks are complex, for example when trying to walk or stand while concurrently performing a secondary cognitive task. We conducted a systematic literature search in PubMed (MEDLINE), Web of Science and Google Scholar to identify eligible studies and performed a random effects meta-analysis to quantify the effects of experimentally induced mental fatigue on balance performance in healthy adults. Subgroup analyses were computed for age (healthy young vs. healthy older adults) and balance task complexity (balance tasks with high complexity vs. balance tasks with low complexity) to examine the moderating effects of these factors on fatigue-mediated balance performance. We identified 7 eligible studies with 9 study groups and 206 participants. Analysis revealed that performing a prolonged cognitive task had a small but significant effect (SMDwm = -0.38) on subsequent balance performance in healthy young and older adults. However, age- and task-related differences in balance responses to fatigue could not be confirmed statistically. Overall, aggregation of the available literature indicates that mental fatigue generally reduces balance in healthy adults. However, interactions between cognitive resource reduction, aging and balance task complexity remain elusive.
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Affiliation(s)
- Markus Brahms
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany.
| | - Stephan Heinzel
- Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - Michael Rapp
- University of Potsdam, Research Focus Cognitive Sciences, Division of Social and Preventive Medicine, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Marie Mückstein
- International Psychoanalytic University, Stromstraße 1, 10555 Berlin, Germany
| | - Tibor Hortobágyi
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary; Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
| | - Christine Stelzel
- International Psychoanalytic University, Stromstraße 1, 10555 Berlin, Germany
| | - Urs Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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Paran I, Nachmani H, Salti M, Shelef I, Melzer I. Balance recovery stepping responses during walking were not affected by a concurrent cognitive task among older adults. BMC Geriatr 2022; 22:289. [PMID: 35387589 PMCID: PMC8988391 DOI: 10.1186/s12877-022-02969-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Most of older adults’ falls are related to inefficient balance recovery after an unexpected loss of balance, i.e., postural perturbation. Effective balance recovery responses are crucial to prevent falls. Due to the considerable consequences of lateral falls and the high incidence of falls when walking, this study aimed to examine the effect of a concurrent cognitive task on older adults’ balance recovery stepping abilities from unannounced lateral perturbations while walking. We also aimed to explore whether cognitive performance accuracy is affected by perturbed walking and between task trade-offs. Methods In a laboratory-based study, 20 older adults (> 70 years old) performed the following test conditions: (1) cognitive task while sitting; (2) perturbed walking; and (3) perturbed walking with a concurrent cognitive task. The cognitive task was serial numbers subtraction by seven. Single-step and multiple-step thresholds, highest perturbation achieved, 3D kinematic analysis of the first recovery step, and cognitive task performance accuracy were compared between single-task and dual-task conditions. Between task trade-offs were examined using dual-task cost (DTC). Results Single-step and multiple-step thresholds, number of recovery step trials, number of foot collision, multiple-step events and kinematic recovery step parameters were all similar in single-task and dual-task conditions. Cognitive performance was not significantly affected by dual-task conditions, however, different possible trade-offs between cognitive and postural performances were identified using DTC. Conclusions In situations where postural threat is substantial, such as unexpected balance loss during walking, balance recovery reactions were unaffected by concurrent cognitive load in older adults (i.e., posture first strategy). The study was approved by the Helsinki Ethics Committee of Soroka University Medical Center in Beer-Sheva, Israel (ClinicalTrials.gov Registration number NCT04455607, ID Numbers: Sor 396–16 CTIL; 02/07/2020). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02969-w.
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Affiliation(s)
- Inbal Paran
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Hadas Nachmani
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Moti Salti
- Scientific Head of the Brain Imaging Research Center (BIRC), Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel.
| | - Ilan Shelef
- Diagnostic Imaging Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Itshak Melzer
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel.
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Age-related enhancement in visuomotor learning by a dual-task. Sci Rep 2022; 12:5679. [PMID: 35383212 PMCID: PMC8983773 DOI: 10.1038/s41598-022-09553-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/25/2022] [Indexed: 11/08/2022] Open
Abstract
Many daily activities require performance of multiple tasks integrating cognitive and motor processes. While the fact that both processes go through deterioration and changes with aging has been generally accepted, not much is known about how aging interacts with stages of motor skill acquisition under a cognitively demanding situation. To address this question, we combined a visuomotor adaptation task with a secondary cognitive task. We made two primary findings beyond the expected age-related performance deterioration. First, while young adults showed classical dual-task cost in the early motor learning phase dominated by explicit processes, older adults instead strikingly displayed enhanced performance in the later stage, dominated by implicit processes. For older adults, the secondary task may have facilitated a shift to their relatively intact implicit learning processes that reduced reliance on their already-deficient explicit processes during visuomotor adaptation. Second, we demonstrated that consistently performing the secondary task in learning and re-learning phases can operate as an internal task-context and facilitate visuomotor memory retrieval later regardless of age groups. Therefore, our study demonstrated age-related similarities and differences in integrating concurrent cognitive load with motor skill acquisition which, may in turn, contributes to the understanding of a shift in balance across multiple systems.
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Salihu AT, Hill KD, Jaberzadeh S. Effect of cognitive task complexity on dual task postural stability: a systematic review and meta-analysis. Exp Brain Res 2022; 240:703-731. [PMID: 35034175 DOI: 10.1007/s00221-021-06299-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/21/2021] [Indexed: 01/01/2023]
Abstract
The dual task experimental paradigm is used to probe the attentional requirements of postural control. However, findings of dual task postural studies have been inconsistent with many studies even reporting improvement in postural stability during dual tasking and thus raising questions about cognitive involvement in postural control. A U-shaped non-linear relationship has been hypothesized between cognitive task complexity and dual task postural stability suggesting that the inconsistent results might have arisen from the use of cognitive tasks of varying complexities. To systematically review experimental studies that compared the effect of simple and complex cognitive tasks on postural stability during dual tasking, we searched seven electronic databases for relevant studies published between 1980 to September 2020. 33 studies involving a total of 1068 participants met the review's inclusion criteria, 17 of which were included in meta-analysis (healthy young adults: 15 studies, 281 participants; Stroke patients: 2 studies, 52 participants). Narrative synthesis of the findings in studies involving healthy old adults was carried out. Our result suggests that in healthy population, cognitive task complexity may not determine whether postural stability increases or decreases during dual tasking (effect of cognitive task complexity was not statistically significant; P > 0.1), and thus the U-shaped non-linear hypothesis is not supported. Rather, differential effect of dual tasking on postural stability was observed mainly based on the age of the participants and postural task challenge, implying that the involvement of cognitive resources or higher cortical functions in the control of postural stability may largely depends on these two factors.
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Affiliation(s)
- Abubakar Tijjani Salihu
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Frankston Victoria 319, P O Box 527, Melbourne, Australia.
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Frankston Victoria 319, P O Box 527, Melbourne, Australia
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Roma E, Gobbo S, Bullo V, Spolaor F, Sawacha Z, Duregon F, Bianchini G, Doria E, Alberton CL, Bocalini DS, Cugusi L, Di Blasio A, Ermolao A, Bergamin M. Influence of age on postural control during dual task: a centre of pressure motion and electromyographic analysis. Aging Clin Exp Res 2022; 34:137-149. [PMID: 34115325 PMCID: PMC8795028 DOI: 10.1007/s40520-021-01888-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/13/2021] [Indexed: 10/28/2022]
Abstract
BACKGROUND Dual task influences postural control. A cognitive task seems to reduce muscle excitation during a postural balance, especially in older adults (OA). AIM The aim of this study is to evaluate the effect of three cognitive tasks on muscle excitation and static postural control in OA and young adults (YA) in an upright posture maintenance task. METHODS 31 YA and 30 OA were evaluated while performing a modified Romberg Test in five different conditions over a force plate: open eyes, closed eyes, spatial-memory brooks' test, counting backwards aloud test and mental arithmetic task. The surface electromyographic signals of Tibialis anterior (TA), Lateral Gastrocnemius (GL), Peroneus Longus (PL), and Erector Spinae (ES) was acquired with an 8-channel surface electromyographic system. The following variables were computed for both the electromyographic analysis and the posturographic assessment: Root mean square (RMS), centre of pressure (CoP) excursion (Path) and velocity, sway area, RMS of the CoP Path and 50%, 95% of the power frequency. Mixed ANOVA was used to detect differences with group membership as factor between and type of task as within. The analysis was performed on the differences between each condition from OE. RESULTS An interaction effect was found for Log (logarithmic) Sway Area. A main effect for task emerged on all posturographic variables except Log 95% frequencies and for Log PL and ES RMS. A main effect for group was never detected. DISCUSSION AND CONCLUSION This study indicates a facilitating effect of mental secondary task on posturographic variables. Non-silent secondary task causes increase in ES and TA muscle activation and a worsening in static postural control performance.
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Lubetzky AV, Coker E, Arie L, Aharoni MMH, Krasovsky T. Postural Control under Cognitive Load: Evidence of Increased Automaticity Revealed by Center-of-Pressure and Head Kinematics. J Mot Behav 2021; 54:466-479. [PMID: 34902292 DOI: 10.1080/00222895.2021.2013768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
How postural responses change with sensory perturbations while also performing a cognitive task is still debatable. This study investigated this question via comprehensive assessment of postural sway, head kinematics and their coupling. Twenty-three healthy young adults stood in tandem with eyes open or wearing the HTC Vive Head-Mounted Display (HMD) with a static or dynamic (i.e., movement in the anterior-posterior direction at 5 mm or 32 mm at 0.2 Hz) 3-wall stars display. On half of the trials, participants performed a cognitive serial subtraction task. Medio-lateral center-of-pressure (COP) path significantly increased with the cognitive task, particularly with dynamic visuals whereas medio-lateral variance decreased with the cognitive task. Head path and velocity significantly increased with the cognitive task in both directions while variance decreased. Head-COP cross-correlations ranged between 0.78 and 0.66. These findings, accompanied by frequency analysis, suggest that postural control switched to primarily relying on somatosensory input under challenging cognitive load conditions. Several differences between head and COP suggest that head kinematics contribute an important additional facet of postural control and the relationship between head and COP may depend on task and stance position. The potential of HMDs for clinical assessments of balance needs to be further explored.
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Affiliation(s)
- Anat V Lubetzky
- Department of Physical Therapy, Steinhardt School of Culture Education and Human Development, New York University, New York, New York, USA
| | - Elizabeth Coker
- Department of Dance, Tisch School of the Arts, New York University, New York, New York, USA
| | - Liraz Arie
- Department of Physical Therapy, Steinhardt School of Culture Education and Human Development, New York University, New York, New York, USA
| | - Moshe M H Aharoni
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tal Krasovsky
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.,Pediatric Rehabilitation Department, Sheba Medical Center, Ramat Gan, Israel
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Wunderlich A, Vogel O, Šömen MM, Peskar M, Fricke M, Gramann K, Protzak J, Marusic U, Wollesen B. Dual-Task Performance in Hearing-Impaired Older Adults-Study Protocol for a Cross-Sectional Mobile Brain/Body Imaging Study. Front Aging Neurosci 2021; 13:773287. [PMID: 34867299 PMCID: PMC8633949 DOI: 10.3389/fnagi.2021.773287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Hearing impairments are associated with reduced walking performance under Dual-task (DT) conditions. Little is known about the neural representation of DT performance while walking in this target group compared to healthy controls or younger adults. Therefore, utilizing the Mobile Brain/Body Imaging approach (MoBI), we aim at gaining deeper insights into the brain dynamics underlying the interaction of cognitive and motor processes during different DT conditions (visual and auditory) controlling for age and the potential performance decrements of older adults with hearing impairments. Methods: The cross-sectional study integrates a multifactorial mixed-measure design. Between-subject factors grouping the sample will be age (younger vs. older adults) and hearing impairment (mild vs. not hearing impaired). The within-subject factors will be the task complexity (single- vs. DT) and cognitive task modality (visual vs. auditory). Stimuli of the cognitive task will vary according to the stimulus modality (visual vs. auditory), presentation side (left vs. right), and presentation-response compatibility (ipsilateral vs. contralateral). Analyses of DT costs and underlying neuronal correlates focus either on gait or cognitive performance. Based on an a priori sample size calculation 96 (48 healthy and 48 mildly hearing impaired) community-dwelling older adults (50–70 years) and 48 younger adults (20–30 years) will be recruited. Gait parameters of speed and rhythm will be captured. EEG activity will be recorded using 64 active electrodes. Discussion: The study evaluates cognitive-motor interference (CMI) in groups of young and older adults as well as older adults with hearing impairment. The underlying processes of the interaction between motor and cognitive tasks will be identified at a behavioral and neurophysiological level comparing an auditory or a visual secondary task. We assume that performance differences are linked to different cognitive-motor processes, i.e., stimulus input, resource allocation, and movement execution. Moreover, for the different DT conditions (auditory vs. visual) we assume performance decrements within the auditory condition, especially for older, hearing-impaired adults. Findings will provide evidence of general mechanisms of CMI (ST vs. DT walking) as well as task-specific effects in dual-task performance while over ground walking.
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Affiliation(s)
- Anna Wunderlich
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Oliver Vogel
- Human Movement and Training Science, Institute of Human Movement Science, Psychology and Human Movement, University Hamburg, Hamburg, Germany
| | - Maja Maša Šömen
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Manca Peskar
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Madeleine Fricke
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Klaus Gramann
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Janna Protzak
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Bettina Wollesen
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany.,Human Movement and Training Science, Institute of Human Movement Science, Psychology and Human Movement, University Hamburg, Hamburg, Germany
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Payne AM, Palmer JA, McKay JL, Ting LH. Lower Cognitive Set Shifting Ability Is Associated With Stiffer Balance Recovery Behavior and Larger Perturbation-Evoked Cortical Responses in Older Adults. Front Aging Neurosci 2021; 13:742243. [PMID: 34938171 PMCID: PMC8685437 DOI: 10.3389/fnagi.2021.742243] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
The mechanisms underlying associations between cognitive set shifting impairments and balance dysfunction are unclear. Cognitive set shifting refers to the ability to flexibly adjust behavior to changes in task rules or contexts, which could be involved in flexibly adjusting balance recovery behavior to different contexts, such as the direction the body is falling. Prior studies found associations between cognitive set shifting impairments and severe balance dysfunction in populations experiencing frequent falls. The objective of this study was to test whether cognitive set shifting ability is expressed in successful balance recovery behavior in older adults with high clinical balance ability (N = 19, 71 ± 7 years, 6 female). We measured cognitive set shifting ability using the Trail Making Test and clinical balance ability using the miniBESTest. For most participants, cognitive set shifting performance (Trail Making Test B-A = 37 ± 20 s) was faster than normative averages (46 s for comparable age and education levels), and balance ability scores (miniBESTest = 25 ± 2/28) were above the threshold for fall risk (23 for people between 70 and 80 years). Reactive balance recovery in response to support-surface translations in anterior and posterior directions was assessed in terms of body motion, muscle activity, and brain activity. Across participants, lower cognitive set shifting ability was associated with smaller peak center of mass displacement during balance recovery, lower directional specificity of late phase balance-correcting muscle activity (i.e., greater antagonist muscle activity 200-300 ms after perturbation onset), and larger cortical N1 responses (100-200 ms). None of these measures were associated with clinical balance ability. Our results suggest that cognitive set shifting ability is expressed in balance recovery behavior even in the absence of profound clinical balance disability. Specifically, our results suggest that lower flexibility in cognitive task performance is associated with lower ability to incorporate the directional context into the cortically mediated later phase of the motor response. The resulting antagonist activity and stiffer balance behavior may help explain associations between cognitive set shifting impairments and frequent falls.
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Affiliation(s)
- Aiden M. Payne
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA, United States
| | - Jacqueline A. Palmer
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - J. Lucas McKay
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States,Jean and Paul Amos PD and Movement Disorders Program, Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Tech, Atlanta, GA, United States,Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States,*Correspondence: Lena H. Ting,
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Fletcher LJ, Osler CJ. Effects of mental fatigue on static upright stance and functional balance in older adults. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2021.100043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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47
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Akinlosotu RY, Alissa N, Waldstein SR, Creath RA, Wittenberg GF, Westlake KP. Examining the influence of mental stress on balance perturbation responses in older adults. Exp Gerontol 2021; 153:111495. [PMID: 34314843 DOI: 10.1016/j.exger.2021.111495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/05/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reach-to-grasp responses following balance perturbations are important to fall prevention but are often ineffective in older adults. The ability to shift attention from an ongoing cognitive task to balance related processes has been shown to influence reach-to-grasp effectiveness in older adults. However, the added influence of stress and anxiety - known to negatively affect attention shifting ability - has not yet been explored in relation to recovery from balance perturbations. Given that fear and anxiety over falling is a key fall risk factor, an understanding of how such a negative mental state may affect postural reactions is important. This study aimed to investigate the effect of varied induced emotional states on reach-to-grasp balance responses in older adults. METHODS Healthy older adults (mean age 70.5 ± 5.38 years) stood laterally between 2 handrails with contact sensors. A safety harness with an integrated loadcell was worn to prevent falls and measure the amount of harness assistance (expressed as percent body weight). With instructions to grasp one rail to restore balance, participants' balance was laterally disturbed using surface translations under three randomized conditions: no cognitive task, neutral (verb generation) task, and mental stress task with negative prompts (paced auditory serial addition). The primary outcome was frequency of protective grasps. Secondary outcomes included frequency of harness assistance during trials with grasp errors as well as wrist movement time, trajectory distance, and peak velocity. RESULTS Perceived level of distress was highest for the mental stress task compared to no task (p < 0.001) and neutral task conditions (p = 0.008). The mental stress task resulted in the lowest percentage of protective grasps (p < 0.001) in response to balance perturbations. Closer examination of trials that resulted in grasp errors (i.e., collisions or overshoots), revealed increased harness assistance and reduced peak velocity of wrist movement (p < 0.001) under the mental stress condition compared to grasp errors that occurred under the no task or neutral task condition. DISCUSSION AND CONCLUSION Distressing mental thoughts immediately prior to a balance perturbation lead to reduced effectiveness in reach-to-grasp balance responses compared to no or neutral cognitive tasks and should be considered as a possible fall risk factor.
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Affiliation(s)
- Ruth Y Akinlosotu
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, Baltimore, MD 21201, USA.
| | - Nesreen Alissa
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, Baltimore, MD 21201, USA.
| | - Shari R Waldstein
- Department of Psychology, University of Maryland Baltimore County, Baltimore, MD 21250, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Robert A Creath
- Department of Exercise Science, Lebanon Valley College, Annville, PA 17003, USA.
| | - George F Wittenberg
- Geriatric Research, Education, and Clinical Center, Human Engineering Research Laboratory, VA Pittsburgh Healthcare System, USA; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
| | - Kelly P Westlake
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science, Baltimore, MD 21201, USA.
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Palmer JA, Payne AM, Ting LH, Borich MR. Cortical Engagement Metrics During Reactive Balance Are Associated With Distinct Aspects of Balance Behavior in Older Adults. Front Aging Neurosci 2021; 13:684743. [PMID: 34335230 PMCID: PMC8317134 DOI: 10.3389/fnagi.2021.684743] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/17/2021] [Indexed: 11/20/2022] Open
Abstract
Heightened reliance on the cerebral cortex for postural stability with aging is well-known, yet the cortical mechanisms for balance control, particularly in relation to balance function, remain unclear. Here we aimed to investigate motor cortical activity in relation to the level of balance challenge presented during reactive balance recovery and identify circuit-specific interactions between motor cortex and prefrontal or somatosensory regions in relation to metrics of balance function that predict fall risk. Using electroencephalography, we assessed motor cortical beta power, and beta coherence during balance reactions to perturbations in older adults. We found that individuals with greater motor cortical beta power evoked following standing balance perturbations demonstrated lower general clinical balance function. Individual older adults demonstrated a wide range of cortical responses during balance reactions at the same perturbation magnitude, showing no group-level change in prefrontal- or somatosensory-motor coherence in response to perturbations. However, older adults with the highest prefrontal-motor coherence during the post-perturbation, but not pre-perturbation, period showed greater cognitive dual-task interference (DTI) and elicited stepping reactions at lower perturbation magnitudes. Our results support motor cortical beta activity as a potential biomarker for individual level of balance challenge and implicate prefrontal-motor cortical networks in distinct aspects of balance control involving response inhibition of reactive stepping in older adults. Cortical network activity during balance may provide a neural target for precision-medicine efforts aimed at fall prevention with aging.
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Affiliation(s)
- Jacqueline A. Palmer
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Aiden M. Payne
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Lena H. Ting
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
- Department of Biomedical Engineering, Emory and Georgia Tech, Atlanta, GA, United States
| | - Michael R. Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
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Wrisley DM, McLean G, Hill JB, Oddsson LIE. Long-Term Use of a Sensory Prosthesis Improves Function in a Patient With Peripheral Neuropathy: A Case Report. Front Neurol 2021; 12:655963. [PMID: 34248817 PMCID: PMC8260940 DOI: 10.3389/fneur.2021.655963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/27/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Peripheral neuropathy (PN) can result in either partial or complete loss of distal sensation resulting in an increased fall risk. Walkasins® uses a shoe insert to detect the magnitude and direction of sway and sends signals to a leg unit that provides sensory balance cues. The objective of this case report is to describe the long-term influence of the Walkasins® lower limb sensory neuroprosthesis on balance and gait for an individual with diabetic PN. Case Description: A 51-year-old male with a 3-year history of PN and a 10-year history of type II diabetes mellitus was fitted bilaterally with Walkasins® and utilized them 8-10 hours/day for more than 2 years. Although, vibration and tactile sensation thresholds were severely impaired at his 1st metatarsophalangeal joint and the lateral malleolus bilaterally he could perceive tactile stimuli from the Walkasins® above the ankles. Outcomes: Following Walkasins® use, his Activities-specific Balance Confidence Scale (ABC) scores improved from 33 to 80%. His mean Vestibular Activities of Daily Living (VADL) scores decreased from 3.54 to 1. His Functional Gait Assessment (FGA) scores increased from 13/30 to 28/30 and his miniBESTest scores improved from 15/28 to 26/28. Gait speed increased from 0.23 to 1.5 m/s. The patient described a decrease in pain and cramping throughout his lower extremities and an increase in function. Discussion: Gait and balance improved with the use of the Walkasins® and participation in a wellness program. This improvement suggests that the use of sensory substitution devices, such as the Walkasins®, may replace sensory deficits related to gait and balance dysfunction experienced by patients with PN. Further research is needed to determine if other patients will have a similar response and what the necessary threshold of sensory function is to benefit from use of the Walkasins®.
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Affiliation(s)
- Diane M. Wrisley
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- Doctor of Physical Therapy Program, College of St Mary, Omaha, NE, United States
| | - Gillian McLean
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- Fyzical Therapy and Balance Centers, Las Vegas, NV, United States
| | - Jennifer Baity Hill
- Department of Physical Therapy, Wingate University, Wingate, NC, United States
- OrthoCarolina Outpatient Winston-Salem, Winston-Salem, NC, United States
| | - Lars I. E. Oddsson
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
- Recanati School of Community Health, Ben Gurion University of the Negev, Beersheba, Israel
- RxFunction Inc., Eden Prairie, MN, United States
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Pitman J, Vallis LA. The Role of Cognition When Executing an Online, Visually Evoked Adjustment to an Obstacle Circumvention Strategy. J Mot Behav 2021; 54:146-157. [PMID: 34058966 DOI: 10.1080/00222895.2021.1932713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We know that performing simultaneous cognitive tasks during locomotion results in reduced performance on either or both tasks, however the role of the cognitive system in the execution of last-minute changes to ongoing adaptive locomotor tasks is not fully understood. Nineteen participants were initially cued to circumvent to left, right, or step over an obstacle while an auditory cognitive task was simultaneously presented. In half of the trials, no change in avoidance strategy was required; in the remaining trials, participants were visually cued two steps in advance to execute a new circumvention strategy. Participants decreased gait velocity and increased cognitive task response times when executing changes in strategy, highlighting the important role the cognitive system plays in these complex tasks.
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Affiliation(s)
- Jenna Pitman
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Lori Ann Vallis
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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