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Grosboillot N, Gallou-Guyot M, Lamontagne A, Bonnyaud C, Perrot A, Allali G, Perrochon A. Towards a Comprehensive Framework for Complex Walking tasks: Characterization, Behavioral Adaptations, and Clinical Implications in Ageing and Neurological Populations. Ageing Res Rev 2024:102458. [PMID: 39153599 DOI: 10.1016/j.arr.2024.102458] [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: 03/12/2024] [Accepted: 08/14/2024] [Indexed: 08/19/2024]
Abstract
Complex walking tasks, including change of direction, patterns and rhythms, require more attentional resources than simple walking and significantly impact walking performance, especially among ageing and neurological populations. More studies are focusing on complex walking situations, with or without the addition of cognitive tasks, creating a multitude of walking situations. Facing the lack of a clear and extensive definition of complex walking, this narrative review aims to identify and more precisely characterize situations and related tests, gain a better understanding of the behavioral adaptations in ageing and neurological populations, and report the clinical applications of complex walking. Based on the studies gathered, we propose a framework that categorizes the different forms of complex walking, considering whether a cognitive task is added or not, as well as the number of distinct objectives within the situation. We observed that combining complex walking tasks with a cognitive assignment places even greater strain on attentional resources, resulting in a more pronounced decline in walking or cognitive performance, or both. This work highlights the relevance of the complex walking as a simple tool for the early detection of cognitive impairments and the risk of falls, and its potential value in cognitive-motor rehabilitation. Future studies should explore the diversity of complex walking tasks in real-life simulated through extended virtual environments.
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Affiliation(s)
- N Grosboillot
- Université de Limoges, HAVAE, UR 20217, F-87000 Limoges, France
| | - M Gallou-Guyot
- Université de Limoges, HAVAE, UR 20217, F-87000 Limoges, France; Department of Human Life and Environmental Sciences, Ochanomizu University, Tokyo, Japan
| | - A Lamontagne
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Jewish Rehabilitation Site-CISSS Laval, Laval, Canada
| | - C Bonnyaud
- Laboratoire d'analyse du mouvement, Explorations fonctionnelles, Hôpital Raymond Poincaré Garches, GHU Paris Saclay, APHP, France; Université Paris-Saclay, UVSQ, Erphan Research unit, 78000, Versailles, France
| | - A Perrot
- CIAMS, Université Paris Saclay, Orsay, France
| | - G Allali
- Leenaards Memory Center, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - A Perrochon
- Université de Limoges, HAVAE, UR 20217, F-87000 Limoges, France.
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Goepp T, Hayes M, Di Domenico H, Hot P, Rupp T. Adding a sustained attention task to a physically demanding cycling exercise exacerbates neuromuscular fatigue and impairs cognitive performance in both normoxia and hypoxia. Eur J Appl Physiol 2024:10.1007/s00421-024-05555-7. [PMID: 39030427 DOI: 10.1007/s00421-024-05555-7] [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: 02/02/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024]
Abstract
PURPOSE Both cognitive motor dual-tasks (CMDT) protocols and hypoxic environments have been associated with significant impairments in cognitive and physical performance. We aimed to determine the effects of hypoxia on cognitive performance and neuromuscular fatigue during a highly physically demanding CMDT. METHODS Fifteen young adults completed a first session involving a cognitive task (CTLCOG) followed by cycling exercise (CTLEX) in normoxia. After that, they randomly participated in CMDT sessions in normoxia (DTNOR) and hypoxia (DTHYP). The physical exercise consisted of 20 min cycling at a "hard" perceived effort, and the cognitive task consisted of 15 min sustained attention to response time task (SART). Concurrent psycho-physiological measurements included: quadriceps neuromuscular fatigue (peripheral/central components from femoral nerve electrostimulation), prefrontal cortex (PFC) oxygenation by near-infrared spectroscopy, and perception of effort. RESULTS SART performance significantly decreased in DTNOR (-15.7 ± 15.6%, P < 0.01) and DTHYP (-26.2 ± 16.0%, P < 0.01) compared to CTLCOG (-1.0 ± 17.7%, P = 0.61). Peripheral fatigue similarly increased across conditions, whereas the ability of the central nervous system to activate the working muscles was impaired similarly in DTNOR (-6.1 ± 5.9%, P < 0.001) and DTHYP (-5.4 ± 7.3%, P < 0.001) compared to CTLEX (-1.1 ± 0.2%, P = 0.52). Exercise-induced perception of effort was higher in DTHYP vs. DTNOR and in DTNOR vs. CTLEX. This was correlated with cognitive impairments in both normoxia and hypoxia. PFC deoxygenation was more pronounced in DTHYP compared to DTNOR and CTLEX. CONCLUSION In conclusion, performing a sustained attention task together with physically challenging cycling exercise promotes central neuromuscular fatigue and impairs cognitive accuracy; the latter is particularly noticeable when the CMDT is performed in hypoxia.
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Affiliation(s)
- T Goepp
- Inter-University Laboratory of Human Movement Sciences EA7424, LIBM University Savoie Mont-Blanc, Chambéry, France
| | - M Hayes
- Environmental Extremes Laboratory, School of Sport and Health Sciences, University of Brighton, Eastbourne, UK
| | - H Di Domenico
- Inter-University Laboratory of Human Movement Sciences EA7424, LIBM University Savoie Mont-Blanc, Chambéry, France
| | - P Hot
- CNRS URM 5105, LPNC, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, 38000, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - T Rupp
- Inter-University Laboratory of Human Movement Sciences EA7424, LIBM University Savoie Mont-Blanc, Chambéry, France.
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Ofori E, Delgado F, James DL, Wilken J, Hancock LM, Doniger GM, Gudesblatt M. Impact of distinct cognitive domains on gait variability in individuals with mild cognitive impairment and dementia. Exp Brain Res 2024; 242:1573-1581. [PMID: 38753043 DOI: 10.1007/s00221-024-06832-9] [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: 02/24/2024] [Accepted: 04/07/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Gait variability is a common feature in neurodegenerative diseases and has been linked to cognitive impairment. Despite this link, the influence of specific cognitive domains, such as memory, visual spatial skills, executive function, and verbal function on gait variability is not well-understood. OBJECTIVE To investigate the predictive value of these specific cognitive domains on gait variability in people with mild cognitive impairment (MCI) and dementia during preferred and dual task walking. METHOD One hundred and two participants with either MCI or dementia underwent a comprehensive cognitive assessment and completed preferred and dual-task walking trials on a pressure-sensing walkway. Gait variability was assessed using the PKMAS software. Lower extremity function was evaluated with a self-reported validated scale. RESULTS Our findings indicate that only visual spatial abilities had a moderate predictive value on gait variability [F (1, 78) = 17.30, p < 0.01, r = 0.43], both in preferred pace walking (70% direct effect) and dual-task walking (90% direct effect) (p's < 0.05). Additionally, lower extremity functional skills had a significant indirect effect (30%) on gait variability in preferred walking contexts. CONCLUSION For individuals diagnosed with MCI or dementia, increased gait variability may be driven by deficits in visual spatial processing. An increased understanding of the role of visual spatial processing in gait variability can aid in the assessment and management of individuals with MCI or dementia, potentially leading to targeted interventions to improve mobility and safety.
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Affiliation(s)
- Edward Ofori
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Ferdinand Delgado
- Department of Kinesiology, University of New Hampshire, Durham, NH, United States
| | - Dara L James
- Edson College of Nursing and Health Innovation, Arizona State, Phoenix, AZ, USA
| | - Jeffrey Wilken
- Department of Neurology, Georgetown University, Washington, DC, USA
- Washington Neuropsychology Research Group, Fairfax, VA, USA
| | - Laura M Hancock
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Naples, FL, USA
- Neuropsychology, Cleveland Clinic, Cleveland, OH, United States
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Chang JJ, Chen YC, Yeh SL, Tang PF, Tu CK. Impacts of audiovisual simultaneity perception on single-task and dual-task gaits in middle-aged and older adults. Gait Posture 2024; 113:99-105. [PMID: 38850854 DOI: 10.1016/j.gaitpost.2024.06.003] [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: 12/09/2023] [Revised: 05/18/2024] [Accepted: 06/04/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND While dual-task walking requires the ability to integrate sensory information from multiple ongoing sources, it remains unknown whether dual-task walking is more affected than single-task walking by the multisensory integration ability. RESEARCH QUESTION How does the audiovisual temporal integration ability affect single-task and dual-task gaits in the aging population? METHODS One hundred and thirty healthy middle-aged and older adults (age = 64.7 ± 6.4 years) completed an audiovisual simultaneity judgment (AVSJ) task and underwent single-task, motor dual-task, and cognitive dual-task gait assessments. In the AVSJ task, participants judged whether a flash and an auditory stimulus presented at different stimulus onset asynchronies were simultaneous. The accuracy and precision of the AVSJ performance were assessed using the point of subjective simultaneity (PSS) and the temporal binding window (δ), respectively. A lower absolute PSS and δ indicated better performance. Participants held a cup of water and performed serial-7 subtraction for motor and cognitive dual-task gait assessments, respectively. The spatiotemporal gait parameters and their variability were calculated. The influences of PSS and δ on the gait parameters of the three gaits were examined with multiple hierarchical regressions. RESULTS Only the cognitive dual-task gait was significantly affected by PSS and δ. Greater PSS predicted a longer single support time (β = 0.195, p = 0.024) and its variability (β = 0.224, p = 0.011). Greater δ predicted greater step time variability (β = 0.198, p = 0.022). SIGNIFICANCE Declined perception of audiovisual simultaneity particularly degrades temporal control of cognitive dual-task walking, highlighting the importance of assessing and training this ability after midlife.
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Affiliation(s)
- Jer-Jen Chang
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Chuan Chen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Su-Ling Yeh
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan; Center for Artificial Intelligence and Robotics, National Taiwan University, Taipei, Taiwan
| | - Pei-Fang Tang
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan; Center for Artificial Intelligence and Robotics, National Taiwan University, Taipei, Taiwan; School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
| | - Chien-Kuang Tu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Rehabilitation Department, Sin-Wu Branch, Tao-Yuan General Hospital, Ministry of Health and Welfare, Taiwan
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Cho H, Rietdyk S. The effect of visual sensory interference during multitask obstacle crossing in younger and older adults. PLoS One 2024; 19:e0302838. [PMID: 38753863 PMCID: PMC11098502 DOI: 10.1371/journal.pone.0302838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
When older adults step over obstacles during multitasking, their performance is impaired; the impairment results from central and/or sensory interference. The purpose was to determine if sensory interference alters performance under low levels of cognitive, temporal, and gait demand, and if the change in performance is different for younger versus older adults. Participants included 17 younger adults (20.9±1.9 years) and 14 older adults (69.7±5.4 years). The concurrent task was a single, simple reaction time (RT) task: depress button in response to light cue. The gait task was stepping over an obstacle (8 m walkway) in three conditions: (1) no sensory interference (no RT task), (2) low sensory interference (light cue on obstacle, allowed concurrent foveation of cue and obstacle), or (3) high sensory interference (light cue away from obstacle, prevented concurrent foveation of cue and obstacle). When standing, the light cue location was not relevant (no sensory interference). An interaction (sensory interference by task, p<0.01) indicated that RT was longer for high sensory interference during walking, but RT was not altered for standing, confirming that sensory interference increased RT during obstacle approach. An interaction (sensory interference by age, p<0.01) was observed for foot placement before the obstacle: With high sensory interference, younger adults placed the trail foot closer to the obstacle while older adults placed it farther back from the obstacle. The change increases the likelihood of tripping with the trail foot for younger adults, but with the lead limb for older adults. Recovery from a lead limb trip is more difficult due to shorter time for corrective actions. Overall, visual sensory interference impaired both RT and gait behavior with low levels of multitask demand. Changes in foot placement increased trip risk for both ages, but for different limbs, reducing the likelihood of balance recovery in older adults.
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Affiliation(s)
- HyeYoung Cho
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States of America
- Center for Aging and the Life Course, Purdue University, West Lafayette, IN, United States of America
- Department of Kinesiology, University of Northern Iowa, Cedar Falls, IA, United States of America
| | - Shirley Rietdyk
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States of America
- Center for Aging and the Life Course, Purdue University, West Lafayette, IN, United States of America
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Jacobs S, Izzetoglu M, Holtzer R. The impact of music making on neural efficiency & dual-task walking performance in healthy older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:438-456. [PMID: 36999570 PMCID: PMC10544664 DOI: 10.1080/13825585.2023.2195615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/22/2023] [Indexed: 04/01/2023]
Abstract
Music making is linked to improved cognition and related neuroanatomical changes in children and adults; however, this has been relatively under-studied in aging. The purpose of this study was to assess neural, cognitive, and physical correlates of music making in aging using a dual-task walking (DTW) paradigm. Study participants (N = 415) were healthy adults aged 65 years or older, including musicians (n = 70) who were identified by current weekly engagement in musical activity. A DTW paradigm consisting of single- and dual-task conditions, as well as portable neuroimaging (functional near-infrared spectroscopy), was administered. Outcome measures included neural activation in the prefrontal cortex assessed across task conditions by recording changes in oxygenated hemoglobin, cognitive performance, and gait velocity. Linear mixed effects models examined the impact of music making on outcome measures in addition to moderating their change between task conditions. Across participants (53.3% women; 76 ± 6.55 years), neural activation increased from single- to dual-task conditions (p < 0.001); however, musicians demonstrated attenuated activation between a single cognitive interference task and dual-task walking (p = 0.014). Musicians also displayed significantly smaller decline in behavioral performance (p < 0.001) from single- to dual-task conditions and faster gait overall (p = 0.014). Given evidence of lower prefrontal cortex activation in the context of similar or improved behavioral performance, results indicate the presence of enhanced neural efficiency in older adult musicians. Furthermore, improved dual-task performance in older adult musicians was observed. Results have important clinical implications for healthy aging, as executive functioning plays an essential role in maintaining functional ability in older adulthood.
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Affiliation(s)
- Sydney Jacobs
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University, Villanova, PA, USA
| | - Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Baek JE, Hyeon SJ, Kim M, Cho HY, Hahm SC. Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial. BMC Geriatr 2024; 24:369. [PMID: 38658827 PMCID: PMC11044356 DOI: 10.1186/s12877-024-04942-1] [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: 08/17/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Regular exercise is emphasized for the improvement of functional capacity and independence of older adults. This study aimed to compare the effects of a dual-task resistance exercise program and resistance exercise on cognition, mood, depression, physical function, and activities of daily living (ADL) in older adults with cognitive impairment. METHODS A total of 44 older adults participated in the study. Participants were randomly allocated to an experimental group (n = 22) performing a dual-task resistance exercise program for cognitive function improvement and a control group (n = 22) performing a resistance exercise program. Both groups performed the exercise for 40 min per session, three times a week, for 6 weeks (18 sessions). Cognition, mood, depression, functional fitness, and ADL were quantified before and after the intervention using the Mini-Mental State Examination (MMSE), profile of mood states (POMS), geriatric depression scale (GDS), senior fitness test (SFT), and Korean version of ADL, respectively. RESULTS There was a significant time and group interaction on the MMSE (p = 0.044). There were no significant time and group interactions in the POMS, GDS, SFT, or ADL. Cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after dual-task resistance exercise, and cognitive function (p < 0.001), mood (p < 0.001), depression (p < 0.001), functional fitness (p < 0.001), and ADL (p < 0.001) significantly improved after resistance exercise. CONCLUSIONS Dual-task resistance exercise is more effective than resistance exercise in improving cognitive function in older adults with cognitive impairment. Both dual-task resistance exercise and resistance exercise improves mood, depression, functional fitness, and ADL after the intervention. We propose using dual-task resistance exercises for cognitive and physical health management in the older adults with cognitive impairment. TRIAL REGISTRATION This study was registered with the Clinical Research Information Service (WHO International Clinical Trials Registry Platform) (Registration ID, KCT0005389; Registration date, 09/09/2020).
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Affiliation(s)
- Ji-Eun Baek
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon
| | - Sang-Jun Hyeon
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea
| | - May Kim
- Department of Physical Education, College of Education, Korea University, Seoul, Republic of Korea
| | - Hwi-Young Cho
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Incheon.
| | - Suk-Chan Hahm
- Graduate School of Integrative Medicine, CHA University, 120 Haeryong-ro, Pocheon-si, 11160, Kyonggi-do, Republic of Korea.
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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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Wu TLY, Murphy A, Chen C, Kulić D. Adaptive auditory assistance for stride length cadence modification in older adults and people with Parkinson's. Front Physiol 2024; 15:1284236. [PMID: 38384796 PMCID: PMC10879360 DOI: 10.3389/fphys.2024.1284236] [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: 08/28/2023] [Accepted: 01/17/2024] [Indexed: 02/23/2024] Open
Abstract
Gait rehabilitation using auditory cues can help older adults and people with Parkinson's improve walking performance. While auditory cues are convenient and can reliably modify gait cadence, it is not clear if auditory cues can reliably modify stride length (SL), another key gait performance metric. Existing algorithms also do not address habituation or fluctuation in motor capability, and have not been evaluated with target populations or under dual-task conditions. In this study, we develop an adaptive auditory cueing framework that aims to modulate SL and cadence. The framework monitors the gait parameters and learns a personalized cue-response model to relate the gait parameters to the input cues. The cue-response model is represented using a multi-output Gaussian Process (MOGP) and is used during optimization to select the cue to provide. The adaptive cueing approach is benchmarked against the fixed approach, where cues are provided at a fixed cadence. The two approaches are tested under single and dual-task conditions with 13 older adults (OA) and 8 people with Parkinson's (PwP). The results show that more than half of the OA and PwP in the study can change both SL and cadence using auditory cues. The fixed approach is best at changing people's gait without secondary task, however, the addition of the secondary task significantly degrades effectiveness at changing SL. The adaptive approach can maintain the same level of SL change regardless of the presence of the secondary task. A separate analysis is conducted to identify factors that influence the performance of the adaptive framework. Gait information from the previous time step, along with the previous input cue, can improve its prediction accuracy. More diversity in the initialization data can also improve the GP model. Finally, we did not find a strong correlation between stride length and cadence when the parameters are contingent upon input cues.
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Affiliation(s)
- Tina L. Y. Wu
- Faculty of Engineering, Monash University, Melbourne, VIC, Australia
| | - Anna Murphy
- Clinical Research Centre for Movement Disorders and Gait, Monash Health, Clayton, VIC, Australia
| | - Chao Chen
- Faculty of Engineering, Monash University, Melbourne, VIC, Australia
| | - Dana Kulić
- Faculty of Engineering, Monash University, Melbourne, VIC, Australia
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Vermette MJ, Prince F, Bherer L, Messier J. Concentrating to avoid falling: interaction between peripheral sensory and central attentional demands during a postural stability limit task in sedentary seniors. GeroScience 2024; 46:1181-1200. [PMID: 37482601 PMCID: PMC10828328 DOI: 10.1007/s11357-023-00860-z] [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: 11/29/2022] [Accepted: 06/25/2023] [Indexed: 07/25/2023] Open
Abstract
Evidence suggests falls and postural instabilities among seniors are attributed to a decline in both the processing of afferent signals (e.g., proprioceptive, vestibular) and attentional resources. We investigated the interaction between the non-visual and attentional demands of postural control in sedentary seniors. Old and young adults performed a postural stability limit task involving a maximal voluntary leaning movement with and without vision as well as a cognitive-attentional subtraction task. These tasks were performed alone (single-task) or simultaneously (dual-task) to vary the sensory-attentional demands. The functional limits of stability were quantified as the maximum center of pressure excursion during voluntary leaning. Seniors showed significantly smaller limits of postural stability compared to young adults in all sensory-attentional conditions. However, surprisingly, both groups of subjects reduced their stability limits by a similar amount when vision was removed. Furthermore, they similarly decreased their anterior-posterior stability limits when concurrently performing the postural and the cognitive-attentional tasks with vision. The overall average cognitive performance of young adults was higher than seniors and was only slightly affected during dual-tasking. In contrast, older adults markedly degraded their cognitive performance from the single- to the dual-task situations, especially when vision was unavailable. Thus, their dual-task costs were higher than those of young adults and increased in the eyes-closed condition, when postural control relied more heavily on non-visual sensory signals. Our findings provide the first evidence that as posture approaches its stability limits, sedentary seniors allot increasingly large cognitive attentional resources to process critical sensory inputs.
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Affiliation(s)
- Marie Julie Vermette
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
| | - François Prince
- Département de Chirurgie, Faculté de Médecine, Université de Montréal, CP6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Louis Bherer
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada
- Département de Médecine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- Institut de Cardiologie de Montréal, Montréal, QC, Canada
| | - Julie Messier
- École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Université de Montréal, 2100 Boul. Édouard-Montpetit, Montréal, QC, H3T 1J4, Canada.
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), 4545 Chemin Queen Mary, Montréal, QC, H3W 1W5, Canada.
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Monz A, Morbe K, Klein M, Schaefer S. Mutual interference between memory encoding and motor skills: the influence of motor expertise. Front Psychol 2023; 14:1196978. [PMID: 38162966 PMCID: PMC10755016 DOI: 10.3389/fpsyg.2023.1196978] [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: 03/30/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
In cognitive-motor dual-task situations, the extent of performance decrements is influenced by the attentional requirements of each task. Well-learned motor skills should be automatized, leading to less interference. This study presents two studies combining an episodic memory encoding task with well-practiced motor tasks in athletes. Study 1 asked 40 rowers (early teenagers to middle adulthood) to row on ergometers at slow or fast speeds. In study 2, Taekwondo athletes (n = 37) of different skill levels performed a well-practiced sequence of martial arts movements. Performing the motor task during encoding led to pronounced performance reductions in memory in both studies, with costs of up to 80%. Cognitive costs were even larger when rowing with the fast compared to the slow speed in study 1. Both studies also revealed decrements in motor performances under dual-task conditions: Rowing became slower and more irregular (study 1), and the quality of the Taekwondo performance was reduced. Although higher-level athletes outperformed others in motor skills under single-task conditions, proportional dual-task costs were similar across skill levels for most domains. This indicates that even well-practiced motor tasks require cognitive resources.
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Affiliation(s)
| | | | | | - Sabine Schaefer
- Institute of Sport Sciences, Saarland University, Saarbrücken, Germany
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12
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Lee SM, Lee HS. Correlation Between Executive Function and Walk While Crossing Over an Obstacle Under Different Gait Phases. Dement Neurocogn Disord 2023; 22:139-147. [PMID: 38025408 PMCID: PMC10654486 DOI: 10.12779/dnd.2023.22.4.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Dual walking task such as crossing over an obstacle may serve as an excellent tool for predicting early cognitive decline. Thus, this study aimed to investigate correlation between walking while crossing over an obstacle and executive functions under different gait phases to validate the use of walking with an obstacle for predicting early cognitive decline. Methods A cross-sectional study was conducted on 48 elderly individuals from 2 day-care centers and 3 welfare-centers in Seoul and Gyeonggi, Korea. Executive function tests (Trail Making Test, Stroop test) and dual walking tests (gait speed, cadence, stance time, gait cycle time) were performed and compared using partial correlation analysis. Results There were significant correlations between executive function and most of the gait variables (stance time, cadence, and gait cycle time) (p<0.05) when crossing over an obstacle while walking. Especially, stance time exhibited significant correlations with most executive functions (p<0.05). Conclusions When evaluating executive function during walking with an obstacle, post-obstacle-crossing phase and stance time need to be observed.
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Affiliation(s)
- Seung Min Lee
- Department of Physical Therapy, COMWEL Donghae Hospital, Donghae, Korea
| | - Han Suk Lee
- Department of Physical Therapy, Eulji University, Seongnam, Korea
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Piche E, Gerus P, Zory R, Jaafar A, Guerin O, Chorin F. Effects of muscular and mental fatigue on spatiotemporal gait parameters in dual task walking in young, non-frail and frail older adults. Aging Clin Exp Res 2023; 35:2109-2118. [PMID: 37535312 DOI: 10.1007/s40520-023-02506-8] [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: 03/31/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Dual-task (DT) walking is of great interest in clinical evaluation to evaluate frailty or cognitive declines in older adults. Frail older adults are known to adopt different walking strategy to overcome fatigue. However, no studies evaluated the effect of muscular or mental fatigue on dual-task walking strategy and the difference between frail and non-frail older adults. AIMS Evaluate the effect of mental and muscular fatigue on spatio-temporal parameters in dual-task walking in young, non-frail and frail older adults. METHODS 59 participants divided into 20 young (Y) (24.9 ± 3 years old), 20 non-frail (NF) (75.8 ± 4.9 years old) and 19 frail older adults (F) (81 ± 4.7 years old) performed single-task (ST) walking, single-task cognitive (serial subtraction of 3), and dual-task (subtraction + walking) for 1 min at their fast pace. Gait speed, step length, step length variability, stance and swing phase time, single and double support time, cadence, gait speed variability were recorded in single- and dual-task walking. The dual-task effect (DTE) was calculated as ((DT - ST)/ST) × 100). Generalized linear mixed models (GLMM) were used to compare the effects of mental and muscular fatigue on gait and cognitive variables between the groups. RESULTS The DTE walking parameters were worse in F compared to NF or Y but no significant effect of fatigue were highlighted except for swing time and single support time DTEs. CONCLUSIONS The results were mitigated but a clear difference in dual-task spatio-temporal parameters was found between F and NF which brings hope into the capacity of DT to better reveal frailty.
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Affiliation(s)
- Elodie Piche
- Université Côte d'Azur, LAMHESS, Nice, France.
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France.
| | | | - Raphaël Zory
- Université Côte d'Azur, LAMHESS, Nice, France
- Institut Universitaire de France, Paris, France
| | - Amyn Jaafar
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
| | - Olivier Guerin
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Université Côte d'Azur, CNRS UMR 7284/INSERM U108, Institute for Research on Cancer and Aging Nice (IRCAN), Faculté de médecine, Nice, France
| | - Frédéric Chorin
- Université Côte d'Azur, LAMHESS, Nice, France
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
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Soangra R, Smith JA, Rajagopal S, Yedavalli SVR, Anirudh ER. Classifying Unstable and Stable Walking Patterns Using Electroencephalography Signals and Machine Learning Algorithms. SENSORS (BASEL, SWITZERLAND) 2023; 23:6005. [PMID: 37447852 DOI: 10.3390/s23136005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
Analyzing unstable gait patterns from Electroencephalography (EEG) signals is vital to develop real-time brain-computer interface (BCI) systems to prevent falls and associated injuries. This study investigates the feasibility of classification algorithms to detect walking instability utilizing EEG signals. A 64-channel Brain Vision EEG system was used to acquire EEG signals from 13 healthy adults. Participants performed walking trials for four different stable and unstable conditions: (i) normal walking, (ii) normal walking with medial-lateral perturbation (MLP), (iii) normal walking with dual-tasking (Stroop), (iv) normal walking with center of mass visual feedback. Digital biomarkers were extracted using wavelet energy and entropies from the EEG signals. Algorithms like the ChronoNet, SVM, Random Forest, gradient boosting and recurrent neural networks (LSTM) could classify with 67 to 82% accuracy. The classification results show that it is possible to accurately classify different gait patterns (from stable to unstable) using EEG-based digital biomarkers. This study develops various machine-learning-based classification models using EEG datasets with potential applications in detecting unsteady gait neural signals and intervening by preventing falls and injuries.
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Affiliation(s)
- Rahul Soangra
- Fowler School of Engineering, Chapman University, Orange, CA 92866, USA
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA
| | - Jo Armour Smith
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA
| | - Sivakumar Rajagopal
- School of Electronics Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Sai Viswanth Reddy Yedavalli
- School of Electronics Engineering, Vellore Institute of Technology, Vellore 632014, India
- School of Electrical and Computer Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Erandumveetil Ramadas Anirudh
- School of Electronics Engineering, Vellore Institute of Technology, Vellore 632014, India
- Department of Electrical and Computer Engineering, University of Windsor, Windsor, ON N9B 3P4, Canada
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Azer L, Xie W, Park HB, Zhang W. Detrimental effects of effortful physical exertion on a working memory dual-task in older adults. Psychol Aging 2023; 38:291-304. [PMID: 37104787 PMCID: PMC10238666 DOI: 10.1037/pag0000746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Action and cognition often interact in everyday life and are both sensitive to the effects of aging. The present study tested the effects of a simple physical action, effortful handgrip exertion, on working memory (WM) and inhibitory control in younger and older adults. Using a novel dual-task paradigm, participants engaged in a WM task with 0 or 5-distractors under concurrent physical exertion (5% vs. 30% individual maximum voluntary contraction). Effortful physical exertion, although failing to effect WM accuracy in the distractor absent condition for both age groups, reduced WM accuracy for the older, but not young adults, in the distractor-present condition. Similarly, older adults experienced greater distractor interference in the distractor-present condition under high physical exertion, indexed by slower reaction time (RT), confirmed by hierarchical Bayesian modeling of RT distributions. Our finding that a simple but effortful physical task results in impaired cognitive control may be empirically important for understanding everyday functions of older adults. For example, the ability to ignore task-irrelevant items declines with age and this decline is greater when simultaneously performing a physical task, which is a frequent occurrence in daily life. The negative interactions between cognitive and motor tasks may further impair daily functions, beyond the negative consequences of reduced inhibitory control and physical abilities in older adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Lilian Azer
- Department of Psychology, University of California, Riverside
| | - Weizhen Xie
- National Institute of Neurological Disorders and Stroke, National Institutes of Health
| | - Hyung-Bum Park
- Department of Psychology, University of California, Riverside
| | - Weiwei Zhang
- Department of Psychology, University of California, Riverside
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Tuena C, Borghesi F, Bruni F, Cavedoni S, Maestri S, Riva G, Tettamanti M, Liperoti R, Rossi L, Ferrarin M, Stramba-Badiale M. Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review. J Med Internet Res 2023; 25:e44484. [PMID: 37213200 PMCID: PMC10242476 DOI: 10.2196/44484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cognitive-motor dual-task (CMDT) is defined as the parallel processing of motor (eg, gait) and cognitive (eg, executive functions) activities and is an essential ability in daily life. Older adults living with frailty, chronic conditions (eg, neurodegenerative diseases), or multimorbidity pay high costs during CMDT. This can have serious consequences on the health and safety of older adults with chronic age-related conditions. However, CMDT rehabilitation can provide useful and effective therapies for these patients, particularly if delivered through technological devices. OBJECTIVE This review aims to describe the current technological applications, CMDT rehabilitative procedures, target populations, condition assessment, and efficacy and effectiveness of technology-assisted CMDT rehabilitation in chronic age-related conditions. METHODS We performed this systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, on 3 databases (Web of Science, Embase, and PubMed). Original articles that were published in English; involved older adults (>65 years) with ≥1 chronic condition and/or frailty; and tested, with a clinical trial, a technology-assisted CMDT rehabilitation against a control condition were included. Risk of bias (Cochrane tool) and the RITES (Rating of Included Trials on the Efficacy-Effectiveness Spectrum) tool were used to evaluate the included studies. RESULTS A total of 1097 papers were screened, and 8 (0.73%) studies met the predefined inclusion criteria for this review. The target conditions for technology-assisted CMDT rehabilitation included Parkinson disease and dementia. However, little information regarding multimorbidity, chronicity, or frailty status is available. The primary outcomes included falls, balance, gait parameters, dual-task performance, and executive functions and attention. CMDT technology mainly consists of a motion-tracking system combined with virtual reality. CMDT rehabilitation involves different types of tasks (eg, obstacle negotiation and CMDT exercises). Compared with control conditions, CMDT training was found to be pleasant, safe, and effective particularly for dual-task performances, falls, gait, and cognition, and the effects were maintained at midterm follow-up. CONCLUSIONS Despite further research being mandatory, technology-assisted CMDT rehabilitation is a promising method to enhance motor-cognitive functions in older adults with chronic conditions.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | | | | | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Sara Maestri
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Lorena Rossi
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | - Maurizio Ferrarin
- Fondazione Don Carlo Gnocchi, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Saraiva M, Castro MA, Vilas-Boas JP. Influence of cognitive and motor tasks using smartphone during gait: EMG and gait performance analysis - Dual-task study. Hum Mov Sci 2023; 89:103097. [PMID: 37146445 DOI: 10.1016/j.humov.2023.103097] [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: 12/19/2022] [Revised: 04/22/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
Previous studies reported changes in spatiotemporal gait parameters during dual-task performance while walking using a smartphone compared to walking without a smartphone. However, studies that assess muscle activity while walking and simultaneously performing smartphone tasks are scarce. So, this study aimed to assess the effects of motor and cognitive tasks using a smartphone while simultaneously performing gait on muscle activity and gait spatiotemporal parameters in healthy young adults. Thirty young adults (22.83 ± 3.92 years) performed five tasks: walking without a smartphone (single-task, ST); typing on a smartphone keyboard in a sitting position (secondary motor single-task); performing a cognitive task on a smartphone in a sitting position (cognitive single-task); walking while typing on a smartphone keyboard (motor dual-task, mot-DT) and walking while performing a cognitive task on a smartphone (cognitive dual-task, cog-DT). Gait speed, stride length, stride width and cycle time were collected using an optical motion capture system coupled with two force plates. Muscle activity was recorded using surface electromyographic signals from bilateral biceps femoris, rectus femoris, tibialis anterior, gastrocnemius medialis, gastrocnemius lateralis, gluteus maximus and lumbar erector spinae. Results showed a decrease in stride length and gait speed from the single-task to cog-DT and mot-DT (p < 0.05). On the other hand, muscle activity increased in most muscles analyzed from single- to dual-task conditions (p < 0.05). In conclusion, performing a cognitive or motor task using a smartphone while walking promote a decline in spatiotemporal gait parameters performance and change muscle activity pattern compared to normal walking.
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Affiliation(s)
- Marina Saraiva
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal; Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal; Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal.
| | - Maria António Castro
- RoboCorp Laboratory, i2A, Polytechnic Institute of Coimbra, 3046-854 Coimbra, Portugal; Centre for Mechanical Engineering, Materials and Processes, CEMMPRE, University of Coimbra, 3030-788 Coimbra, Portugal; School of Health Sciences, Sector of Physiotherapy, Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal.
| | - João Paulo Vilas-Boas
- Faculty of Sports and CIAFEL, University of Porto, 4200-450 Porto, Portugal; LABIOMEP-UP, Faculty of Sports and CIFI2D, The University of Porto, 4200-450 Porto, Portugal.
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Nascimento MDM, Maduro PA, Rios PMB, Nascimento LDS, Silva CN, Kliegel M, Ihle A. The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085498. [PMID: 37107780 PMCID: PMC10139030 DOI: 10.3390/ijerph20085498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
- Correspondence: ; Tel.: +55-(87)-21016856
| | - Paula Andreatta Maduro
- University Hospital of the Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Pâmala Morais Bagano Rios
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Lara dos Santos Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Carolina Nascimento Silva
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Tasseel-Ponche S, Roussel M, Toba MN, Sader T, Barbier V, Delafontaine A, Meynier J, Picard C, Constans JM, Schnitzler A, Godefroy O, Yelnik AP. Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT). Trials 2023; 24:172. [PMID: 36890548 PMCID: PMC9994785 DOI: 10.1186/s13063-023-07138-x] [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: 07/07/2022] [Accepted: 02/07/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Gait disorders and cognitive impairments are prime causes of disability and institutionalization after stroke. We hypothesized that relative to single-task gait rehabilitation (ST GR), cognitive-motor dual-task (DT) GR initiated at the subacute stage would be associated with greater improvements in ST and DT gait, balance, and cognitive performance, personal autonomy, disability, and quality of life in the short, medium and long terms after stroke. METHODS This multicenter (n=12), two-arm, parallel-group, randomized (1:1), controlled clinical study is a superiority trial. With p<0.05, a power of 80%, and an expected loss to follow-up rate of 10%, the inclusion of 300 patients will be required to evidence a 0.1-m.s-1 gain in gait speed. Trial will include adult patients (18-90 years) in the subacute phase (0 to 6 months after a hemispheric stroke) and who are able to walk for 10 m (with or without a technical aid). Registered physiotherapists will deliver a standardized GR program (30 min three times a week, for 4 weeks). The GR program will comprise various DTs (phasic, executive function, praxis, memory, and spatial cognition tasks during gait) in the DT (experimental) group and gait exercises only in the ST (control) group. The primary outcome measure is gait speed 6 months after inclusion. The secondary outcomes are post-stroke impairments (National Institutes of Health Stroke Scale and the motor part of the Fugl-Meyer Assessment of the lower extremity), gait speed (10-m walking test), mobility and dynamic balance (timed up-and-go test), ST and DT cognitive function (the French adaptation of the harmonization standards neuropsychological battery, and eight cognitive-motor DTs), personal autonomy (functional independence measure), restrictions in participation (structured interview and the modified Rankin score), and health-related quality of life (on a visual analog scale). These variables will be assessed immediately after the end of the protocol (probing the short-term effect), 1 month thereafter (the medium-term effect), and 5 months thereafter (the long-term effect). DISCUSSION The main study limitation is the open design. The trial will focus on a new GR program applicable at various stages after stroke and during neurological disease. TRIAL REGISTRATION NCT03009773 . Registered on January 4, 2017.
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Affiliation(s)
- Sophie Tasseel-Ponche
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France. .,Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France.
| | - Martine Roussel
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France.,Department of Neurology, Amiens University Hospital, Amiens, France
| | - Monica N Toba
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France
| | - Thibaud Sader
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Vincent Barbier
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Arnaud Delafontaine
- Department of Physical Medicine and Rehabilitation, Amiens University Hospital, Amiens, France
| | - Jonathan Meynier
- Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
| | - Carl Picard
- Clinical Research and Innovation Directorate, Amiens University Hospital, Amiens, France
| | | | - Alexis Schnitzler
- PRM Department, Hôpital Lariboisière-F.Widal AP-HP, Paris, France.,INSERM U1153 - CRESS EpiAgeing, Paris University, Hôtel-Dieu, Paris, France
| | - Olivier Godefroy
- Laboratory of Functional Neurosciences, UR UPJV 4559, Jules Verne University of Picardie, Amiens, France.,Department of Neurology, Amiens University Hospital, Amiens, France
| | - Alain Pierre Yelnik
- PRM Department, Hôpital Lariboisière-F.Widal AP-HP, Paris, France.,UMR 9010, Paris University, Centre Borelli, Paris, France
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Stojan R, Mack M, Bock O, Voelcker-Rehage C. Inefficient frontal and parietal brain activation during dual-task walking in a virtual environment in older adults. Neuroimage 2023; 273:120070. [PMID: 37004827 DOI: 10.1016/j.neuroimage.2023.120070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Walking while performing an additional cognitive task (dual-task walking; DT walking) is a common yet highly demanding behavior in daily life. Previous neuroimaging studies have shown that performance declines from single- (ST) to DT conditions are accompanied by increased prefrontal cortex (PFC) activity. This increment is particularly pronounced in older adults and has been explained either by compensation, dedifferentiation, or ineffective task processing in fronto-parietal circuits. However, there is only limited evidence for the hypothesized fronto-parietal activity changes measured under real life conditions such as walking. In this study, we therefore assessed brain activity in PFC and parietal lobe (PL), to investigate whether higher PFC activation during DT walking in older adults is related to compensation, dedifferentiation, or neural inefficiency. Fifty-six healthy older adults (69.11 ± 4.19 years, 30 female) completed three tasks (treadmill walking at 1 m/s, Stroop task, Serial 3's task) under ST and DT conditions (Walking + Stroop, Walking + Serial 3's), and a baseline Standing task. Behavioral outcomes were step time variability (Walking), Balance Integration Score BIS (Stroop), and number of correct calculations S3corr (Serial 3's). Brain activity was measured using functional near-infrared spectroscopy (fNIRS) over ventrolateral and dorsolateral PFC (vlPFC, dlPFC) and inferior and superior PL (iPL, sPL). Neurophysiological outcome measures were oxygenated (HbO2) and deoxygenated hemoglobin (HbR). Linear mixed models with follow-up estimated marginal means contrasts were applied to investigate region-specific upregulations of brain activation from ST to DT conditions. Furthermore, the relationships of DT-specific activations across all brain regions was analyzed as well as the relationship between changes in brain activation and changes in behavioral performance from ST to DT. Data indicated the expected upregulation from ST to DT and that DT-related upregulation was more pronounced in PFC (particularly in vlPFC) than in PL regions. Activation increases from ST to DT were positively correlated between all brain regions, and higher brain activation changes predicted higher declines in behavioral performance from ST to DT. Results were largely consistent for both DTs (Stroop and Serial 3's). These findings more likely suggest neural inefficiency and dedifferentiation in PFC and PL rather than fronto-parietal compensation during DT walking in older adults. Findings have implications for interpreting and promoting efficacy of long-term interventions to improve DT walking in older persons.
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Haggard AV, Tennant JE, Shaikh FD, Hamel R, Kline PW, Zukowski LA. Including cognitive assessments with functional testing predicts capabilities relevant to everyday walking in older adults. Gait Posture 2023; 100:75-81. [PMID: 36493686 DOI: 10.1016/j.gaitpost.2022.11.015] [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: 01/05/2022] [Revised: 10/21/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Dual-task (DT) testing reflects real-world walking demands in older adults but is not always feasible to perform in clinic. Whether clinical measures that predict single-task (ST) performance also predict DT performance or dual-task effects (DTEs) has not been fully explored. RESEARCH QUESTION What are the relationships between cognitive performance, functional mobility, and self-reported physical activity and balance confidence and ST and DT Gait Speed and Cognitive Reaction Time, as well as DTEs on Gait Speed (DTEGS) and Cognitive Reaction Time (DTERT), in older adults? METHODS Sixty-two older adults (71.5 ± 7.1 years, 17 males) completed cognitive performance, functional mobility, and self-report physical activity and balance confidence assessments. Three 1-min trials were performed: 1) ST Cognition (clock task), 2) ST Gait and 3) DT Cognition + Gait, with Cognitive Reaction Time (recorded during clock task performance via DirectRT) and Gait Speed (measured during walking trial via APDM system) recorded, and DTEGS and DTERT calculated, as the cognitive and gait outcomes. Six multivariate regressions were conducted to test whether cognitive performance, functional mobility, and self-report assessments predicted Gait Speed and Cognitive Reaction Time in ST and DT conditions and DTEs. RESULTS The Comprehensive Trail Making Test (CTMT) predicted Reaction Time in ST cognitive (β = - 0.525, p = .003) and DT (β = - 0.510, p = .006) trials. The Physical Activity Scale for the Elderly (PASE) predicted DTERT (β = - 0.397, p = .008). The 10-Meter Walk Test (10MWT) predicted Gait Speed in ST gait (β = 0.692, p < .001) and DT (β = 0.715, p < .001) trials. The Four Square Step Test (FSST) predicted ST Gait Speed (β = - 0.233, p = .034). The Montreal Cognitive Assessment (MoCA) (β = 0.293, p = .027), 10MWT (β = 0.322, p = .046), and the FSST (β = 0.378, p = .019) predicted DTEGS. SIGNIFICANCE The 10MWT, CTMT, and MoCA can be easily implemented in the clinic and may be good choices to assess cognitive and functional abilities necessary for ambulation in older adults.
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Affiliation(s)
- Alexa V Haggard
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | | | - Faisal D Shaikh
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Renee Hamel
- Department of Physical Therapy, High Point University, High Point, NC, USA; School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Paul W Kline
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, USA.
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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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Korivand S, Jalili N, Gong J. Experiment protocols for brain-body imaging of locomotion: A systematic review. Front Neurosci 2023; 17:1051500. [PMID: 36937690 PMCID: PMC10014824 DOI: 10.3389/fnins.2023.1051500] [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: 09/22/2022] [Accepted: 02/06/2023] [Indexed: 03/05/2023] Open
Abstract
Introduction Human locomotion is affected by several factors, such as growth and aging, health conditions, and physical activity levels for maintaining overall health and well-being. Notably, impaired locomotion is a prevalent cause of disability, significantly impacting the quality of life of individuals. The uniqueness and high prevalence of human locomotion have led to a surge of research to develop experimental protocols for studying the brain substrates, muscle responses, and motion signatures associated with locomotion. However, from a technical perspective, reproducing locomotion experiments has been challenging due to the lack of standardized protocols and benchmarking tools, which impairs the evaluation of research quality and the validation of previous findings. Methods This paper addresses the challenges by conducting a systematic review of existing neuroimaging studies on human locomotion, focusing on the settings of experimental protocols, such as locomotion intensity, duration, distance, adopted brain imaging technologies, and corresponding brain activation patterns. Also, this study provides practical recommendations for future experiment protocols. Results The findings indicate that EEG is the preferred neuroimaging sensor for detecting brain activity patterns, compared to fMRI, fNIRS, and PET. Walking is the most studied human locomotion task, likely due to its fundamental nature and status as a reference task. In contrast, running has received little attention in research. Additionally, cycling on an ergometer at a speed of 60 rpm using fNIRS has provided some research basis. Dual-task walking tasks are typically used to observe changes in cognitive function. Moreover, research on locomotion has primarily focused on healthy individuals, as this is the scenario most closely resembling free-living activity in real-world environments. Discussion Finally, the paper outlines the standards and recommendations for setting up future experiment protocols based on the review findings. It discusses the impact of neurological and musculoskeletal factors, as well as the cognitive and locomotive demands, on the experiment design. It also considers the limitations imposed by the sensing techniques used, including the acceptable level of motion artifacts in brain-body imaging experiments and the effects of spatial and temporal resolutions on brain sensor performance. Additionally, various experiment protocol constraints that need to be addressed and analyzed are explained.
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Affiliation(s)
- Soroush Korivand
- Department of Mechanical Engineering, The University of Alabama, Tuscaloosa, AL, United States
- Department of Computer Science, The University of Alabama, Tuscaloosa, AL, United States
| | - Nader Jalili
- Department of Mechanical Engineering, The University of Alabama, Tuscaloosa, AL, United States
| | - Jiaqi Gong
- Department of Computer Science, The University of Alabama, Tuscaloosa, AL, United States
- *Correspondence: Jiaqi Gong
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Paas Oliveros LK, Pieczykolan A, Pläschke RN, Eickhoff SB, Langner R. Response-code conflict in dual-task interference and its modulation by age. PSYCHOLOGICAL RESEARCH 2023; 87:260-280. [PMID: 35122495 PMCID: PMC9352817 DOI: 10.1007/s00426-021-01639-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/19/2021] [Indexed: 01/31/2023]
Abstract
Difficulties in performing two tasks at once can arise from several sources and usually increase in advanced age. Tasks with concurrent bimodal (e.g., manual and oculomotor) responding to single stimuli consistently revealed crosstalk between conflicting response codes as a relevant source. However, how this finding translates to unimodal (i.e., manual only) response settings and how it is affected by age remains open. To address this issue, we had young and older adults respond to high- or low-pitched tones with one (single task) or both hands concurrently (dual task). Responses were either compatible or incompatible with the pitch. When responses with the same level of compatibility were combined in dual-task conditions, their response codes were congruent to each other, whereas combining a compatible and an incompatible response created mutually incongruent (i.e., conflicting) response codes, potentially inducing detrimental crosstalk. Across age groups, dual-task costs indeed were overall highest with response-code incongruency. In these trials, compatible responses exhibited higher costs than incompatible ones, even after removing trials with strongly synchronized responses. This underadditive cost asymmetry argues against mutual crosstalk as the sole source of interference and corroborates notions of strategic prioritization of limited processing capacity based on mapping-selection difficulty. As expected, the effects of incongruent response codes were found to be especially deleterious in older adults, supporting assumptions of age-related deficits in multiple-action control at the level of task-shielding. Overall, our results suggest that aging is linked to higher response confusability and less efficient flexibility for capacity sharing in dual-task settings.
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Affiliation(s)
- Lya K. Paas Oliveros
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany ,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Aleks Pieczykolan
- Institute of Psychology, University of Würzburg, Würzburg, Germany ,Human Technology Center, RWTH Aachen University, Aachen, Germany
| | - Rachel N. Pläschke
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Simon B. Eickhoff
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany ,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Robert Langner
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany ,Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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25
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Omana H, Madou E, Montero-Odasso M, Payne MW, Viana R, Hunter SW. The effect of dual-task testing on the balance and gait of people with lower limb amputations: A systematic review. PM R 2023; 15:94-128. [PMID: 34464018 DOI: 10.1002/pmrj.12702] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/12/2021] [Accepted: 08/22/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA). LITERATURE SURVEY Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020). METHODOLOGY Inclusion criteria: participants were adults with transtibial, knee-disarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. Methodological quality of reporting was examined using the Downs and Black Scale. A meta-analysis was unable to be performed owing to substantial participant and protocol heterogeneity among the studies included. SYNTHESIS Of 3950 articles screened, 22 met inclusion criteria. Four assessed dual-task balance and 18 dual-task gait. During single-task standing, PLLA demonstrated higher sway distance and sway velocity than controls (CN); however, a greater dual-task effect was observed only for sway velocity. Gait pace, rhythm, variability, asymmetry, and postural control were observed to be worse in PLLA relative to CN during single-task. Dual-task gait testing resulted in a disproportionally reduced pace and rhythm and increased asymmetry in PLLA compared to CN. CONCLUSIONS People with lower limb amputations have impaired balance and gait, which is affected by dual-task to a greater degree compared to healthy adults. An examination of how PLLA-specific factors such as level of amputation, reason for amputation, and experience with a prosthesis affect dual-task performance has not yet been thoroughly explored. Future research should continue to characterize the cognitive-mobility link to better understand the challenges associated with the use of a prosthesis.
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Affiliation(s)
- Humberto Omana
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Edward Madou
- School of Physical Therapy, University of Western Ontario, London, Ontario, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.,Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Michael W Payne
- Department of Physical Medicine & Rehabilitation, Parkwood Institute, London, Ontario, Canada.,Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Ricardo Viana
- Department of Physical Medicine & Rehabilitation, Parkwood Institute, London, Ontario, Canada.,Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Susan W Hunter
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,School of Physical Therapy, University of Western Ontario, London, Ontario, Canada.,Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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26
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Effects of age, sex, frailty and falls on cognitive and motor performance during dual-task walking in older adults. Exp Gerontol 2023; 171:112022. [PMID: 36371049 DOI: 10.1016/j.exger.2022.112022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/26/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dual-task (DT) walking is of great interest in clinical evaluation to evaluate the risk of falling or cognitive declines in older adults. However, it appears necessary to investigate deeply the confounding factors to better understand their impact on dual-task performance. OBJECTIVE To evaluate the effect of age, sex, falls and frailty on cognitive and motor parameters in dual-task walking. SUBJECTS 66 older participants (mean age = 75.5 ± 6.3; mean height = 165.8 ± 8.4 cm; mean weight = 68.4 ± 14 kgs) were split into groups based on their age, sex, fall and frailty status. METHODS Participants performed single-task walking, single-task cognitive (serial subtraction of 3), and dual-task walking (subtraction + walking) for 1 min at their fast pace. Gait speed, step length, step length variability, stance and swing phase time, single and double support, cadence, step time variability and gait speed variability were recorded in single- and dual-task walking and used to calculate the dual-task effect (DTE) as ((DT - ST) / ST) ∗ 100). The cognitive score (DTEcog) was calculated as the number of correct responses minus errors. Generalized linear mixed models (GLMM) were used to compare the effects of falls, frailty, age and sex on gait and cognitive variables. RESULTS The interaction frailty*sex and frailty*age were the major effect on the DTEs. Specifically, the DTE was higher in women than men and in the frail group compared to non-frail. CONCLUSIONS The present findings provide a better understanding on the confounding factors explaining the behavior in DT that could be used to develop more effective dual-task clinical programs for community-living older adults.
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Nascimento VYS, Cavalcante BR, de Souza FT, Silva MS, Tays da Silva D, de Souza MF, de Araújo RC. Effects of instability resistance training on static postural control of cognitively impaired older adults. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND: Mounting evidence has demonstrated functional and cognitive-related benefits after Instability Resistance Training (IRT) in individuals, healthy as wellas patients presenting with neurological disorders. However, whether IRT may play a significant role in the postural control of older adults has not been established. OBJECTIVE: To evaluate the effects of 12- weeks of IRT on static postural control of older adults with subjective cognitive impairment. METHODS: In this randomized controlled trial, a total of 67 participants (aged 65 years and older) were randomly assigned to either 12 weeks of IRT (n= 22), traditional resistance training (RT) (n= 23), or a health education control group (CON) (n= 22). Static postural control was assessed using a force platform that recorded the displacement amplitude of the center of pressure (CoP) in the anteroposterior (AP) and mediolateral (ML) directions in bipedal support (30 seconds) with eyes open and closed. RESULTS: All groups increased AP displacement in the conditions of eyes open and closed. During the eyes-closed condition, only the IRT group increased the ML displacement. No between-group differences were detected in any postural control (p> 0.05). CONCLUSIONS: 12 weeks of IRT does not improve the static postural control in older adults with cognitive impairment.
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Affiliation(s)
- Vinicius Yan Santos Nascimento
- Post-graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil
- Laboratório de Pesquisa em Saúde e Desempenho Funcional, University of Pernambuco, Petrolina, PE, Brazil
| | - Bruno Remígio Cavalcante
- Post-graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil
- Laboratório de Pesquisa em Saúde e Desempenho Funcional, University of Pernambuco, Petrolina, PE, Brazil
- Clinic Exercise Lab, Federal University of Vale do São Francisco Petrolina, PE, Brazil
| | - Francis Trombini de Souza
- Post-graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil
| | - Mateus Santos Silva
- Post-graduate Program in Physical Education, Federal University of Vale do São Francisco Petrolina, PE, Brazil
- Clinic Exercise Lab, Federal University of Vale do São Francisco Petrolina, PE, Brazil
| | - Dayane Tays da Silva
- Post-graduate Program in Physical Education, Federal University of Vale do São Francisco Petrolina, PE, Brazil
- Clinic Exercise Lab, Federal University of Vale do São Francisco Petrolina, PE, Brazil
| | - Mariana Ferreira de Souza
- Post-graduate Program in Physical Education, Federal University of Vale do São Francisco Petrolina, PE, Brazil
- Clinic Exercise Lab, Federal University of Vale do São Francisco Petrolina, PE, Brazil
| | - Rodrigo Cappato de Araújo
- Post-graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, Petrolina, PE, Brazil
- Laboratório de Pesquisa em Saúde e Desempenho Funcional, University of Pernambuco, Petrolina, PE, Brazil
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AYAN KARATAŞ H, KARA B, ERBAYRAKTAR RS. SPATIOTEMPORAL GAIT PARAMETERS, PELVIC MOVEMENTS AND PELVIC SYMMETRY DURING SINGLE AND DUAL TASK IN INDIVIDUALS WITH CHRONIC IDIOPATHIC NECK PAIN. TÜRK FIZYOTERAPI VE REHABILITASYON DERGISI 2022. [DOI: 10.21653/tjpr.1019582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purpose: Neck pain is associated with gait disturbances. The first aim of this study was to examine spatiotemporal gait parameters, pelvic movements and pelvic symmetry during single and dual task conditions in persons with CINP compared to healthy subjects (HS). The second aim was to investigate the relationship between disability and gait in persons with CINP.Methods: Thirty-one individuals with CINP (mean age 22.06±1.38 years, range 18-56 years) and 24 HS (mean age 22.60±1.51 years, range 18-43 years) participated in the study. CINP group completed Neck Disability Index. All participants performed 10-meter walking test in two conditions: (1) walking with head straight at usual speed, (2) walking with head straight at usual speed while carrying a tray. The BTS G-Walk wearable sensor was used to assess spatiotemporal parameters (speed, cadence, step length), pelvic movements (tilt, obliquity, rotation), and pelvic symmetry. Results: During single task gait, the CINP group had significantly lower walking speed, shorter stride length and worse pelvic tilt symmetry (p<0.05), but pelvic movements did not differ significantly according to the HS (p<0.05). During dual task condition, the CINP group had significantly lower cadence, gait speed and stride length, significantly increased pelvic movements and significantly worse pelvic rotation symmetry compared to HS (p<0.05). Conclusion: Patients with CINP had a slower gait, lower stride length, decreased pelvic symmetry and increased pelvic movements compared to HS. Differences in gait and pelvic movements between the two groups were more pronounced during the dual task gait than single task gait.
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Udina C, Avtzi S, Mota-Foix M, Rosso AL, Ars J, Kobayashi Frisk L, Gregori-Pla C, Durduran T, Inzitari M. Dual-task related frontal cerebral blood flow changes in older adults with mild cognitive impairment: A functional diffuse correlation spectroscopy study. Front Aging Neurosci 2022; 14:958656. [PMID: 36605362 PMCID: PMC9807627 DOI: 10.3389/fnagi.2022.958656] [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: 05/31/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction In a worldwide aging population with a high prevalence of motor and cognitive impairment, it is paramount to improve knowledge about underlying mechanisms of motor and cognitive function and their interplay in the aging processes. Methods We measured prefrontal cerebral blood flow (CBF) using functional diffuse correlation spectroscopy during motor and dual-task. We aimed to compare CBF changes among 49 older adults with and without mild cognitive impairment (MCI) during a dual-task paradigm (normal walk, 2- forward count walk, 3-backward count walk, obstacle negotiation, and heel tapping). Participants with MCI walked slower during the normal walk and obstacle negotiation compared to participants with normal cognition (NC), while gait speed during counting conditions was not different between the groups, therefore the dual-task cost was higher for participants with NC. We built a linear mixed effects model with CBF measures from the right and left prefrontal cortex. Results MCI (n = 34) showed a higher increase in CBF from the normal walk to the 2-forward count walk (estimate = 0.34, 95% CI [0.02, 0.66], p = 0.03) compared to participants with NC, related to a right- sided activation. Both groups showed a higher CBF during the 3-backward count walk compared to the normal walk, while only among MCI, CFB was higher during the 2-forward count walk. Discussion Our findings suggest a differential prefrontal hemodynamic pattern in older adults with MCI compared to their NC counterparts during the dual-task performance, possibly as a response to increasing attentional demand.
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Affiliation(s)
- Cristina Udina
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain,*Correspondence: Cristina Udina,
| | - Stella Avtzi
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Miriam Mota-Foix
- Statistics and Bioinformatics Unit, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Andrea L. Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Joan Ars
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lisa Kobayashi Frisk
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Clara Gregori-Pla
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Turgut Durduran
- ICFO – Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Barcelona, Spain,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Marco Inzitari
- REFiT Barcelona Research Group, Parc Sanitari Pere Virgili and Vall d’Hebron Research Institute (VHIR), Barcelona, Spain,Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
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Zukowski LA, Shaikh FD, Haggard AV, Hamel RN. Acute effects of virtual reality treadmill training on gait and cognition in older adults: A randomized controlled trial. PLoS One 2022; 17:e0276989. [PMID: 36322594 PMCID: PMC9629584 DOI: 10.1371/journal.pone.0276989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/17/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Everyday walking often involves walking with divided attention (i.e., dual-tasking). Exercise interventions for older adults should mimic these simultaneous physical and cognitive demands. This proof-of-concept study had a two-fold purpose: 1) identify acute cognitive and gait benefits of a single session of virtual reality treadmill training (VRTT), relative to conventional treadmill training (CTT), and 2) identify differences between those who reduced dual-task costs (i.e., responders) on gait or cognition and those who did not, after the session. METHODS Sixty older adults were randomized to complete a single 30-minute session of VRTT (n = 30, 71.2±6.5 years, 22 females) or CTT (n = 30, 72.0±7.7 years, 21 females). Pre- and post-exercise session, participants performed single-task walking, single-task cognitive, and dual-task walking trials while gait and cognition were recorded. Gait variables were gait speed and gait speed variability. Cognition variables were response reaction time, response accuracy, and cognitive throughput. Dual-task effects (DTE) on gait and cognition variables were also calculated. RESULTS Post-exercise, there were no group differences (all p>0.05). During single- and dual-task trials, both groups walked faster (single-task: F(1, 58) = 9.560, p = 0.003; dual-task: F(1, 58) = 19.228, p<0.001), responded more quickly (single-task: F(1, 58) = 5.054, p = 0.028; dual-task: F(1, 58) = 8.543, p = 0.005), and reduced cognitive throughput (single-task: F(1, 58) = 6.425, p = 0.014; dual-task: F(1, 58) = 28.152, p<0.001). Both groups also exhibited reduced DTE on gait speed (F(1, 58) = 8.066, p = 0.006), response accuracy (F(1, 58) = 4.123, p = 0.047), and cognitive throughput (F(1, 58) = 6.807, p = 0.012). Gait responders and non-responders did not differ (all p>0.05), but cognitive responders completed fewer years of education (t(58) = 2.114, p = 0.039) and better information processing speed (t(58) = -2.265, p = 0.027) than cognitive non-responders. CONCLUSIONS The results indicate that both VRTT and CTT may acutely improve gait and cognition. Therefore, older adults will likely benefit from participating in either type of exercise. The study also provides evidence that baseline cognition can impact training effects on DTE on cognition.
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Affiliation(s)
- Lisa A. Zukowski
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- * E-mail:
| | - Faisal D. Shaikh
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Alexa V. Haggard
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
| | - Renee N. Hamel
- Department of Physical Therapy, High Point University, High Point, North Carolina, United States of America
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Bianchini E, Warmerdam E, Romijnders R, Hansen C, Pontieri FE, Maetzler W. Cognitive dual-task cost depends on the complexity of the cognitive task, but not on age and disease. Front Neurol 2022; 13:964207. [PMID: 36313514 PMCID: PMC9615561 DOI: 10.3389/fneur.2022.964207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Dual-tasking (DT) while walking is common in daily life and can affect both gait and cognitive performance depending on age, attention prioritization, task complexity and medical condition. The aim of the present study was to investigate the effects of DT on cognitive DT cost (DTC) (i) in a dataset including participants of different age groups, with different neurological disorders and chronic low-back pain (cLBP) (ii) at different levels of cognitive task complexity, and (iii) in the context of a setting relevant to daily life, such as combined straight walking and turning. Materials and methods Ninety-one participants including healthy younger and older participants and patients with Parkinson's disease, Multiple Sclerosis, Stroke and cLBP performed a simple reaction time (SRT) task and three numerical Stroop tasks under the conditions congruent (StC), neutral (StN) and incongruent (StI). The tasks were performed both standing (single task, ST) and walking (DT), and DTC was calculated. Mixed ANOVAs were used to determine the effect of group and task complexity on cognitive DTC. Results A longer response time in DT than in ST was observed during SRT. However, the response time was shorter in DT during StI. DTC decreased with increasing complexity of the cognitive task. There was no significant effect of age and group on cognitive DTC. Conclusion Our results suggest that regardless of age and disease group, simple cognitive tasks show the largest and most stable cognitive effects during DT. This may be relevant to the design of future observational studies, clinical trials and for clinical routine.
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Affiliation(s)
- Edoardo Bianchini
- Department of Neurology, Kiel University, Kiel, Germany
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Elke Warmerdam
- Department of Neurology, Kiel University, Kiel, Germany
- Division of Surgery, Saarland University, Homburg, Germany
| | - Robbin Romijnders
- Department of Neurology, Kiel University, Kiel, Germany
- Faculty of Engineering, Kiel University, Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Kiel University, Kiel, Germany
| | - Francesco E. Pontieri
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Rome, Italy
- Santa Lucia Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Walter Maetzler
- Department of Neurology, Kiel University, Kiel, Germany
- *Correspondence: Walter Maetzler
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Mack M, Stojan R, Bock O, Voelcker-Rehage C. Cognitive-motor multitasking in older adults: a randomized controlled study on the effects of individual differences on training success. BMC Geriatr 2022; 22:581. [PMID: 35840893 PMCID: PMC9284902 DOI: 10.1186/s12877-022-03201-5] [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: 01/11/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Multitasking is an essential part of our everyday life, but performance declines typically in older age. Many studies have investigated the beneficial effects of cognitive, motor and combined cognitive-motor training on multitasking performance in older adults. Previous work, however, has not regarded interindividual differences in cognitive functioning and motor fitness that may affect training benefits. The current study aims to identify whether different training programs may have differential effects on multitasking performance depending on the initial level of cognitive functioning and motor fitness. Methods We conduct a 12-week single-blinded randomized controlled trial. A total of N = 150 healthy older adults are assigned to either a single cognitive, a single motor, or a simultaneous cognitive-motor training. Participants are trained twice per week for 45 min. A comprehensive test battery assesses cognitive functions, motor and cardiovascular fitness, and realistic multitasking during walking and driving in two virtual environments. We evaluate how multitasking performance is related not only to the training program, but also to participants’ initial levels of cognitive functioning and motor fitness. Discussion We expect that multitasking performance in participants with lower initial competence in either one or both domains (cognitive functioning, motor fitness) benefits more from single-task training (cognitive training and/or motor training). In contrast, multitasking performance in participants with higher competence in both domains should benefit more from multitask training (simultaneous cognitive-motor training). The results may help to identify whether tailored training is favorable over standardized one-size-fits all training approaches to improve multitasking in older adults. In addition, our findings will advance the understanding of factors that influence training effects on multitasking. Trial registration DRKS (German Clinical Trials Register), DRKS00022407. Registered 26/08/2020 - Retrospectively registered at https://www.drks.de/drks_web/setLocale_EN.do
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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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Sasaki K, Ooi T, Yokota A, Azuma T, Asano K, Yadai G. The effects of cognitive tasks on the frequency of non-MTC gait cycle during walking in healthy older and young adults. J Phys Ther Sci 2022; 34:497-502. [PMID: 35784603 PMCID: PMC9246408 DOI: 10.1589/jpts.34.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effects of cognitive tasks on the non-minimum toe clearance
gait cycles (nMTC) frequency during walking in healthy older and young adults.
[Participants and Methods] This study included 20 healthy older and 20 young adults. The
participants performed 3 min preferred-speed walking under a single-task and three
dual-tasks (DTs) consisting of verbal, subtraction, and recall tasks. We determined the
nMTC, which could not detect a trough in the toe trajectory during the swing phase. We
evaluated the nMTC frequency (the cases of nMTC / total gait cycles) and compared them
among the tasks and between groups. [Results] The results of the two-way analysis of
variance revealed that there were no differences among the tasks, while the nMTC frequency
in the older group was higher than that in the young group. The DT cost (DTc), which was
used as an indicator of cognitive-motor interference (CMI), was higher in the subtraction
and recall tasks in the older group than those in the young group. [Conclusion] This study
showed that adding a cognitive task while walking increased in the nMTC frequency in older
adults. These results suggest that the nMTC frequency under DT would reflect the increased
CMI in healthy older adults.
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Affiliation(s)
- Kentaro Sasaki
- Graduate School of Health Sciences, Kinjo University: 1200 Kasama, Hakusan city, Ishikawa 924-8511, Japan
| | - Takafumi Ooi
- Department of Medical Technology Rehabilitation Center, Kaga Medical Center, Japan
| | - Ayako Yokota
- Department of Physical Therapy, Kinjo University, Japan
| | - Toshiki Azuma
- Department of Rehabilitation, Yawata Medical Center, Japan
| | - Keisuke Asano
- Department of Physical Therapy, Keiju Kanazawa Hospital, Japan
| | - Go Yadai
- Department of Rehabilitation, Toyama University Hospital, Japan
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Teraz K, Šlosar L, Paravlić AH, de Bruin ED, Marusic U. Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychol 2022; 13:837710. [PMID: 35783735 PMCID: PMC9245546 DOI: 10.3389/fpsyg.2022.837710] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Efficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults. Methods Six online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00. Results From 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585). Conclusions This study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.
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Affiliation(s)
- Kaja Teraz
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Šlosar
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Armin H. Paravlić
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- *Correspondence: Eling D. de Bruin
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Health Sciences, Alma Mater Europaea – ECM, Maribor, Slovenia
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Hupfeld KE, Geraghty JM, McGregor HR, Hass CJ, Pasternak O, Seidler RD. Differential Relationships Between Brain Structure and Dual Task Walking in Young and Older Adults. Front Aging Neurosci 2022; 14:809281. [PMID: 35360214 PMCID: PMC8963788 DOI: 10.3389/fnagi.2022.809281] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when they perform a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underlie dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18–34 years) and 23 older adults (66–86 years). We also collected T1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: (1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and (2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.
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Affiliation(s)
- Kathleen E. Hupfeld
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Justin M. Geraghty
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Heather R. McGregor
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - C. J. Hass
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- University of Florida Norman Fixel Institute for Neurological Diseases, Gainesville, FL, United States
- *Correspondence: Rachael D. Seidler
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Magnani PE, Zanellato NFG, Genovez MB, Alvarenga IC, Faganello-Navega FR, de Abreu DCC. Usual and dual-task gait adaptations under visual stimulation in older adults at different ages. Aging Clin Exp Res 2022; 34:383-389. [PMID: 34213747 DOI: 10.1007/s40520-021-01925-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND During the walk along the streets, older adults are exposed to various visual stimuli that can affect their gait in a harmful or beneficial way. AIMS To evaluate gait strategies during different situations with and without visual stimulation in older adults to identify the influence of the visual stimulus on these gait parameters. METHODS A total of 200 older adults were divided into 4 groups according to age range between 60 and 102 years. Gait was evaluated in the following situations: (1) habitual gait (HG); (2) gait with the visual stimulation (GVS) provided by a pedestrian traffic light, and (3) GVS associated with a cognitive task (GVS-C). The GAITRite Platinum equipment was used to assess gait variables. RESULTS Comparison of GVS and HG revealed that the visual stimulus influences the gait parameters and promotes a gait speed increase. However, to increase their gait speed, older adults aged 60-89 years used strategies of increased step length and cadence, whereas subjects older than 90 years used only strategies of increased cadence. In addition, comparison of GVS and GVS-C revealed a decrease in gait speed in all age ranges when the cognitive task was added, although this reduction was more pronounced in subjects older than 70 years. CONCLUSION Visual stimulus influences the gait parameters in older adults and the strategy used is different depending on their age, a fact that shows that traffic light may be an interesting strategy to improve the gait performance during physical therapy.
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Affiliation(s)
- Paola Errera Magnani
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Health Sciences, Ribeirão Preto School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Maiara Baena Genovez
- Physiotherapy Course, Department of Health Sciences, School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Isabella Camargo Alvarenga
- Physiotherapy Course, Department of Health Sciences, School of Medicine, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Flávia Roberta Faganello-Navega
- Department of Physical Therapy and Occupational Therapy, School of Philosophy and Science, São Paulo State University (UNESP), Marília, SP, Brazil
| | - Daniela Cristina Carvalho de Abreu
- Department of Health Sciences, Rehabilitation and Functional Performance Program, Ribeirão Preto Medical School, University of São Paulo (USP), Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
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Kim H, Fraser S. Neural correlates of dual-task walking in people with central neurological disorders: a systematic review. J Neurol 2022; 269:2378-2402. [PMID: 34989867 DOI: 10.1007/s00415-021-10944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with central neurological disorders experience difficulties with dual-task walking due to disease-related impairments. The objective of this review was to provide a comprehensive examination of the neural correlates (structural/functional brain changes) of dual-task walking in people with Parkinson's disease (PD), multiple sclerosis (MS), stroke, and Alzheimer's disease (AD). METHODS A systematic review of the literature was conducted, following PRISMA guidelines, on Medline, Embase, and Scopus. Included studies examined the relationship between structural and functional brain imaging and dual-task walking performance in people with PD, MS, stroke, and AD. Articles that met the inclusion criteria had baseline characteristics, study design, and behavioral and brain outcomes extracted. Twenty-three studies were included in this review. RESULTS Most structural imaging studies (75%) found an association between decreased brain integrity and poor dual-task performance. Specific brain regions that showed this association include the striatum regions and hippocampus in PD and supplementary motor area in MS. Functional imaging studies reported an association between increased prefrontal activity and maintained (compensatory recruitment) or decreased dual-task walking performance in PD and stroke. A subset (n = 2) of the stroke papers found no significant correlations. Increased supplementary motor area activity was associated with decreased performance in MS and stroke. No studies on AD were identified. CONCLUSION In people with PD, MS, and stroke, several neural correlates of dual-task walking have been identified, however, the direction of the association between neural and performance outcomes varied across the studies. The type of cognitive task used and presentation modality (e.g., visual) may have contributed to these mixed findings.
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Affiliation(s)
- Hyejun Kim
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 7K4, Canada.
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Sasaki K, Ooi T, Yokota A, Azuma T, Asano K, Ooizumi S, Kimura T. Effects of cognitive tasks on center-of-foot pressure displacements and brain activity during single leg stance: comparison in community-dwelling healthy older and young people. J Phys Ther Sci 2022; 34:177-182. [PMID: 35291478 PMCID: PMC8918108 DOI: 10.1589/jpts.34.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022] Open
Abstract
[Purpose] This study aimed to investigate the effect of cognitive tasks on the
center-of-foot pressure (COP) displacements and brain activity during single leg stance
(SLS) in older people. [Participants and Methods] This study included 25 healthy older
(age, 68.8 ± 4.9 years) and 25 young (age, 21.0 ± 0.9 years) participants. Participants
performed SLS for 35 s under a single-task (ST) and three dual-tasks (DTs), namely verbal,
subtraction, and recall tasks. We measured the total length of COP
(COP_TL) and change in oxygenated hemoglobin
(HbO2) levels during SLS under four tasks. [Results] There were no
differences in COP_TL and HbO2 levels in the young
group, whereas COP_TL in the recall task was significantly
longer than in ST in the older group. In the comparisons of the DTc (the relative change
of DT to ST), no differences were found among three DTs in the young group, whereas the
DTc of COP_TL in the recall task was significantly higher than
that in the verbal task in the older group. Regarding HbO2, no differences were
observed among the four tasks in both groups. [Conclusion] These results suggest that SLS
combined with a recall task may be useful for fall risk screening in healthy older
individuals.
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Affiliation(s)
- Kentaro Sasaki
- Graduate School of Health Sciences, Kinjo University: 1200 Kasama, Hakusan city, Ishikawa 924-8511, Japan
| | - Takafumi Ooi
- Department of Medical Technology Rehabilitation Center, Kaga Medical Center, Japan
| | - Ayako Yokota
- Department of Physical Therapy, Kinjo University, Japan
| | - Toshiki Azuma
- Department of Rehabilitation, Yawata Medical Center, Japan
| | - Keisuke Asano
- Department of Physical Therapy, Keiju Kanazawa Hospital, Japan
| | - Shinichi Ooizumi
- Department of Medical Technology Rehabilitation Center, Kaga Medical Center, Japan
| | - Tsuyoshi Kimura
- Department of Social Welfare, Faculty of Social Welfare, Kinjo University, Japan
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Hennah C, Ellis G, Doumas M. Dual task walking in healthy aging: Effects of narrow and wide walking paths. PLoS One 2021; 16:e0261647. [PMID: 34936676 PMCID: PMC8694444 DOI: 10.1371/journal.pone.0261647] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022] Open
Abstract
Dual-task walking may lead to gait instability and a higher fall risk in older adults, particularly when walking in a busy city street. Challenging street features such as narrow sidewalks not only discourage walking, but are also likely to be taxing for older adults’ cognitive resources and gait characteristics. The aim of this study was to assess the way older adults’ gait characteristics are affected by walking on a narrow path while performing a challenging cognitive task in lab conditions imitating common urban environments. Nineteen young and eighteen older adults walked on a narrow (40cm) and a wide (80cm) path and performed a cognitive (n-back) task individually adjusted to 80% accuracy. The two tasks were performed separately (Single-Task) and concurrently (Dual-Task). Both groups walked faster, and their step width was narrower on the narrow path. During dual-task walking on the narrow path, older adults showed significant dual-task costs in the cognitive task, gait speed, step width, and stride length. Dual-task walking was associated with decreased gait speed and stride length in both age groups, suggesting that dual-task walking may adversely affect gait, particularly when walking on narrow paths. These conditions may lead to gait instability and an increased fall risk for older adults, particularly when walking along the narrow sidewalks commonly found within the built environment. However, more research is needed in an urban setting to determine the extent of the fall risk narrow sidewalks present for older adults.
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Affiliation(s)
- Charlotte Hennah
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
| | - Geraint Ellis
- School of Natural and Built Environment, Queen’s University Belfast, Belfast, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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40
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Orcioli-Silva D, Islam A, Baker MR, Gobbi LTB, Rochester L, Pantall A. Bi-Anodal Transcranial Direct Current Stimulation Combined With Treadmill Walking Decreases Motor Cortical Activity in Young and Older Adults. Front Aging Neurosci 2021; 13:739998. [PMID: 34924993 PMCID: PMC8681021 DOI: 10.3389/fnagi.2021.739998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/01/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Walking in the "real world" involves motor and cognitive processes. In relation to this, declines in both motor function and cognition contribute to age-related gait dysfunction. Transcranial direct current stimulation (tDCS) and treadmill walking (STW) have potential to improve gait, particularly during dual-task walking (DTW); walking whilst performing a cognitive task. Our aims were to analyze effects of combined anodal tDCS + STW intervention on cortical activity and gait during DTW. Methods: Twenty-three young adults (YA) and 21 older adults (OA) were randomly allocated to active or sham tDCS stimulation groups. Participants performed 5-min of mixed treadmill walking (alternating 30 s bouts of STW and DTW) before and after a 20-min intervention of active or sham tDCS + STW. Anodal electrodes were placed over the left prefrontal cortex (PFC) and the vertex (Cz) using 9 cm2 electrodes at 0.6 mA. Cortical activity of the PFC, primary motor cortex (M1), premotor cortex (PMC), and supplementary motor area (SMA) bilaterally were recorded using a functional near-infrared spectroscopy (fNIRS) system. Oxygenated hemoglobin (HbO2) levels were analyzed as indicators of cortical activity. An accelerometer measured gait parameters. We calculated the difference between DTW and STW for HbO2 and gait parameters. We applied linear mixed effects models which included age group (YA vs. OA), stimulation condition (sham vs. active), and time (pre- vs. post-intervention) as fixed effects. Treadmill belt speed was a covariate. Partial correlation tests were also performed. Results: A main effect of age group was observed. OA displayed higher activity bilaterally in the PFC and M1, unilaterally in the right PMC and higher gait variability than YA. M1 activity decreased in both YA and OA following active tDCS + STW. There was no overall effect of tDCS + STW on PFC activity or gait parameters. However, negative correlations were observed between changes in left PFC and stride length variability following active tDCS + STW intervention. Conclusion: Increased activity in multiple cortical areas during DTW in OA may act as a compensatory mechanism. Reduction in M1 activity following active tDCS + STW with no observed gait changes suggests improved neural efficiency.
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Affiliation(s)
- Diego Orcioli-Silva
- Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil.,Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Aisha Islam
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mark R Baker
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lilian Teresa Bucken Gobbi
- Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil.,Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Lynn Rochester
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Annette Pantall
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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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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42
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Soulard J, Vaillant J, Baillet A, Gaudin P, Vuillerme N. The effects of a secondary task on gait in axial spondyloarthritis. Sci Rep 2021; 11:19537. [PMID: 34599222 PMCID: PMC8486771 DOI: 10.1038/s41598-021-98732-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/27/2021] [Indexed: 02/08/2023] Open
Abstract
Studies on the effects of dual tasking in patients with chronic inflammatory rheumatic diseases are limited. The aim of this study was to assess dual tasking while walking in patients with axial spondyloarthritis (axSpA) in comparison to healthy controls. Thirty patients with axSpA and thirty healthy controls underwent a 10-m walk test at a self-selected comfortable walking speed in single- and dual-task conditions. Foot-worn inertial sensors were used to compute spatiotemporal gait parameters. Analysis of spatiotemporal gait parameters showed that the secondary manual task negatively affected walking performance in terms of significantly decreased mean speed (p < 0.001), stride length (p < 0.001) and swing time (p = 0.008) and increased double support (p = 0.002) and stance time (p = 0.008). No significant interaction of group and condition was observed. Both groups showed lower gait performance in dual task condition by reducing speed, swing time and stride length, and increasing double support and stance time. Patients with axSpA were not more affected by the dual task than matched healthy controls, suggesting that the secondary manual task did not require greater attention in patients with axSpA. Increasing the complexity of the walking and/or secondary task may increase the sensitivity of the dual-task design to axial spondyloarthritis.
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Affiliation(s)
- Julie Soulard
- University Grenoble Alpes, AGEIS, Grenoble, France.
- CHU Grenoble Alpes, Grenoble, France.
| | | | - Athan Baillet
- CHU Grenoble Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Philippe Gaudin
- CHU Grenoble Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Nicolas Vuillerme
- University Grenoble Alpes, AGEIS, Grenoble, France
- Institut Universitaire de France, Paris, France
- LabCom Telecom4Health, Orange Labs & Univ. Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
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43
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The State-of-the-art of Research into Human Multitasking: An Editorial. J Cogn 2021; 4:54. [PMID: 34568746 PMCID: PMC8428299 DOI: 10.5334/joc.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/20/2022] Open
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Bishnoi A, Hernandez ME. Dual task walking costs in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1618-1629. [PMID: 32757759 DOI: 10.1080/13607863.2020.1802576] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis (PROSPERO registration No CRD42020192121) is to review existing literature focusing on effects of different dual task paradigms on walking speed in older adults with and without Mild Cognitive Impairment. METHODS (1) Data Sources: PubMEd, Cumulative Index of Nursing and Allied Health, Cochrane library, and Web of Science. (2) Study Selection: The key terms searched included those associated with dual task, walking speed, executive function, older adults, and MCI. (3) Data Extraction: The search yielded 140 results with 20 studies meeting the inclusion criteria, which were rated by two independent reviewers using the Quality Assessment Tool. Descriptions of each study including the single and dual task protocol, outcome measure, and final outcomes were extracted. Meta-analysis was performed to evaluate the dual task effects on walking costs in older adults with and without MCI. RESULTS Meta-analysis revealed that there were significant differences in the dual task walking costs among older adults with or without MCI (p < .05). Pooled effect sizes of the serial subtraction (9.54; 95%CI, 3.93-15.15) and verbal fluency tasks (10.06; 95%CI, 6.26-15.65) showed that there are higher motor dual-task costs in older adults with MCI than age-matched controls. For quality assessment, all studies ranged from 12 to 16 in score, out of 18 (high quality). CONCLUSIONS In the studies included in this review, mental tracking tasks, consisting of serial subtraction and verbal fluency, were found to be the most sensitive in detecting MCI-related changes in older adults, and could serve an important role as a target measure for evaluating the efficacy of interventions aimed at improving cognitive and motor function in older adults.
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Affiliation(s)
- Alka Bishnoi
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Manuel E Hernandez
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Zemp DD, Giannini O, Quadri P, Rabuffetti M, Tettamanti M, de Bruin ED. Signatures of Gait Movement Variability in CKD Patients Scheduled for Hemodialysis Indicate Pathological Performance Before and After Hemodialysis: A Prospective, Observational Study. Front Med (Lausanne) 2021; 8:702029. [PMID: 34395481 PMCID: PMC8355421 DOI: 10.3389/fmed.2021.702029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/30/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The frailty status of hemodialysis patients is well-known, but the role of the therapy in the frailty process is not yet clear. Nowadays gait analysis in nephrology is neglected, although gait performance is known to be related to frailty and kidney function. We hypothesized that gait quality and physical activity level is already affected before, and does not change because of the start of hemodialysis. Methods: Fourteen patients (72.3 ± 5.7 years old) in a pre-dialysis program underwent an instrumental gait analysis and their physical activity was monitored for a week. This protocol was repeated 3, 6, 12, and 24 months after the first hemodialysis session. Results: At baseline, our sample showed a conservative gait with pathologic gait variability, high dual-task cost, and a sedentary lifestyle. No statistically significant change was found in any parameter in the analyzed period, but there was a tendency toward an improvement of gait quality and physical activity in the first year of treatment, and a decline in the second year. Conclusion: Elderly patients in the pre-dialysis stage show a conservative gait, however variability was in a pathological range and did not change post-hemodialysis. This hints toward changes in the central nervous system due to the kidney disease. This finding suggests the importance of gait analysis in the early stages of renal disease in the diagnosis of changes in the nervous system due to kidney failure that affect gait. Early detection of these changes would potentially allow a prevention program tailored to this population to be developed.
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Affiliation(s)
- Damiano D Zemp
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Geriatric Service, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
| | - Olivier Giannini
- Department of Internal Medicine, Ente Ospedaliero Cantonale, Mendrisio, Switzerland.,Service of Nephrology, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland.,Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Pierluigi Quadri
- Geriatric Service, Ente Ospedaliero Cantonale, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland.,Department of Internal Medicine, Ente Ospedaliero Cantonale, Mendrisio, Switzerland
| | | | - Mauro Tettamanti
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCSS, Milan, Italy
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.,OST - Eastern Swiss University of Applied Sciences, Department of Health, St. Gallen, Switzerland
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46
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Wang C, Wang G, Lu A, Zhao Y. Effects of Attentional Control on Gait and Inter-Joint Coordination During Dual-Task Walking. Front Psychol 2021; 12:665175. [PMID: 34366983 PMCID: PMC8334006 DOI: 10.3389/fpsyg.2021.665175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
In the process of walking, attentional resources are flexibly allocated to deal with varying environmental constraints correlated with attentional control (AC). A dual-task paradigm was used to investigate the effects of AC on gait and inter-joint coordination. Fifty students volunteered to participate in this study. Based on the reaction time (RT) in the Stroop task, the top 15 participants were assigned to the High Attentional Control (HAC) group, while the last 15 participants were assigned to the Low Attentional Control (LAC) group. The participants in the two groups were randomly asked to perform three tasks: (i) single 2-back working memory task (ST 2-back); (ii) single walking task (ST walking); and (iii) dual task (DT). Cognitive outcomes and gait spatiotemporal parameters were measured. Continuous relative phase (CRP), derived from phase angles of two adjacent joints, was used to assess inter-joint coordination. The LAC group exhibited significant task effects regarding RT, correct rate (CR), step width, gait cycle, step time, forefoot contact times, heel-forefoot times, hip-knee mean absolute relative phase (MARP), and deviation phase (DP) in the stance and swing phases (p < 0.05). In the HAC group, significant task effects were only detected in RT and foot progression angle of the left foot (p < 0.05). Under the three task conditions, the LAC group exhibited a higher CR in ST, longer heel contact times, and longer heel-forefoot times when compared with the LAC group (p < 0.05). Compared with the LAC group, the HAC group exhibited significantly smaller (closer to zero) MARP and weaker hip-knee DP values in the swing phase across all gait conditions (p < 0.05). In the stance phase, the HAC group had smaller MARP (closer to zero) values when compared with the LAC group (p < 0.05). In conclusion, the ability to maintain gait control and modulate inter-joint coordination patterns in young adults is affected by the level of attentional control in accommodating gait disturbances. AC is correlated with the performance of motor control, which theoretically supports the competitive selection of athletes and fall prevention strategies for a specific population.
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Affiliation(s)
- Cenyi Wang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
| | - Guodong Wang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
| | - Aming Lu
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
| | - Ying Zhao
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
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Åhman HB, Berglund L, Cedervall Y, Giedraitis V, McKee KJ, Rosendahl E, Åberg AC. Timed "Up & Go" Dual-Task Tests: Age- and Sex-Specific Reference Values and Test-Retest Reliability in Cognitively Healthy Controls. Phys Ther 2021; 101:6323192. [PMID: 34272869 PMCID: PMC8557829 DOI: 10.1093/ptj/pzab179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/22/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of the study was to establish reference values for the Uppsala-Dalarna Dementia and Gait (UDDGait) Timed "Up & Go" dual-task (TUGdt) test variables in cognitively healthy adults and to assess these variables' test-retest reliability. METHODS For reference values, 166 participants were recruited with approximately equal numbers and proportions of women and men in the age groups 50 to 59, 60 to 69, 70 to 79, and 80+ years (mean age = 70 years, age range = 50-91 years, 51% women). For reliability testing, 43 individuals (mean age = 69 years, age range = 50-89 years, 51% women) were recruited. Two dt tests were carried out: TUGdt naming animals and TUGdt months backward, representing 8 test variables: time scores, costs (the relative difference between single-task and dt time scores), "number of animals," "number of months," "animals/10 seconds ," and "months/10 seconds ." Reference ranges for the variables were established by quantile regression in age- and sex-specific groups. For reliability, intraclass correlation coefficients (ICCs), standard error of measurement, minimal detectable change, and Bland-Altman plots were used. RESULTS Reference values for the TUGdt test variables are presented for the 2.5th and 97.5th percentiles. The reliability of TUGdt time scores was excellent (ICCs between 0.85 and 0.86). "Number of animals" and "animals/10 seconds" as well as "months/10 seconds" showed fair to good levels of reliability (ICCs between 0.45 and 0.58), whereas the reliability for both cost measures and "number of months" was poor (ICCs between 0.34 and 0.39). CONCLUSION Normative reference values, potentially useful for clinical and research purposes, were presented in 4 age- and sex-specific groups from 50 years and older. Reliability for the test variables varied between poor and excellent, the lower estimates partly explained by some variables being the ratio of 2 other variables. In UDDGait, TUGdt tests are intended for diagnostic and predictive purposes, for which these tests are promising and require further investigations. IMPACT Normative reference values and test-retest reliability results for the UDDGait TUGdt test variables were presented. These results should be useful for both clinical and research purposes.
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Affiliation(s)
- Hanna B Åhman
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,Address all correspondence to Ms Åhman at:
| | - Lars Berglund
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Ylva Cedervall
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Vilmantas Giedraitis
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Kevin J McKee
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Anna Cristina Åberg
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden,School of Health and Welfare, Dalarna University, Falun, Sweden
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Marshall MR, Giboney A, Duckworth SC, Schmid D, Rogers RR. Is pregnancy brain real? Comparison of dual task cost during overground walking in pregnant versus control women. Gait Posture 2021; 88:180-184. [PMID: 34098403 DOI: 10.1016/j.gaitpost.2021.05.024] [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: 01/26/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Many pregnant women report that their memory is impaired compared to non-pregnancy, but results of studies of cognitive abilities are mixed. The effect of pregnancy on dual tasking, or performance of two tasks simultaneously, has not been studied, however. RESEARCH QUESTION What is the effect of walking overground at a self-selected speed while also performing a cognitive task on gait and cognitive performance during 3rd trimester of pregnancy compared to non-pregnant controls? METHODS A total of n = 22 3rd trimester pregnant women (mean 33.3 ± 3.3 weeks gestation, age 32.1 ± 4.7 years) and n = 21 non-pregnant controls (age 31.9 ± 3.3 years) were recruited to participate. All participants performed single task walking on a GAITRite gait analysis system and performed three cognitive tests while walking: serial 3 and 7 subtraction tests and a phoneme monitoring test. Participants completed the same assessments while seated and order of the testing was counterbalanced. Dual task cost (DTC) was calculated using the formula (Single task score - Dual task score)/Single task score)*100. Independent t-tests or Mann Whitney U tests were used to compare the two groups depending on normality of data. RESULTS There were no significant differences in cognitive test performance between control and pregnant women while walking or seated (p > 0.05). There were no significant differences between groups for DTC during any cognitive tests, but DTC was significantly greater for walking velocity in pregnant women compared to controls for serial 3 (p < 0.001) and serial 7 (p = 0.005) but not phoneme monitoring (p = 0.061). SIGNIFICANCE Pregnant women had elevated cost of dual tasking, though the decrements were not in cognitive tests but in gait, specifically with greater DTC of walking velocity. This suggests that pregnant women modify their walking velocity to preserve cognitive function during activities requiring focus on both cognitive and physical tasks.
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Affiliation(s)
- Mallory R Marshall
- Samford University, Department of Kinesiology, Birmingham, AL, 35229, United States.
| | - Amy Giboney
- Samford University, Department of Kinesiology, Birmingham, AL, 35229, United States
| | - Sarah C Duckworth
- Samford University, Department of Kinesiology, Birmingham, AL, 35229, United States
| | - Daphne Schmid
- Samford University, Department of Kinesiology, Birmingham, AL, 35229, United States
| | - Rebecca R Rogers
- Samford University, Department of Kinesiology, Birmingham, AL, 35229, United States
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The Beneficial Effects of Cognitive Walking Program on Improving Cognitive Function and Physical Fitness in Older Adults. Healthcare (Basel) 2021; 9:healthcare9040419. [PMID: 33916351 PMCID: PMC8066196 DOI: 10.3390/healthcare9040419] [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: 03/09/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 11/21/2022] Open
Abstract
Exercise and cognitive training can improve the brain-related health of the elderly. We investigated the effects of a cognitive walking program (CWP) involving simultaneous performance of indoor walking and cognitive training on cognitive function and physical fitness compared to normal walking (NW) outdoors. Participants were grouped according to whether they performed regular exercise for at least 3 months prior to the participation in this study. Active participants were assigned to the CWP-active group (CWPAG). Sedentary participants were randomly assigned to the CWP (CWPSG) or NW group (NWSG). CWP and NW were performed for 60 min, 3 times a week, for 6 months. Cognitive function (attention, visuospatial function, memory, and frontal/executive function) and physical fitness (cardiorespiratory fitness, lower extremity muscular strength, and active balance ability) were measured at baseline, 3 months, and 6 months after the program onset. Cognitive function showed improvements over time in all three groups, especially in CWPAG. No clear difference was observed between CWPSG and NWSG. Improvements in all fitness measures were also observed in all three groups. These findings collectively indicate the beneficial effects of CWP, as well as NW, on improving cognitive function and physical fitness in older adults, especially those who are physically active.
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50
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Salzman T, Tobón Vallejo D, Polskaia N, Michaud L, St‐Amant G, Lajoie Y, Fraser S. Hemodynamic and behavioral changes in older adults during cognitively demanding dual tasks. Brain Behav 2021; 11:e02021. [PMID: 33417301 PMCID: PMC7994703 DOI: 10.1002/brb3.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/27/2020] [Accepted: 12/19/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Executive functions play a fundamental role in walking by integrating information from cognitive-motor pathways. Subtle changes in brain and behavior may help identify older adults who are more susceptible to executive function deficits with advancing age due to prefrontal cortex deterioration. This study aims to examine how older adults mitigate executive demands while walking during cognitively demanding tasks. METHODS Twenty healthy older adults (M = 71.8 years, SD = 6.4) performed simple reaction time (SRT), go/no-go (GNG), n-back (NBK), and double number sequence (DNS) cognitive tasks of increasing difficulty while walking (i.e., dual task). Functional near infra-red spectroscopy (fNIRS) was used to measure the hemodynamic response (i.e., oxy- [HbO2] and deoxyhemoglobin [HbR]) changes in the prefrontal cortex (PFC) during dual and single tasks (i.e., walking alone). In addition, performance was measured using gait speed (m/s), response time (s), and accuracy (% correct). RESULTS Using repeated measures ANOVAs, neural findings demonstrated a main effect of task such that ∆HbO2 (p = .047) and ∆HbR (p = .040) decreased between single and dual tasks. An interaction between task and cognitive difficulty (p = .014) revealed that gait speed decreased in the DNS between single and dual tasks. A main effect of task in response time indicated that the SRT response time was faster than all other difficulty levels (p < .001). Accuracy performance declined between single and dual tasks (p = .028) and across difficulty levels (p < .001) but was not significantly different between the NBK and DNS. CONCLUSION Findings suggest that a healthy older adult sample might mitigate executive demands using an automatic locomotor control strategy such that shifting conscious attention away from walking during the dual tasks resulted in decreased ∆HbO2 and ∆HbR. However, decreased prefrontal activation was inefficient at maintaining response time and accuracy performance and may be differently affected by increasing cognitive demands.
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Affiliation(s)
- Talia Salzman
- Interdisciplinary School of Health SciencesUniversity of OttawaOttawaONCanada
| | | | - Nadia Polskaia
- School of Human KineticsUniversity of OttawaOttawaONCanada
| | - Lucas Michaud
- School of Human KineticsUniversity of OttawaOttawaONCanada
| | | | - Yves Lajoie
- School of Human KineticsUniversity of OttawaOttawaONCanada
| | - Sarah Fraser
- Interdisciplinary School of Health SciencesUniversity of OttawaOttawaONCanada
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