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Lee HS, Ko M, Kim HJ. Concurrent Validity of Dual-Task Walking Speed With CERAD-NP Assessment Battery in Community-Dwelling Older Adults. Arch Rehabil Res Clin Transl 2023; 5:100291. [PMID: 38163023 PMCID: PMC10757158 DOI: 10.1016/j.arrct.2023.100291] [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] [Indexed: 01/03/2024] Open
Abstract
Objective To explore the concurrent validity of the dual-task walking speed assessments in older adults using the Consortium to Establish a Registry for Alzheimer's Disease Neuro-Psychological (CERAD-NP) Assessment Battery. Design Cross-sectional design. Setting Welfare care centers, Senior complex centers, and Dementia prevention care centers. Participants A total of 163 community-dwelling older adults (N=163) were recruited using consecutive sampling. Participants were composed of 65 older adults with cognitive decline and 98 without cognitive decline. Interventions Not applicable. Main Outcome Measures This study assessed the concurrent validity between dual-task walking speed assessments and the Total II score of CERAD-NP using Spearman's rank order correlations. The effect of the dual-task walking speed assessments on the Total II score was further investigated through multiple linear regression analysis. Results There was a moderate and statically significant association between the Total II score and all 8 dual-task walking speed assessments (P<.05). The Total II score was strongly associated with the dual tasks of walking on a straight path while counting backward and crossing over an obstacle (r=0.698, r=0.697, respectively; P<.05). According to multiple linear regression, only the dual task of walking while counting backward was significantly associated with the Total II score (P<.05). Conclusion The dual-task walking speed assessments, which involved walking and performing a secondary task such as counting backward or crossing an obstacle on a straight path, were highly indicative of cognitive decline. The combination of results from both tasks may provide a more comprehensive evaluation of cognitive decline compared with relying solely on a single-task assessment.
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Affiliation(s)
- Han suk Lee
- Department of Physical Therapy, Eulji University, Seongnam-si, Gyeonggi-do, South Korea
| | - Mansoo Ko
- Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, USA
| | - Hyung-Ji Kim
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, South Korea
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Grijalva C, Mullins VA, Michael BR, Hale D, Wu L, Toosizadeh N, Chilton FH, Laksari K. Neuroimaging, wearable sensors, and blood-based biomarkers reveal hyperacute changes in the brain after sub-concussive impacts. BRAIN MULTIPHYSICS 2023; 5:100086. [PMID: 38292249 PMCID: PMC10827333 DOI: 10.1016/j.brain.2023.100086] [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] [Indexed: 02/01/2024] Open
Abstract
Impacts in mixed martial arts (MMA) have been studied mainly in regard to the long-term effects of concussions. However, repetitive sub-concussive head impacts at the hyperacute phase (minutes after impact), are not understood. The head experiences rapid acceleration similar to a concussion, but without clinical symptoms. We utilize portable neuroimaging technology - transcranial Doppler (TCD) ultrasound and functional near infrared spectroscopy (fNIRS) - to estimate the extent of pre- and post-differences following contact and non-contact sparring sessions in nine MMA athletes. In addition, the extent of changes in neurofilament light (NfL) protein biomarker concentrations, and neurocognitive/balance parameters were determined following impacts. Athletes were instrumented with sensor-based mouth guards to record head kinematics. TCD and fNIRS results demonstrated significantly increased blood flow velocity (p = 0.01) as well as prefrontal (p = 0.01) and motor cortex (p = 0.04) oxygenation, only following the contact sparring sessions. This increase after contact was correlated with the cumulative angular acceleration experienced during impacts (p = 0.01). In addition, the NfL biomarker demonstrated positive correlations with angular acceleration (p = 0.03), and maximum principal and fiber strain (p = 0.01). On average athletes experienced 23.9 ± 2.9 g peak linear acceleration, 10.29 ± 1.1 rad/s peak angular velocity, and 1,502.3 ± 532.3 rad/s2 angular acceleration. Balance parameters were significantly increased following contact sparring for medial-lateral (ML) center of mass (COM) sway, and ML ankle angle (p = 0.01), illustrating worsened balance. These combined results reveal significant changes in brain hemodynamics and neurophysiological parameters that occur immediately after sub-concussive impacts and suggest that the physical impact to the head plays an important role in these changes.
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Affiliation(s)
- Carissa Grijalva
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
| | - Veronica A. Mullins
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Bryce R. Michael
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Dallin Hale
- University of Arizona, Department of Physiology, Tucson, AZ, United States
| | - Lyndia Wu
- Univerisity of British Columbia, Department of Mechanical Engineering, Vancouver, BC, Canada
| | - Nima Toosizadeh
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Medicine, Arizona Center for Aging, Tucson, AZ, United States
| | - Floyd H. Chilton
- University of Arizona, School of Nutritional Sciences and Wellness, Tucson, AZ, United States
| | - Kaveh Laksari
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
- University of Arizona, Department of Aerospace and Mechanical Engineering, Tucson, AZ, United States
- University of California Riverside, Department of Mechanical Engineering, Riverside, CA, United States
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Duan Q, Zhang Y, Zhuang W, Li W, He J, Wang Z, Cheng H. Gait Domains May Be Used as an Auxiliary Diagnostic Index for Alzheimer's Disease. Brain Sci 2023; 13:1599. [PMID: 38002557 PMCID: PMC10669801 DOI: 10.3390/brainsci13111599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a progressive neurodegenerative disorder with cognitive dysfunction and behavioral impairment. We aimed to use principal components factor analysis to explore the association between gait domains and AD under single and dual-task gait assessments. METHODS A total of 41 AD participants and 41 healthy control (HC) participants were enrolled in our study. Gait parameters were measured using the JiBuEn® gait analysis system. The principal component method was used to conduct an orthogonal maximum variance rotation factor analysis of quantitative gait parameters. Multiple logistic regression was used to adjust for potential confounding or risk factors. RESULTS Based on the factor analysis, three domains of gait performance were identified both in the free walk and counting backward assessments: "rhythm" domain, "pace" domain and "variability" domain. Compared with HC, we found that the pace factor was independently associated with AD in two gait assessments; the variability factor was independently associated with AD only in the counting backwards assessment; and a statistical difference still remained after adjusting for age, sex and education levels. CONCLUSIONS Our findings indicate that gait domains may be used as an auxiliary diagnostic index for Alzheimer's disease.
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Affiliation(s)
- Qi Duan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Yinuo Zhang
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou 325000, China;
| | - Weihao Zhuang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Wenlong Li
- Radiotherapy Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Zhen Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
| | - Haoran Cheng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; (Q.D.); (W.Z.); (J.H.); (Z.W.)
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Bouillet K, Lemonnier S, Clanche F, Gauchard G. Does the introduction of a cobot change the productivity and posture of the operators in a collaborative task? PLoS One 2023; 18:e0289787. [PMID: 37556492 PMCID: PMC10411803 DOI: 10.1371/journal.pone.0289787] [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: 06/02/2022] [Accepted: 07/26/2023] [Indexed: 08/11/2023] Open
Abstract
Musculoskeletal disorders (MSDs) are the main occupational diseases and are pathologies of multifactorial origin, with posture being one of them. This creates new human-robot collaboration situations that can modify operator behaviors and performance in their task. These changes raise questions about human-robot team performance and operator health. This study aims to understand the consequences of introducing a cobot on work performance, operator posture, and the quality of interactions. It also aims to evaluate the impact of two levels of difficulty in a dual task on these measures. For this purpose, thirty-four participants performed an assembly task in collaboration with a co-worker, either a human or a cobot with two articulated arms. In addition to this motor task, the participants had to perform an auditory task with two levels of difficulty (dual task). They were equipped with seventeen motion capture sensors. The collaborative work was filmed with a camera, and the actions of the participants and co-worker were coded based on the dichotomy of idle and activity. Interactions were coded based on time out, cooperation, and collaboration. The results showed that performance (number of products manufactured) was lower when the participant collaborated with a cobot rather than a human, with also less collaboration and activity time. However, RULA scores were lower-indicating a reduced risk of musculoskeletal disorders-during collaboration with a cobot compared to a human. Despite a decrease in production and a loss of fluidity, likely due to the characteristics of the cobot, working in collaboration with a cobot makes the task safer in terms of the risk of musculoskeletal disorders.
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Affiliation(s)
- Kévin Bouillet
- EA 3450 DevAH “Développement, Adaptation et Handicap”, Université de Lorraine, Vandœuvre-lès-Nancy, Metz, France
| | - Sophie Lemonnier
- EA 7312 PErSEUs “Psychologie Ergonomique et Sociale pour l’Expérience Utilisateurs”, Université de Lorraine, Metz, France
| | - Fabien Clanche
- Faculté des Sciences du Sport, Université de Lorraine, Villers-lès-Nancy, Metz, France
| | - Gérome Gauchard
- EA 3450 DevAH “Développement, Adaptation et Handicap”, Université de Lorraine, Vandœuvre-lès-Nancy, Metz, France
- Faculté des Sciences du Sport, Université de Lorraine, Villers-lès-Nancy, Metz, France
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Camp N, Vagnetti R, Bisele M, Felton P, Hunter K, Magistro D. The Effect of Cognitive Task Complexity on Healthy Gait in the Walking Corsi Test. Brain Sci 2023; 13:1019. [PMID: 37508951 PMCID: PMC10377536 DOI: 10.3390/brainsci13071019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Dual-task activities are essential within everyday life, requiring visual-spatial memory (VSM) and mobility skills. Navigational memory is an important component of VSM needed to carry out everyday activities, but this is often not included in traditional tests such as the Corsi block tapping test (CBT). The Walking Corsi Test (WalCT) allows both VSM and navigational memory to be tested together, as well as allowing measures of gait to be collected, thus providing a more complete understanding of dual-task function. The aim of this study was to investigate the effect of an increasingly complex cognitive task on gait in a healthy adult population, using the WalCT and body-worn inertial measurement unit (IMU) sensors. Participants completed both the CBT and WalCT, where they were asked to replicate increasingly complex sequences until they were no longer able to carry this out correctly. IMU sensors were worn on the shins throughout the WalCT to assess changes in gait as task complexity increased. Results showed that there were significant differences in several gait parameters between completing a relatively simple cognitive task and completing a complex task. The type of memory used also appeared to have an impact on some gait variables. This indicates that even within a healthy population, gait is affected by cognitive task complexity, which may limit function in everyday dual-task activities.
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Affiliation(s)
- Nicola Camp
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Roberto Vagnetti
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Maria Bisele
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Paul Felton
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Kirsty Hunter
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Daniele Magistro
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
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6
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Goh HT, Pearce M, Vas A. Task matters: an investigation on the effect of different secondary tasks on dual-task gait in older adults. BMC Geriatr 2021; 21:510. [PMID: 34563129 PMCID: PMC8465774 DOI: 10.1186/s12877-021-02464-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022] Open
Abstract
Background Dual-task gait performance declines as humans age, leading to increased fall risk among older adults. It is unclear whether different secondary cognitive tasks mediate age-related decline in dual-task gait. This study aimed to examine how type and difficulty level of the secondary cognitive tasks differentially affect dual-task gait in older adults. Methods Twenty young and twenty older adults participated in this single-session study. We employed four different types of secondary tasks and each consisted of two difficulty levels, yielding eight different dual-task conditions. The dual-task conditions included walking and 1) counting backward by 3 s or by 7 s; 2) remembering a 5-item or 7-item lists; 3) responding to a simple or choice reaction time tasks; 4) generating words from single or alternated categories. Gait speed and cognitive task performance under single- and dual-task conditions were used to compute dual-task cost (DTC, %) with a greater DTC indicating a worse performance. Results A significant three-way interaction was found for the gait speed DTC (p = .04). Increased difficulty in the reaction time task significantly increased gait speed DTC for older adults (p = .01) but not for young adults (p = .90). In contrast, increased difficulty level in the counting backward task significantly increased gait speed DTC for young adults (p = .03) but not for older adults (p = .85). Both groups responded similarly to the increased task difficulty in the other two tasks. Conclusions Older adults demonstrated a different response to dual-task challenges than young adults. Aging might have different impacts on various cognitive domains and result in distinctive dual-task gait interference patterns.
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Affiliation(s)
- Hui-Ting Goh
- School of Physical Therapy-Dallas, Texas Woman's University, Dallas, TX, USA.
| | - Miranda Pearce
- School of Physical Therapy-Dallas, Texas Woman's University, Dallas, TX, USA
| | - Asha Vas
- School of Occupational Therapy-Dallas, Texas Woman's University, Dallas, TX, USA
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7
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Hu X, Zeng X, Xu Y, Luo C, Jia L, Zhao Z, Sun Z, Qu X. A Soft Robotic Intervention for Gait Enhancement in Older Adults. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1838-1847. [PMID: 34469304 DOI: 10.1109/tnsre.2021.3109729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Falls continue to be a major safety and health concern for older adults. Researchers reported that increased gait variability was associated with increased fall risks. In the present study, we proposed a novel wearable soft robotic intervention and examined its effects on improving gait variability in older adults. The robotic system used customized pneumatic artificial muscles (PAMs) to provide assistive torque for ankle dorsiflexion during walking. Twelve older adults with low fall risks and twelve with medium-high fall risks participated in an experiment. The participants were asked to walk on a treadmill under no soft robotic intervention, inactive soft robotic intervention, and active soft robotic intervention, and their gait variability during treadmill walking was measured. The results showed that the proposed soft robotic intervention could reduce step length variability for elderly people with medium-high fall risks. These findings provide supporting evidence that the proposed soft robotic intervention could potentially serve as an effective solution to fall prevention for older adults.
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8
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Qu X, Hu X, Tao D. Gait initiation differences between overweight and normal weight individuals. ERGONOMICS 2021; 64:995-1001. [PMID: 33663344 DOI: 10.1080/00140139.2021.1896788] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Accidental falls often occur during gait initiation. Excess body weight has been identified as a risk factor for accidental falls. This study aimed to examine the differences of gait initiation between overweight and normal-weight individuals. Fourteen overweight and 14 normal-weight young adults participated in the study. They were instructed to perform the gait initiation task under single-task and dual-task conditions. Dependent variables for the assessment of gait initiation included spatial-temporal measures and postural stability measures. The results showed that overweight could compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. Cognitive task interference with gait initiation was found to be similar between the overweight and normal weight groups. The findings from the present study can aid in better understanding the mechanisms associated with increased fall risks among overweight individuals. They also highlight the importance of overweight control in fall prevention. Practitioner summary: Overweight was found to compromise postural stability during gait initiation, primarily by decreasing margin of stability in the anterior-posterior direction. The findings highlight the importance of overweight control in fall prevention. Abbreviations: ANOVA: analyses of variance; AP: anterior-posterior; APA: anticipatory postural adjustment; BOS: base of support; BW: Body weight; COM: centre-of-mass; COP: center-of-pressure; CT: cognitive task; GI: Gait initiation; GRF: ground reaction force; HC: heel-contact; HO: heel-off; ML: medial-lateral; MOS: margin of stability; SD: standard deviation; SE: step execution; SL: step length; SW: step width; VEL_COM: velocity of the COM; XCOM: extrapolated center of mass.
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Affiliation(s)
- Xingda Qu
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Xinyao Hu
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
| | - Da Tao
- Institute of Human Factors and Ergonomics, Shenzhen University, Shenzhen, China
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9
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Ye M, Wang L, Xiong J, Zheng G. The effect of mind-body exercise on memory in older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2021; 33:1163-1173. [PMID: 32329024 DOI: 10.1007/s40520-020-01557-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The current systematic review aims to examine the effect of mind-body exercise on different memory types in the elderly population. METHODS Four literature databases (Pubmed, Cochrane library, Embase and Sinomed) were searched from inception to March 19, 2019. Randomized controlled trials (RCTs) examining the effect of mind-body exercise on memory in older adults were included. The assessment of risk of bias for the included studies and data synthesis were conducted using the software of review manager 5.3 based on the Cochrane handbook. RESULTS Twelve eligible RCTs with a total 1051 participants were identified that met the inclusion criteria for the systematic review. Meta-analysis in elderly adults without known neurological diseases showed mind-body exercise intervention had a large effect on general memory (SMD = 1.24, p = 0.005), a moderate effect on short-term memory (SMD = 0.51, p = 0.02) and long-term memory (SMD = 0.78, p < 0.001), a small effect on working memory (SMD = 0.28, p = 0.009), and a moderate effect on episodic memory (SMD = 0.74, p < 0.001) and semantic memory (SMD = 0.59, p = 0.003) compared to no specific exercise intervention. Similar results were also found in elderly adults with known neurological diseases, showing a moderate effect on general memory (SMD = 0.56, p < 0.001), short-term memory (SMD = 0.68, p = 0.01), and long-term memory (SMD = 0.80, p = 0.003); a small effect on working memory (SMD = 0.46, p < 0.001); and a large effect on episodic memory (SMD = 0.91, p < 0.001). CONCLUSION Compared with no specific exercise, mind-body exercise enhances memory in older adults. However, larger, more robust trials with longer follow-up periods and standardized neuropsychological outcome measures are needed before more definitive conclusions can be drawn.
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Affiliation(s)
- Mingzhu Ye
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Lecong Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jian Xiong
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Guohua Zheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China.
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Working memory is a core executive function supporting dual-task locomotor performance across childhood and adolescence. J Exp Child Psychol 2020; 197:104869. [PMID: 32574754 DOI: 10.1016/j.jecp.2020.104869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 01/23/2023]
Abstract
Most daily-life ambulatory tasks involve dual tasking, for example, talking while walking. In children, the evidence supporting the effects of age on dual tasking is confounded by the difficulty of the cognitive task and lack of adjustment to suit individual cognitive abilities. To address this issue, the current study examined the effects of age, cognitive load, and executive functioning on the degree of dual-task gait interference across childhood and adolescence. We tested 120 typically developing children aged 6-11 years, adolescents aged 12-16 years, and young adults aged 18-25 years. Participants were asked to walk while performing a visuospatial working memory task at two levels of cognitive load (easy and difficult) adjusted to suit each participant's cognitive ability. Spatiotemporal characteristics and intra-individual variability of gait were measured using a GAITRite electronic walkway. Irrespective of the cognitive load level, children aged 6 to 11 years showed greater dual-task gait interference for selective spatiotemporal gait characteristics; however, the younger children showed a trade-off pattern in gait variability whereby they prioritized gait stability at the expense of cognitive performance. Our results also showed that age and working memory capacity were significant predictors of dual-task interference for a range of complementary gait parameters in the combined sample. Importantly, working memory capacity was part of a moderating relationship between age and dual-task gait interference. These findings emphasize the importance of dual-task prioritization strategies in younger children and highlight the role of individual differences in working memory capacity in performance in dual-task gait situations.
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Ehsani H, Parvaneh S, Mohler J, Wendel C, Zamrini E, O'Connor K, Toosizadeh N. Can motor function uncertainty and local instability within upper-extremity dual-tasking predict amnestic mild cognitive impairment and early-stage Alzheimer's disease? Comput Biol Med 2020; 120:103705. [PMID: 32217286 DOI: 10.1016/j.compbiomed.2020.103705] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/14/2020] [Accepted: 03/15/2020] [Indexed: 01/10/2023]
Abstract
In this study, we examined the uncertainty and local instability of motor function for cognitive impairment screening using a previously validated upper-extremity function (UEF). This approach was established based upon the fact that elders with an impaired executive function have trouble in the simultaneous execution of a motor and a cognitive task (dual-tasking). Older adults aged 65 years and older were recruited and stratified into 1) cognitive normal (CN), 2) amnestic MCI of the Alzheimer's type (aMCI), and 3) early-stage Alzheimer's Disease (AD). Participants performed normal-paced repetitive elbow flexion without counting and while counting backward by ones and threes. The influence of cognitive task on motor function was measured using uncertainty (measured by Shannon entropy), and local instability (measured by the largest Lyapunov exponent) of elbow flexion and compared between cognitive groups using ANOVAs, while adjusting for age, sex, and BMI. We developed logistic ordinal regression models for predicting cognitive groups based on these nonlinear measures. A total of 81 participants were recruited, including 35 CN (age = 83.8 ± 6.9), 30 aMCI (age = 83.9 ± 6.9), and 16 early AD (age = 83.2 ± 6.6). Uncertainty of motor function demonstrated the strongest associations with cognitive impairment, with an effect size of 0.52, 0.88, and 0.51 for CN vs. aMCI, CN vs. AD, and aMCI vs. AD comparisons, respectively. Ordinal logistic models predicted cognitive impairment (aMCI and AD combined) with a sensitivity and specificity of 0.82. The findings accentuate the potential of employing nonlinear dynamical features of motor functions during dual-tasking, especially uncertainty, in detecting cognitive impairment.
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Affiliation(s)
- Hossein Ehsani
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Department of Kinesiology, University of Maryland, College Park, MD, USA.
| | | | - Jane Mohler
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, Tucson, AZ, USA; Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Christopher Wendel
- Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, Tucson, AZ, USA; Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Edward Zamrini
- Banner Sun Health Research Institute, Sun City, AZ, USA; Banner Alzheimer's Institute, University of Arizona, Tucson, AZ, USA; Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Kathy O'Connor
- Banner Sun Health Research Institute, Sun City, AZ, USA; Banner Alzheimer's Institute, University of Arizona, Tucson, AZ, USA
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Arizona Center on Aging (ACOA), Department of Medicine, University of Arizona, College of Medicine, Tucson, AZ, USA; Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
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Duncan AL, Thomas AC, Hubbard-Turner T, Burcal CJ, Turner MJ, Wikstrom EA. Spatiotemporal Parameters of Treadmill Walking While Dual-Tasking in Those With Chronic Ankle Instability Versus Uninjured Controls. ACTA ACUST UNITED AC 2019. [DOI: 10.3928/19425864-20190131-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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13
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Kwon Y, Kwon JW, Cho IH. The difference of gait characteristic according to the variety of dual tasks in young healthy adults. Work 2019; 63:33-38. [PMID: 31127742 DOI: 10.3233/wor-192905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Walking in daily life is often accompanied by an attention-demanding task, which requires a different attentional load and external environments. Therefore, various gaits require complex and systematic interactions between several nervous systems, such as sensory association, cognitive functions, and the musculoskeletal system. OBJECTIVE Dual-task conditions during gait can affect the interaction between cognitive processing and motor behavior. This study investigated the effect of two types of cognitive dual tasks and one type of manual dual task (MDT) on kinematic and spatiotemporal parameters of gait in young healthy adults. METHODS We recruited 30 healthy young adults in this study. All participants performed normal gait, and two types of cognitive tasks (subtraction dual task, SDT; and working memory dual task, WMDT) and MDT (carrying a cup filled with water) during gait. This study assessed kinematic data during the stance and swing phases and spatiotemporal parameters. RESULTS MDT gait showed a significant decrement of hip-joint movement during the stance phase compared to the normal gait (p < 0.05). Stride velocity significantly decreased during SDT and WMDT gait compared with the normal gait (p < 0.05). MDT gait showed significant decrement of all spatiotemporal parameters of gait compared with normal gait (p < 0.05). CONCLUSION We reported that MDT gait can induce decreased hip-joint motion during the stance phase and reduced all spatiotemporal parameters to maintain balance and reduce the risk of falling. Therefore, motor dual tasks while walking would be useful as an intervention strategy to rehabilitate or train people at risk for falling.
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Affiliation(s)
- Yonghyun Kwon
- Department of Physical Therapy, Yeungnam University College, Daegu, South Korea
| | - Jung Won Kwon
- Department of Physical Therapy, College of Health Sciences, Dankook University, Cheonan, South Korea
| | - In Hee Cho
- Department of Clinical Science, Graduate School of Health and Welfare, Dankook University, Cheonan, South Korea
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Ehsani H, Mohler MJ, O'Connor K, Zamrini E, Tirambulo C, Toosizadeh N. The association between cognition and dual-tasking among older adults: the effect of motor function type and cognition task difficulty. Clin Interv Aging 2019; 14:659-669. [PMID: 31040655 PMCID: PMC6459153 DOI: 10.2147/cia.s198697] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Dual-task actions challenge cognitive processing. The usefulness of objective methods based on dual-task actions to identify the cognitive status of older adults has been previously demonstrated. However, the properties of select motor and cognitive tasks are still debatable. We investigated the effect of cognitive task difficulty and motor task type (walking versus an upper-extremity function [UEF]) in identifying cognitive impairment in older adults. Methods Older adults (≥65 years) were recruited, and cognitive ability was measured using the Montreal Cognitive Assessment (MoCA). Participants performed repetitive elbow flexion under three conditions: 1) at maximum pace alone (Single-task); and 2) while counting backward by ones (Dual-task 1); and 3) threes (Dual-task 2). Similar single- and dual-task gait were performed at normal speed. Three-dimensional kinematics were measured for both motor functions using wearable sensors. Results One-hundred older adults participated in this study. Based on MoCA score <20, 21 (21%) of the participants were considered cognitively impaired (mean age =86±10 and 85±5 for cognitively impaired and intact participants, respectively). Within ANOVA models adjusted with demographic information, UEF dual-task parameters, including speed and range-of-motion variability were significantly higher by 52% on average, among cognitively impaired participant (p<0.01). Logistic models with these UEF parameters plus age predicted cognitive status with sensitivity, specificity, and area under curve (AUC) of 71%, 81% and 0.77 for Dual-task 1. The corresponding values for UEF Dual-task 2 were 91%, 73% and 0.81, respectively. ANOVA results were non-significant for gait parameters within both dual-task conditions (p>0.26). Conclusion This study demonstrated that counting backward by threes within a UEF dual-task experiment was a pertinent and challenging enough task to detect cognitive impairment in older adults. Additionally, UEF was superior to gait as the motor task component of the dual-task. The UEF dual-task could be applied as a quick memory screen in a clinical setting.
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Affiliation(s)
- Hossein Ehsani
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA, .,Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA,
| | - Martha Jane Mohler
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA, .,Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA, .,Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Kathy O'Connor
- Neurology Department, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Edward Zamrini
- Neurology Department, Banner Sun Health Research Institute, Sun City, AZ, USA.,Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Coco Tirambulo
- Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA,
| | - Nima Toosizadeh
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA, .,Arizona Center on Aging, Department of Medicine, University of Arizona, Tucson, AZ, USA, .,Division of Geriatrics, General Internal Medicine and Palliative Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
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Battisto J, Echt KV, Wolf SL, Weiss P, Hackney ME. The Body Position Spatial Task, a Test of Whole-Body Spatial Cognition: Comparison Between Adults With and Without Parkinson Disease. Neurorehabil Neural Repair 2018; 32:961-975. [PMID: 30317924 PMCID: PMC6226349 DOI: 10.1177/1545968318804419] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The Body Position Spatial Task (BPST) is a novel measure of whole-body spatial cognition involving multidirectional steps and turns. Individuals with Parkinson disease (PD) are affected by motor and cognitive impairments, particularly in spatial function, which is important for mental imagery and navigation. Performance on the BPST may inform understanding of motor-cognitive and spatial cognitive function of individuals with PD. OBJECTIVES We conducted this study to determine feasibility and validity of the BPST with standard, validated, and reliable measures of spatial cognition and motor-cognitive integration and to compare BPST performance in adults with and without PD. METHODS A total of 91 individuals with mild-moderate PD and 112 neurotypical (NT) adults of similar age were recruited for the study to complete the BPST and other measures of mobility and cognition. Correlations were used to determine construct and concurrent validity of BPST with valid measures of spatial cognition and motor-cognitive integration. Performance was compared between PD and NT adults using independent t-tests. RESULTS BPST was feasible to administer. Analyses show evidence of construct validity for spatial cognition and for motor-cognitive integration. Concurrent validity was demonstrated with other tests of mobility and cognition. Relationships were stronger and more significant for individuals with PD than for NT individuals. BPST performance was not significantly different between groups. CONCLUSION Tests that integrate cognitive challenge in mobility contexts are necessary to assess the health of spatial cognitive and motor-cognitive integration. The BPST is a feasible and valid test of whole-body spatial cognition and motor-cognitive integration in individuals with PD.
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Affiliation(s)
| | - Katharina V. Echt
- Atlanta Veterans Affairs Medical Center, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
- Geriatric Research, Education, and Clinical Center (GRECC), Birmingham/Atlanta Veterans Affairs Medical Centers
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
| | - Steven L. Wolf
- Atlanta Veterans Affairs Medical Center, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
- Emory University Department of Rehabilitation Medicine, Division of Physical Therapy
| | - Paul Weiss
- Atlanta Veterans Affairs Medical Center, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
- Rollins School of Public Health, Emory University
| | - Madeleine E. Hackney
- Atlanta Veterans Affairs Medical Center, Center for Visual and Neurocognitive Rehabilitation, Decatur, Georgia
- Geriatric Research, Education, and Clinical Center (GRECC), Birmingham/Atlanta Veterans Affairs Medical Centers
- Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia
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Grabiner MD, Marone JR, Wyatt M, Sessoms P, Kaufman KR. Performance of an attention-demanding task during treadmill walking shifts the noise qualities of step-to-step variation in step width. Gait Posture 2018; 63:154-158. [PMID: 29738957 DOI: 10.1016/j.gaitpost.2018.04.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The fractal scaling evident in the step-to-step fluctuations of stepping-related time series reflects, to some degree, neuromotor noise. RESEARCH QUESTION The primary purpose of this study was to determine the extent to which the fractal scaling of step width, step width and step width variability are affected by performance of an attention-demanding task. We hypothesized that the attention-demanding task would shift the structure of the step width time series toward white, uncorrelated noise. METHODS Subjects performed two 10-min treadmill walking trials, a control trial of undisturbed walking and a trial during which they performed a mental arithmetic/texting task. Motion capture data was converted to step width time series, the fractal scaling of which were determined from their power spectra. RESULTS Fractal scaling decreased by 22% during the texting condition (p < 0.001) supporting the hypothesized shift toward white uncorrelated noise. Step width and step width variability increased 19% and five percent, respectively (p < 0.001). However, a stepwise discriminant analysis to which all three variables were input revealed that the control and dual task conditions were discriminated only by step width fractal scaling. SIGNIFICANCE The change of the fractal scaling of step width is consistent with increased cognitive demand and suggests a transition in the characteristics of the signal noise. This may reflect an important advance toward the understanding of the manner in which neuromotor noise contributes to some types of falls. However, further investigation of the repeatability of the results, the sensitivity of the results to progressive increases in cognitive load imposed by attention-demanding tasks, and the extent to which the results can be generalized to the gait of older adults seems warranted.
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Affiliation(s)
- Mark D Grabiner
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 1919 W. Taylor Street, Room 648, Chicago, IL 60612, United States.
| | - Jane R Marone
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, 901 W. Roosevelt Rd, 336 PEB, Chicago, IL 60612, United States.
| | - Marilynn Wyatt
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, United States.
| | - Pinata Sessoms
- Naval Health Research Center, San Diego, 140 Sylvester Rd., San Diego, CA 92106-3521, United States.
| | - Kenton R Kaufman
- Motion Analysis Laboratory, Dan Abraham Health Living Center 4-214A, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States.
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Nishiguchi S, Yorozu A, Adachi D, Takahashi M, Aoyama T. Association between mild cognitive impairment and trajectory-based spatial parameters during timed up and go test using a laser range sensor. J Neuroeng Rehabil 2017; 14:78. [PMID: 28789676 PMCID: PMC5549311 DOI: 10.1186/s12984-017-0289-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/01/2017] [Indexed: 11/16/2022] Open
Abstract
Background The Timed Up and Go (TUG) test may be a useful tool to detect not only mobility impairment but also possible cognitive impairment. In this cross-sectional study, we used the TUG test to investigate the associations between trajectory-based spatial parameters measured by laser range sensor (LRS) and cognitive impairment in community-dwelling older adults. Methods The participants were 63 community-dwelling older adults (mean age, 73.0 ± 6.3 years). The trajectory-based spatial parameters during the TUG test were measured using an LRS. In each forward and backward phase, we calculated the minimum distance from the marker, the maximum distance from the x-axis (center line), the length of the trajectories, and the area of region surrounded by the trajectory of the center of gravity and the x-axis (center line). We measured mild cognitive impairment using the Mini-Mental State Examination score (26/27 was the cut-off score for defining mild cognitive impairment). Results Compared with participants with normal cognitive function, those with mild cognitive impairment exhibited the following trajectory-based spatial parameters: short minimum distance from the marker (p = 0.044), narrow area of center of gravity in the forward phase (p = 0.012), and a large forward/whole phase ratio of the area of the center of gravity (p = 0.026) during the TUG test. In multivariate logistic regression analyses, a short minimum distance from the marker (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.69–0.98), narrow area of the center of gravity in the forward phase (OR: 0.01, 95% CI: 0.00–0.36), and large forward/whole phase ratio of the area of the center of gravity (OR: 0.94, 95% CI: 0.88–0.99) were independently associated with mild cognitive impairment. Conclusions In conclusion, our results indicate that some of the trajectory-based spatial parameters measured by LRS during the TUG test were independently associated with cognitive impairment in older adults. In particular, older adults with cognitive impairment exhibit shorter minimum distances from the marker and asymmetrical trajectories during the TUG test.
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Affiliation(s)
- Shu Nishiguchi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Ayanori Yorozu
- Graduate School of Science and Technology, Keio University, Yokohama, Japan
| | - Daiki Adachi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Takahashi
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku Yokohama, 223-8522, Japan.
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Magnani RM, Lehnen GC, Rodrigues FB, de Sá E Souza GS, de Oliveira Andrade A, Vieira MF. Local dynamic stability and gait variability during attentional tasks in young adults. Gait Posture 2017; 55:105-108. [PMID: 28437756 DOI: 10.1016/j.gaitpost.2017.04.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 04/12/2017] [Accepted: 04/13/2017] [Indexed: 02/02/2023]
Abstract
Cell phone use while walking may be a cognitive distraction and reduce visual and motor attention. Thus, the aim of this study was to verify the effects of attentional dual-tasks while using a cell phone in different conditions. Stability, regularity, and linear variability of trunk kinematics, and gait spatiotemporal parameters in young adults were measured. Twenty young subjects of both genders were asked to walk on a treadmill for 4min under the following conditions: (a) looking forward at a fixed target 2.5m away (walking); (b) talking on a cell phone with unilateral handling (talking); (c) texting messages on a cell phone with unilateral handling (texting); and (d) looking forward at the aforementioned target while listening to music without handling the phone (listening). Local dynamic stability measured in terms of the largest Lyapunov exponent decreased while handling a cell phone (talking and texting). Gait variability and regularity increased when talking on a cell phone, but no variable changed in the listening condition. Under all dual-task conditions, there were significant increases in stride width and its variability. We conclude that young adults who use a cell phone when walking adapt their gait pattern conservatively, which can be because of increased attentional demand during cell phone use.
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Affiliation(s)
- Rina Márcia Magnani
- Universidade Federal de Goiás, Bioengineering and Biomechanics Laboratory, Goiânia, Goiás, Brazil.
| | - Georgia Cristina Lehnen
- Universidade Federal de Goiás, Bioengineering and Biomechanics Laboratory, Goiânia, Goiás, Brazil
| | - Fábio Barbosa Rodrigues
- Universidade Federal de Goiás, Bioengineering and Biomechanics Laboratory, Goiânia, Goiás, Brazil
| | | | | | - Marcus Fraga Vieira
- Universidade Federal de Goiás, Bioengineering and Biomechanics Laboratory, Goiânia, Goiás, Brazil
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Szturm TJ, Sakhalkar VS, Kanitkar A, Nankar M. Computerized Dual-Task Testing of Gait and Visuospatial Cognitive Functions; Test-Retest Reliability and Validity. Front Hum Neurosci 2017; 11:105. [PMID: 28367119 PMCID: PMC5355418 DOI: 10.3389/fnhum.2017.00105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/20/2017] [Indexed: 11/13/2022] Open
Abstract
The common occurrence of age decline in mobility and cognition does cause a decrease in the level of physical activity and an increased falls risk. Consequently, dual -task (DT) assessment that simultaneously addresses both mobility skills and cognitive functions are important because, continued difficulties and fall injuries will have a sizable impact in this population. The first objective of the present study was to assess test-retest reliability of a computerized DT treadmill walking protocol and concurrent outcome measures of gait and visuospatial executive function in a group of healthy older adults. Secondly, discriminative validity was evaluated by examining the effect of DT conditions (single task vs. dual-task) on; (a) spatiotemporal gait measures (average and coefficient of variation) and (b) visuomotor and visuospatial executive performance measures. Twenty-five community-dwelling individuals median age 65 (range 61-67) were recruited from a Fitness Facility. Participants performed a computerized visuomotor tracking task and a visuospatial executive game task in standing and while treadmill walking. Testing was conducted on two occasions, 1 week apart. Moderate to high test-retest reliability (ICC values of 0.65-0.88) were observed for spatiotemporal gait variables. No significant differences between the group means were observed between test periods in any gait variable. Moderate test-retest reliability (ICC values of 0.6-0.65) was observed for measures of visuomotor and visuospatial executive performance during treadmill walking. Significant DT effects were observed for both spatiotemporal gait variables and visuospatial executive performance measures. This study demonstrates the reliability and reproducibility of the computer-based assessment tool for dual task treadmill walking. The high to moderate ICC values and the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable data from community-dwelling older adults. The present computerized dual-task protocols broaden the types of standardized visuomotor and visuospatial executive activities for use with DT treadmill walking that has previously been reported.
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Affiliation(s)
- Tony J Szturm
- Mobility and Cognition Lab, College of Rehabilitation Sciences, University of ManitobaWinnipeg, MB, Canada; Department of Physical Therapy, University of ManitobaWinnipeg, MB, Canada
| | - Vedant S Sakhalkar
- Mobility and Cognition Lab, College of Rehabilitation Sciences, University of ManitobaWinnipeg, MB, Canada; School of Medical Rehabilitation, University of ManitobaWinnipeg, MB, Canada
| | - Anuprita Kanitkar
- Mobility and Cognition Lab, College of Rehabilitation Sciences, University of ManitobaWinnipeg, MB, Canada; Applied Health Sciences, University of ManitobaWinnipeg, MB, Canada
| | - Mayur Nankar
- Mobility and Cognition Lab, College of Rehabilitation Sciences, University of Manitoba Winnipeg, MB, Canada
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Hagner-Derengowska M, Kałużny K, Hagner W, Kałużna A, Kochański B, Borkowska A, Budzyński J. The Effect of Two Different Cognitive Tests on Gait Parameters during Dual Tasks in Healthy Postmenopausal Women. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1205469. [PMID: 27022602 PMCID: PMC4789027 DOI: 10.1155/2016/1205469] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The paper aims to evaluate the influence of two different demanding cognitive tasks on gait parameters using BTS SMART system analysis. PATIENTS AND METHODS The study comprised 53 postmenopausal women aged 64.5 ± 6.7 years (range: 47-79). For every subject, gait analysis using a BTS SMART system was performed in a dual-task study design under three conditions: (I) while walking only (single task), (II) walking while performing a simultaneous simple cognitive task (SCT) (dual task), and (III) walking while performing a simultaneous complex cognitive task (CCT) (dual task). Time-space parameters of gait pertaining to the length of a single support phase, double support phase, gait speed, step length, step width, and leg swing speed were analyzed. RESULTS Performance of cognitive tests during gait resulted in a statistically significant prolongation of the left (by 7%) and right (by 7%) foot gait cycle, shortening of the length of steps made with the right extremity (by 4%), reduction of speed of swings made with the left (by 11%) and right (by 8%) extremity, and reduction in gait speed (by 6%). CONCLUSIONS Performance of cognitive tests during gait changes its individual pattern in relation to the level of the difficulty of the task.
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Affiliation(s)
- Magdalena Hagner-Derengowska
- Chair of Clinical Neuropsychology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Krystian Kałużny
- Chair and Clinic of Rehabilitation, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Wojciech Hagner
- Chair and Clinic of Rehabilitation, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Anna Kałużna
- Chair and Clinic of Rehabilitation, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Bartosz Kochański
- Chair and Clinic of Rehabilitation, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Alina Borkowska
- Chair of Clinical Neuropsychology, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, M. Skłodowskiej-Curie 9 Street, 85-094 Bydgoszcz, Poland
| | - Jacek Budzyński
- Chair of Vascular and Internal Diseases, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Ujejskiego 75 Street, 85-168 Bydgoszcz, Poland
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Mirelman A, Bernad-Elazari H, Nobel T, Thaler A, Peruzzi A, Plotnik M, Giladi N, Hausdorff JM. Effects of Aging on Arm Swing during Gait: The Role of Gait Speed and Dual Tasking. PLoS One 2015; 10:e0136043. [PMID: 26305896 PMCID: PMC4549059 DOI: 10.1371/journal.pone.0136043] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 07/29/2015] [Indexed: 11/18/2022] Open
Abstract
Healthy walking is characterized by pronounced arm swing and axial rotation. Aging effects on gait speed, stride length and stride time variability have been previously reported, however, less is known about aging effects on arm swing and axial rotation and their relationship to age-associated gait changes during usual walking and during more challenging conditions like dual tasking. Sixty healthy adults between the ages of 30-77 were included in this study designed to address this gap. Lightweight body fixed sensors were placed on each wrist and lower back. Participants walked under 3 walking conditions each of 1 minute: 1) comfortable speed, 2) walking while serially subtracting 3's (Dual Task), 3) walking at fast speed. Aging effects on arm swing amplitude, range, symmetry, jerk and axial rotation amplitude and jerk were compared between decades of age (30-40; 41-50; 51-60; 61-77 years). As expected, older adults walked slower (p = 0.03) and with increased stride variability (p = 0.02). Arm swing amplitude decreased with age under all conditions (p = 0.04). In the oldest group, arm swing decreased during dual task and increased during the fast walking condition (p<0.0001). Similarly, arm swing asymmetry increased during the dual task in the older groups (p<0.004), but not in the younger groups (p = 0.67). Significant differences between groups and within conditions were observed in arm swing jerk (p<0.02), axial rotation amplitude (p<0.02) and axial jerk (p<0.001). Gait speed, arm swing amplitude of the dominant arm, arm swing asymmetry and axial rotation jerk were all independent predictors of age in a multivariate model. These findings suggest that the effects of gait speed and dual tasking on arm swing and axial rotation during walking are altered among healthy older adults. Follow-up work is needed to examine if these effects contribute to reduced stability in aging.
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Affiliation(s)
- Anat Mirelman
- Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| | - Hagar Bernad-Elazari
- Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tomer Nobel
- School of Healthy Related Professions, Ben Gurion University, Beer Sheba, Israel
| | - Avner Thaler
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Agnese Peruzzi
- Information Engineering Unit, POLCOMING Department, Sassari University, Sassari, Italy
| | - Meir Plotnik
- The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
| | - Nir Giladi
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sieratzki Chair in Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M. Hausdorff
- Center for the study of Movement, Cognition and Mobility, Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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