scholarly journals The Effect of Two Different Cognitive Tests on Gait Parameters during Dual Tasks in Healthy Postmenopausal Women

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Magdalena Hagner-Derengowska ◽  
Krystian Kałużny ◽  
Wojciech Hagner ◽  
Anna Kałużna ◽  
Bartosz Kochański ◽  
...  

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.

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.


2020 ◽  
pp. 1-12
Author(s):  
Emily L. Messerschmidt ◽  
Eric E. Hall ◽  
Caroline J. Ketcham ◽  
Kirtida Patel ◽  
Srikant Vallabhajosula

Context: Though previous research has focused on examining the effects of concussion history using a dual-task paradigm, the influence of factors like symptoms (unrelated to concussion), gender, and type of sport on gait in college athletes is unknown. Objective: To examine the effect of concussion history, symptoms, gender, and type of sport (noncontact/limited contact/contact) individually on gait among college athletes. Design: Exploratory cross-sectional study. Setting: Laboratory. Participants: In total, 98 varsity athletes (age, 18.3 [1.0] y; height, 1.79 [0.11] m; mass, 77.5 [19.2] kg; 27 with concussion history, 58 reported at least one symptom, 44 females; 8 played noncontact sports and 71 played contact sports) walked under single- and dual-task (walking while counting backward by 7) conditions. Interventions: Not applicable. Main Outcome Measures: Dual-task cost (DTC; % difference between single task and dual task) of gait speed, cadence, step length and width, percentage of swing and double-support phases, symptom score, and total symptom severity score. Independent samples t tests and 1-way analysis of variance were conducted (α value = .05). Results: Self-reported concussion history resulted in no significant differences (P > .05). Those who reported symptoms at testing time showed significantly greater DTC of step length (mean difference [MD], 2.7%; 95% confidence interval [CI], 0.3% to 5.1%; P = .012), % of swing phase (MD, 1.0%; 95% CI, −0.2 to 2.1%; P = .042), and % of double-support phase (MD, 3.9%; 95% CI, 0.2% to 7.8%; P = .019). Females demonstrated significantly higher DTC of gait speed (MD, 5.3%; 95% CI, 1.3% to 9.3%; P = .005), cadence (MD, 4.0%; 95% CI, 1.4% to 6.5%; P = .002), % of swing phase (MD, 1.2%; 95% CI, 0.1% to 2.3%; P = .019), and % of double-support phase (MD, 4.1%; 95% CI, 0.4% to 7.9%; P = .018). Noncontact sports athletes had significantly greater step width DTC than contact sports athletes (MD, 14.2%; 95% CI, 0.9% to 27.6%; P = .032). Conclusions: Reporting symptoms at testing time may influence gait under dual-task conditions. Additionally, female athletes showed more gait changes during a dual task. Sports medicine professionals should be aware that these variables, while unrelated to injury, may affect an athlete’s gait upon analysis.


2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Rabiatul Adawiah Abdul Rahman ◽  
Fazira Rafi ◽  
Fazah Akhtar Hanapiah ◽  
Azlina Wati Nikmat ◽  
Nor Azira Ismail ◽  
...  

Background. Tasks requiring simultaneous mobility and cognition (dual tasks) have been associated with incidence of falls. Although these deficits have been documented in individuals with neurologic disorder, the effect of dual task in children with traumatic brain injury has not been fully explored. Objective. To investigate the effect of dual-task (dual-motor and dual-cognitive task) conditions on spatiotemporal gait parameters during timed up and go test in children with traumatic brain injury. Methods and Material. A total of 14 children with traumatic brain injury and 21 typically developing children participated in this case-control study. Functional balance was assessed before the actual testing to predict the risk of falls. Timed up and go test was performed under single-task and dual-task (dual-motor and dual-cognitive task) conditions. Spatiotemporal gait parameters were determined using the APDM Mobility Lab system. The descriptive statistics and t-test were used to analyze demographic characteristics and repeated measure ANOVA test was used to analyze the gait parameters. Results. Under dual-task (dual-motor and dual-cognitive task) conditions during the timed up and go test, gait performance significantly deteriorated. Furthermore, the total time to complete the timed up and go test, stride velocity, cadence, and step time during turning were significantly different between children with traumatic brain injury and typically developing children. Conclusions. These findings suggest that gait parameters were compromised under dual-task conditions in children with traumatic brain injury. Dual-task conditions may become a component of gait training to ensure a complete and comprehensive rehabilitation program.


2015 ◽  
Vol 28 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Juliana Hotta Ansai ◽  
Thais Rabiatti Aurichio ◽  
José Rubens Rebelatto

ABSTRACTBackground:The purpose of the study was to investigate the relationship between dual task walking, cognition, and depression in oldest old people living in the community.Methods:We conducted an observational cross-sectional study at Federal University of São Carlos (Brazil). We assessed 67 community-dwelling older adults aged 80 years and over, who were able to walk alone and did not present with a risk of dementia (assessed by Mini-Mental State Examination, MMSE). The assessment consisted of anamnesis, dual task using the Timed Up and Go test associated with a motor task (TUGT-motor) and a cognitive task (TUGT-cognitive); cognitive measures using MMSE, Montreal Cognitive Assessment (MoCA), Clock Drawing test (CDT) and verbal fluency, and depressive measures by the Geriatric Depression Scale (GDS).Results:There was a correlation with higher magnitude between cognitive tests and TUGT-cognitive, compared to TUGT-motor. For TUGT-motor, the highest correlations with cognitive tests were found between time and MMSE, MoCA (total score), and MoCA visuospatial/executive domain. For TUGT-cognitive, the highest correlations with cognitive tests were between number of steps and MMSE and between time and MMSE. GDS showed a significant weak correlation with number of steps taken in TUGT-motor, wrong words, and correct/time of TUGT-cognitive.Conclusions:Dual task performances are associated with cognition in oldest old. Furthermore, dual task tests have less influence of educational level, are functional, fast, and easily applicable in clinical practice. Future studies are needed to confirm if dual task test is useful for cognitive screening in oldest old.


2020 ◽  
Vol 9 (9) ◽  
pp. 2835 ◽  
Author(s):  
Yosuke Osuka ◽  
Hunkyung Kim ◽  
Yutaka Watanabe ◽  
Yu Taniguchi ◽  
Narumi Kojima ◽  
...  

This study aimed to examine the concurrent validity of a novel motor-cognitive dual-task test, the Stepping Trail Making Test (S-TMT), as an indicator of cognitive impairment (CI), and compare its screening performance to that of motor or cognitive tests alone. This was a population-based cross-sectional study including 965 Japanese adults aged ≥ 70 years. To measure the time taken to perform the S-TMT, the participants were instructed to step on 16 numbers in sequence as quickly and accurately as possible. Motor and cognitive functions were assessed by gait speed and TMT part A (TMT-A), respectively. Participants were classified into CI (< 24 points), mild CI (MCI, 24–27 points), and intact cognition (> 27 points) categories based on their Mini-Mental State Examination score. Binary logistic regression models showed that the addition of the S-TMT to the covariates model gave the highest discrimination index (c-statistics), and significantly improved reclassification indices (net reclassification improvement and integrated discrimination improvement) for screening both CI and MCI compared to those of gait speed or TMT-A alone. These results show that S-TMT has a concurrent validity as a dual-task test for screening CI and MCI and better discrimination and reclassification performance than motor or cognitive tests alone in older adults.


2021 ◽  
Author(s):  
Chang Yoon Baek ◽  
Woo Nam Chang ◽  
Beom Yeol Park ◽  
Kyoung Bo Lee ◽  
Kyoung Yee Kang ◽  
...  

Abstract Objective This study aimed to investigate the effects of dual-task gait training using a treadmill on gait ability, dual-task interference, and fall efficacy in people with stroke. Methods Patients with chronic stroke (N = 34) were recruited and randomly allocated to the experimental or control group. Both groups underwent gait training on a treadmill and a cognitive task. In the experimental group, gait training was conducted in conjunction with the cognitive task, whereas in the control group, the training and the cognitive task were conducted separately. Each intervention was provided for 60 minutes, twice a week, for a period of 6 weeks for both groups. The primary outcomes were as follows: gait parameters (speed, stride, variability, and cadence) under single-task and dual-task conditions, correct response rate (CRR) under single-task and dual-task conditions, and dual-task cost (DTC) in gait parameters and CRR. The secondary outcome was the fall efficacy scale. Results Dual-task gait training using a treadmill improved all gait parameters in the dual-task condition, speed, stride, and variability in the single-task condition, and CRR in both conditions. Difference between the groups was observed in speed, stride, and variability in the dual-task condition. Furthermore, dual-task gait training on a treadmill improved DTC in speed, variability, and cadence along with that in CRR, indicating true improvement of DTC, which led to significant improvement in DTC in speed and variability compared with single-task training. Conclusions Dual-task gait treadmill training was more effective in improving gait ability in dual-task training and DTI than single-task training involving gait and cognitive task separately in people with chronic stroke.


2021 ◽  
Vol 8 (06) ◽  
pp. 5437-5441
Author(s):  
Raee Saeed Alqhtani ◽  
Adel Alshahrani ◽  
Mohammed Abdul Rahman Jarrar ◽  
Reyaz Ahmed ◽  
Hashim Ahmed

Since walking is a dynamic activity which is an automatic process and attention demanding task. Dual task while walking may cause changes in gait, therefore this study primarily aims to identify whether a secondary cognitive or motor task would have a greater effect on gait parameters in different age groups. Secondarily, it aims to examine difference in gait performance between young and older adults while performing cognitive and motor tasks. Student’s t- test and Repeated measure analysis of variance was used for Statistical analyses. Older group had significantly higher gait time (mean difference: 2.61,3.86, and 6.37seconds), lower stride length (mean difference: 0.26, 0.25, and 0.28 cm), and higher step width (mean difference: 1.46,1.85, and 3.13cm) during simple walking task, motor task and cognitive task while walking, respectively as compared to young adults.This study concludes that the secondary cognitive task has affect the selected gait parameters more in young and older adults as compared to secondary motor task. Additionally, dual task performance has shown difference between gait of young and older adults    


2016 ◽  
Vol 33 (S1) ◽  
pp. S77-S77
Author(s):  
A. Oliveira-Maia ◽  
I. Coelho ◽  
J.B. Barahona-Corrêa ◽  
V. Paixão ◽  
M. Camacho ◽  
...  

IntroductionMethods for measuring cognitive reserve (CR) are limited and controversial. Dual task cost (DTC) paradigms, assessing links between gait and cognition, are increasingly regarded as robust measures of CR.ObjectivesHere, we aimed to validate a simplified methodology for a DTC paradigm in healthy volunteers for application in clinical settings as a measurement of CR.MethodsWe tested if subtracting by 7's (cognitive task) while walking (motor task) induced a DTC in a sample of 39 healthy young adults. For the cognitive task, we recorded the number of correct and incorrect subtractions, as well as the latency between subtractions. Gait parameters were recorded on a tri-axial accelerometer fixed to the left ankle. Both tasks were performed separately (single task) and simultaneously (double task) to assess the DTC. A battery for neuropsychological assessment and questionnaires to assess quality of life and affective symptoms were also applied, to measure possible correlations with the DTC.ResultsSubtracting 7's while walking caused significant changes in gait parameters and in cognitive task performance. A significant decrease in the autocorrelation of the accelerometer signal during the dual task was also found (DTC = 37.92 ± 7.56%; P < 0.0001). This measure has not been previously used and may be a more sensitive measure of the dual task induced disturbance of the gait periodic signal pattern. Correlations between DTC and quality of life, affective or cognitive measures were not significant.ConclusionOur study provides an effective, portable and non-intrusive DTC experimental protocol that can be easily applied in clinical settings.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
Vol 35 (5) ◽  
pp. 621-621
Author(s):  
M A Kelly ◽  
N Morelli ◽  
H L Clayton ◽  
A M Parks ◽  
N R Heebner ◽  
...  

Abstract Objective To investigate the effect of a cognitive task on postural control during treadmill walking. We hypothesized that postural sway acceleration would decrease during dual-task compared to single-task gait. Method Ten (5 females, 5 males) physically active, healthy young adults (Age: 22.50 ± 3.01) with no history of cognitive deficits or head injury were recruited from a University campus for this cross-sectional study. Participants reported to a biomechanics laboratory for a single testing session and completed two, 5-minute walking trials on a treadmill at 90% of maximal gait-speed under single and dual-task conditions while instrumented with a single inertial measurement unit (IMU) on the lower-back. During dual-task gait, participants concurrently performed a Stroop Test displayed on a mounted screen in front of the treadmill during the entire trial. Root mean square (RMS) of acceleration was analyzed in the medial-lateral, anterior-posterior, superior-inferior, and resultant planes during the dual-task trial. Paired t-tests and effect sizes (ES) were calculated for each sway plane between single and dual-tasks. Results No differences were identified between single and dual-task RMS acceleration in the medial-lateral (p = 0.98, ES = 0.01), anterior-posterior (p = 0.49, ES = 0.23) or superior-inferior (p = 0.98, ES = 0.01) planes. However, the RMS acceleration in the resultant plane was lower in the dual-task condition (Mean Difference: 0.031 ± 0.037; p = 0.02, ES = 0.85). Conclusions This novel dual-task gait paradigm utilized constant sub-maximal gait speed to investigate the influence of a sustained cognitive dual-task on postural sway using a single IMU. These preliminary results indicate that this dual-task gait paradigm may affect gross postural sway in healthy adults.


2017 ◽  
Vol 23 (6) ◽  
pp. 493-501 ◽  
Author(s):  
Rebecca K. MacAulay ◽  
Mark T. Wagner ◽  
Dana Szeles ◽  
Nicholas J. Milano

AbstractObjectives: Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Methods: Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Results: Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, ps<.05. Follow-up analysis indicated that the MCI group had significantly slower dual-task gait speed but did not differ in simple-gait speed. Multivariate linear regression across groups found that executive attention performance accounted for 27.4% of the variance in dual-task gait speed beyond relevant demographic and health risk factors. Conclusions: The present study increases the external validity of dual-task gait assessment of MCI. Differences in dual-task gait speed appears to be largely attributable to executive attention processes. These findings have clinical implications as they demonstrate expected patterns of gait-brain behavior relationships in response to a cognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493–501)


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