scholarly journals Smartphone App�Based Assessment of Gait During Normal and Dual-Task Walking: Demonstration of Validity and Reliability (Preprint)

2017 ◽  
Author(s):  
Brad Manor ◽  
Wanting Yu ◽  
Hao Zhu ◽  
Rachel Harrison ◽  
On-Yee Lo ◽  
...  
Keyword(s):  
Dual Task ◽  
Intraclass Correlation ◽  
Motor Task ◽  
Motion Sensors ◽  
Stride Time ◽  
Validity And Reliability ◽  
Home Based ◽  
Reliable Assessment ◽  
Highly Correlated ◽  
Task Conditions

BACKGROUND Walking is a complex cognitive motor task that is commonly completed while performing another task such as talking or making decisions. Gait assessments performed under normal and “dual-task” walking conditions thus provide important insights into health. Such assessments, however, are limited primarily to laboratory-based settings. OBJECTIVE The objective of our study was to create and test a smartphone-based assessment of normal and dual-task walking for use in nonlaboratory settings. METHODS We created an iPhone app that used the phone’s motion sensors to record movements during walking under normal conditions and while performing a serial-subtraction dual task, with the phone placed in the user’s pants pocket. The app provided the user with multimedia instructions before and during the assessment. Acquired data were automatically uploaded to a cloud-based server for offline analyses. A total of 14 healthy adults completed 2 laboratory visits separated by 1 week. On each visit, they used the app to complete three 45-second trials each of normal and dual-task walking. Kinematic data were collected with the app and a gold-standard–instrumented GAITRite mat. Participants also used the app to complete normal and dual-task walking trials within their homes on 3 separate days. Within laboratory-based trials, GAITRite-derived heel strikes and toe-offs of the phone-side leg aligned with smartphone acceleration extrema, following filtering and rotation to the earth coordinate system. We derived stride times—a clinically meaningful metric of locomotor control—from GAITRite and app data, for all strides occurring over the GAITRite mat. We calculated stride times and the dual-task cost to the average stride time (ie, percentage change from normal to dual-task conditions) from both measurement devices. We calculated similar metrics from home-based app data. For these trials, periods of potential turning were identified via custom-developed algorithms and omitted from stride-time analyses. RESULTS Across all detected strides in the laboratory, stride times derived from the app and GAITRite mat were highly correlated (P<.001, r2=.98). These correlations were independent of walking condition and pocket tightness. App- and GAITRite-derived stride-time dual-task costs were also highly correlated (P<.001, r2=.95). The error of app-derived stride times (mean 16.9, SD 9.0 ms) was unaffected by the magnitude of stride time, walking condition, or pocket tightness. For both normal and dual-task trials, average stride times derived from app walking trials demonstrated excellent test-retest reliability within and between both laboratory and home-based assessments (intraclass correlation coefficient range .82-.94). CONCLUSIONS The iPhone app we created enabled valid and reliable assessment of stride timing—with the smartphone in the pocket—during both normal and dual-task walking and within both laboratory and nonlaboratory environments. Additional work is warranted to expand the functionality of this tool to older adults and other patient populations.

scholarly journals VALIDITY AND RELIABILITY OF REMOTE, SMARTPHONE-BASED ASSESSMENT OF DUAL-TASK STANDING AND WALKING IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S10-S10
Author(s):  
Brad Manor ◽  
Wanting Yu ◽  
On-Ye Lo ◽  
Hao Zhu ◽  
Thomas G Travison ◽  
...  
Keyword(s):  
Older Adults ◽  
Motor Function ◽  
Dual Task ◽  
Smartphone App ◽  
Motion Sensors ◽  
Validity And Reliability ◽  
Retest Reliability ◽  
Home Based ◽  
Multi Media ◽  
Test Retest Reliability

Abstract Dual task walking assessments provide valuable insights into cognitive-motor function in aging. To date, such assessments have been limited primarily to laboratory-based settings. We thus created a smartphone App utilizing multi-media instructions and the phone’s motion sensors to record movements during normal and dual task walking, with the phone placed in the user’s pants pocket. Thirty younger and older adults completed two lab visits, during which walking data were simultaneously acquired by the App and the GAITRite mat. Participants also completed App-based assessments in their homes on three separate days. Across all detected strides in laboratory trials, gait metrics derived from the App correlated closely with those derived from the GAITRite mat (r2&gt;0.96). Across trials, gait metrics demonstrated excellent test-retest reliability, both within and between laboratory visits and home-based assessments (ICC: 0.79–0.90). Remote, smartphone-based dual task walking assessments may therefore be feasible for relatively healthy younger and older adults.

Effects of Concurrent Manual Task Performance on Connected Speech Acoustics in Individuals With Parkinson Disease

2019 ◽  
Vol 62 (7) ◽  
pp. 2099-2117 ◽  
Author(s):  
Jason A. Whitfield ◽  
Zoe Kriegel ◽  
Adam M. Fullenkamp ◽  
Daryush D. Mehta
Keyword(s):  
Task Performance ◽  
Speech Production ◽  
Dual Task ◽  
Motor Task ◽  
Task Condition ◽  
Connected Speech ◽  
Speech Acoustics ◽  
Single Task ◽  
Manual Task ◽  
Task Conditions

Purpose Prior investigations suggest that simultaneous performance of more than 1 motor-oriented task may exacerbate speech motor deficits in individuals with Parkinson disease (PD). The purpose of the current investigation was to examine the extent to which performing a low-demand manual task affected the connected speech in individuals with and without PD. Method Individuals with PD and neurologically healthy controls performed speech tasks (reading and extemporaneous speech tasks) and an oscillatory manual task (a counterclockwise circle-drawing task) in isolation (single-task condition) and concurrently (dual-task condition). Results Relative to speech task performance, no changes in speech acoustics were observed for either group when the low-demand motor task was performed with the concurrent reading tasks. Speakers with PD exhibited a significant decrease in pause duration between the single-task (speech only) and dual-task conditions for the extemporaneous speech task, whereas control participants did not exhibit changes in any speech production variable between the single- and dual-task conditions. Conclusions Overall, there were little to no changes in speech production when a low-demand oscillatory motor task was performed with concurrent reading. For the extemporaneous task, however, individuals with PD exhibited significant changes when the speech and manual tasks were performed concurrently, a pattern that was not observed for control speakers. Supplemental Material https://doi.org/10.23641/asha.8637008

Effects of Hearing Loss on Dual-Task Performance in an Audiovisual Virtual Reality Simulation of Listening While Walking

2016 ◽  
Vol 27 (07) ◽  
pp. 567-587 ◽  
Author(s):  
Sin Tung Lau ◽  
M. Kathleen Pichora-Fuller ◽  
Karen Z. H. Li ◽  
Gurjit Singh ◽  
Jennifer L. Campos
Keyword(s):  
Virtual Reality ◽  
Hearing Loss ◽  
Word Recognition ◽  
Dual Task ◽  
Recognition Accuracy ◽  
Lower Probability ◽  
Stride Time ◽  
Task Condition ◽  
Kinematic Parameters ◽  
Task Conditions

Background: Most activities of daily living require the dynamic integration of sights, sounds, and movements as people navigate complex environments. Nevertheless, little is known about the effects of hearing loss (HL) or hearing aid (HA) use on listening during multitasking challenges. Purpose: The objective of the current study was to investigate the effect of age-related hearing loss (ARHL) on word recognition accuracy in a dual-task experiment. Virtual reality (VR) technologies in a specialized laboratory (Challenging Environment Assessment Laboratory) were used to produce a controlled and safe simulated environment for listening while walking. Research Design: In a simulation of a downtown street intersection, participants completed two single-task conditions, listening-only (standing stationary) and walking-only (walking on a treadmill to cross the simulated intersection with no speech presented), and a dual-task condition (listening while walking). For the listening task, they were required to recognize words spoken by a target talker when there was a competing talker. For some blocks of trials, the target talker was always located at 0° azimuth (100% probability condition); for other blocks, the target talker was more likely (60% of trials) to be located at the center (0° azimuth) and less likely (40% of trials) to be located at the left (270° azimuth). Study Sample: The participants were eight older adults with bilateral HL (mean age = 73.3 yr, standard deviation [SD] = 8.4; three males) who wore their own HAs during testing and eight controls with normal hearing (NH) thresholds (mean age = 69.9 yr, SD = 5.4; two males). No participant had clinically significant visual, cognitive, or mobility impairments. Data Collection and Analysis: Word recognition accuracy and kinematic parameters (head and trunk angles, step width and length, stride time, cadence) were analyzed using mixed factorial analysis of variances with group as a between-subjects factor. Task condition (single versus dual) and probability (100% versus 60%) were within-subject factors. In analyses of the 60% listening condition, spatial expectation (likely versus unlikely) was a within-subject factor. Differences between groups in age and baseline measures of hearing, mobility, and cognition were tested using t tests. Results: The NH group had significantly better word recognition accuracy than the HL group. Both groups performed better when the probability was higher and the target location more likely. For word recognition, dual-task costs for the HL group did not depend on condition, whereas the NH group demonstrated a surprising dual-task benefit in conditions with lower probability or spatial expectation. For the kinematic parameters, both groups demonstrated a more upright and less variable head position and more variable trunk position during dual-task conditions compared to the walking-only condition, suggesting that safe walking was prioritized. The HL group demonstrated more overall stride time variability than the NH group. Conclusions: This study provides new knowledge about the effects of ARHL, HA use, and aging on word recognition when individuals also perform a mobility-related task that is typically experienced in everyday life. This research may help inform the development of more effective function-based approaches to assessment and intervention for people who are hard-of-hearing.

Change-of-Direction Ability of Para-Footballers With Cerebral Palsy Under a New Evidence-Based and Sport-Specific Classification System

2020 ◽  
pp. 1-6
Author(s):  
Iván Peña-González ◽  
Alba Roldan ◽  
Carlos Toledo ◽  
Tomás Urbán ◽  
Raúl Reina
Keyword(s):  
Cerebral Palsy ◽  
Classification System ◽  
Intraclass Correlation ◽  
Football Players ◽  
Validity And Reliability ◽  
New Classification ◽  
Change Of Direction ◽  
Speed Test ◽  
Highly Correlated ◽  
New Evidence

Purpose: This study aimed (1) to explore the validity and reliability of a new and specific change-of-direction (COD) test that requires dribbling skills to classify international footballers with cerebral palsy (CP) and compare it with another valid and reliable COD test without ball dribbling and (2) to probe whether both tests can discriminate between the new CP football classes (ie, FT1, FT2, and FT3) established worldwide in 2018. Methods: This study involved 180 international para-footballers with CP from 23 national teams at the 3 regional competitions held in 2018. They performed 2 COD tests, the modified agility test (no dribbling skills) and the dribbling speed test (DST). Results: Reliability was excellent for both the modified agility test (intraclass correlation coefficient [ICC]2,1 = .91, SEM = 5.75%) and the DST (ICC2,1 = .92, SEM = 4.66%). The modified agility test and DST results were highly to very highly correlated to one another for the whole group and considering the sport classes (r = .60–.80; P < .001). A 1-way analysis of variance showed significant differences between sport classes in both tests (P < .001). However, among classes, there were significant differences between FT1 and FT2 and FT3 (P < .01, effect size = large) and low to moderate effect sizes between FT2 and FT3 for either test. Conclusion: The DST appears to be valid and reliable to classify CP football players within the new classification system. Regression analysis revealed that 18.2% of the variance in the new sport classes could be explained by the 2 examined tests.

scholarly journals Strength Assessment Under Dual Task Conditions in Women with Fibromyalgia: A Test–Retest Reliability Study

2019 ◽  
Vol 16 (24) ◽  
pp. 4971
Author(s):  
Juan Luis Leon-Llamas ◽  
Santos Villafaina ◽  
Alvaro Murillo-Garcia ◽  
Daniel Collado-Mateo ◽  
Francisco Javier Domínguez-Muñoz ◽  
...  
Keyword(s):  
Dual Task ◽  
Intraclass Correlation ◽  
Retest Reliability ◽  
Chair Stand ◽  
Stand Test ◽  
Performance Variable ◽  
Chair Stand Test ◽  
Total Performance ◽  
Task Conditions ◽  
Test Retest Reliability

The present study aimed to: (1) analyze the test–retest reliability of the 30 s chair stand test and the 30 s arm curl test under dual-task conditions; (2) analyze the test–retest reliability of a new variable which assesses the total performance (cognitive + physical) in both tests. A total of 37 women with fibromyalgia participated in the study. Participants completed the 30 s arm curl test and 30 s chair stand test in both simple and dual-task conditions. These tests were repeated after seven days. In the 30 s chair stand dual-task test the reliability was low to good whereas that of the total performance variable was low to moderate. The reliability in both the 30 s arm curl dual-task test and the total performance variable were good to moderate. Both the 30 s chair stand test and 30 s arm curl test under dual-task conditions and the total performance variables had good test–retest reliability. However, it is necessary to consider the fluctuations of the intraclass correlation coefficient (ICC).

scholarly journals Foot-Worn Inertial Sensors Are Reliable to Assess Spatiotemporal Gait Parameters in Axial Spondyloarthritis under Single and Dual Task Walking in Axial Spondyloarthritis

Sensors ◽  
2020 ◽  
Vol 20 (22) ◽  
pp. 6453
Author(s):  
Julie Soulard ◽  
Jacques Vaillant ◽  
Romain Balaguier ◽  
Athan Baillet ◽  
Philippe Gaudin ◽  
...  
Keyword(s):  
Dual Task ◽  
Axial Spondyloarthritis ◽  
Inertial Sensors ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Relative Reliability ◽  
Gait Parameters ◽  
The Mean ◽  
Task Conditions ◽  
Absolute Reliability

The aim of this study was (1) to evaluate the relative and absolute reliability of gait parameters during walking in single- and dual-task conditions in patients with axial spondyloarthritis (axSpA), (2) to evaluate the absolute and relative reliability of dual task effects (DTE) parameters, and (3) to determine the number of trials required to ensure reliable gait assessment, in patients with axSpA. Twenty patients with axSpa performed a 10-m walk test in single- and dual-task conditions, three times for each condition. Spatiotemporal, symmetry, and DTE gait parameters were calculated from foot-worn inertial sensors. The relative reliability (intraclass correlation coefficients-ICC) and absolute reliability (standard error of measurement-SEM and minimum detectable change-MDC) were calculated for these parameters in each condition. Spatiotemporal gait parameters showed good to excellent reliability in both conditions (0.59 < ICC < 0.90). The reliability of symmetry and DTE parameters was low. ICC, SEM, and MDC were better when using the mean of the second and the third trials. Spatiotemporal gait parameters obtained from foot-worn inertial sensors assessed in patients with axSpA in single- and dual-task conditions are reliable. However, symmetry and DTE parameters seem less reliable and need to be interpreted with caution. Finally, better reliability of gait parameters was found when using the mean of the 2nd and the 3rd trials.

scholarly journals Cognitive and motor task performance under single- and dual-task conditions: effects of consecutive versus concurrent practice

2021 ◽  
Author(s):  
Rainer Beurskens ◽  
Dennis Brueckner ◽  
Hagen Voigt ◽  
Thomas Muehlbauer
Keyword(s):  
Task Performance ◽  
Dual Task ◽  
Cognitive Task ◽  
Motor Task ◽  
Significant Group ◽  
Task Values ◽  
Concurrent Execution ◽  
Test Conditions ◽  
Task Measure ◽  
Task Conditions

AbstractThe concurrent execution of two or more tasks simultaneously results in performance decrements in one or both conducted tasks. The practice of dual-task (DT) situations has been shown to decrease performance decrements. The purpose of this study was to investigate the effects of consecutive versus concurrent practice on cognitive and motor task performance under single-task (ST) and DT conditions. Forty-five young adults (21 females, 24 males) were randomly assigned to either a consecutive practice (INT consecutive) group, a concurrent practice (INT concurrent) group or a control (CON) group (i.e., no practice). Both INT groups performed 2 days of acquisition, i.e., practicing a cognitive and a motor task either consecutively or concurrently. The cognitive task required participants to perform an auditory stroop task and the number of correct responses was used as outcome measure. In the motor task, participants were asked to stand on a stabilometer and to keep the platform as close to horizontal as possible. The time in balance was calculated for further analysis. Pre- and post-practice testing included performance assessment under ST (i.e., cognitive task only, motor task only) and DT (i.e., cognitive and motor task simultaneously) test conditions. Pre-practice testing revealed no significant group differences under ST and DT test conditions neither for the cognitive nor the motor task measure. During acquisition, both INT groups improved their cognitive and motor task performance. The post-practice testing showed significantly better cognitive and motor task values under ST and DT test conditions for the two INT groups compared to the CON group. Further comparisons between the two INT groups revealed better motor but not cognitive task values in favor of the INT consecutive practice group (ST: p = 0.022; DT: p = 0.002). We conclude that consecutive and concurrent practice resulted in better cognitive (ST condition) and motor (ST and DT test conditions) task performance than no practice. In addition, consecutive practice resulted in superior motor task performance (ST and DT test conditions) compared to concurrent practice and is, therefore, recommended when executing DT practice schedules.

scholarly journals Impairment of dual-task gait dynamics in older adults with mild cognitive impairment: Relationships to neuropsychological status, fitness and brain morphology

2019 ◽  
Author(s):  
Tess C Hawkins ◽  
Rebecca Samuel ◽  
Maria A Fiatarone Singh ◽  
Nicola Gates ◽  
Guy C Wilson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Dual Task ◽  
Well Being ◽  
Gait Variability ◽  
Time Variability ◽  
Stride Time ◽  
Gait Dynamics ◽  
Dual Tasking ◽  
Task Conditions

ABSTRACTBackgroundIndividuals with Mild Cognitive Impairment (MCI) have more gait variability under dual-task conditions than cognitively healthy adults. However, characteristics associated with this susceptibility of gait to dual-task stress are unknown.MethodsTesting was performed at baseline in the Study of Mental And Resistance Training (SMART). Ninety-three adults with MCI (age 70±6.8 years; 66.6% female) performed a single- and dual-task walk (cognitive distractor=letter fluency), in random order. Linear and non-linear gait variability were measured using force-sensitive insoles. Cognitive performance during dual-tasking was assessed by the number of correct words vocalized. Cognitive function, brain Magnetic Resonance Imaging (MRI), muscle strength, aerobic capacity, body composition, physical and psychosocial function were also assessed as potential correlates of gait dynamics.ResultsGait dynamics worsened during dual-tasking, with decrements in both stride time variability (p<0.001) and detrended fluctuation analysis (DFA) (p=0.001). Lower aerobic capacity and thinner posterior cingulate cortex were associated with greater decrements in DFA (p<0.05). Smaller hippocampal volume, worse psychological well-being and poorer static balance were associated with greater decrements in stride time variability (p<0.05). By contrast, cognitive performance did not change under dual-task conditions compared to seated testing (p=0.13).ConclusionsUnder dual-task conditions, participants with MCI preserved their cognitive performance at the expense of gait stability. Decrements in dual-tasking gait were associated with lower aerobic fitness, balance, psychological well-being, and brain volume in cognitively-relevant areas of the posterior cingulate and hippocampus, all potentially modifiable characteristics. Trials of targeted interventions are needed to determine the potential plasticity of gait variability in high-risk cohorts.

Abstract WP194: Interference of Cognitive Tasks and Upper Limb Movements in Chronic Stroke Patients: A Dual-Task Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hogene Kim ◽  
Hyunki Kim ◽  
Na Young Kim ◽  
Hyun Choi ◽  
Joonho Shin ◽  
...  
Keyword(s):  
Dual Task ◽  
Cognitive Task ◽  
Motor Task ◽  
Control Group ◽  
Motor Tasks ◽  
Stroke Patients ◽  
Movement Accuracy ◽  
Movement Trajectories ◽  
Stroke Group ◽  
Task Conditions

Background: This study investigated cognitive-motor interference effects after a chronic stroke diagnosis. Methods: Ten stroke patients (54.7±12.3 yrs.) and seven age-matched controls (58.4±10.6 yrs.) took part in a series of cognitive-motor tasks. Under single-motor task conditions, participants moved a cursor of the robot arm along the annulus using unaffected hand ( Circle task), or performed a center-out movement in four directions ( Cross task). Under single-cognitive task conditions, participants performed the Serial 7 (S7 task) or the Controlled Oral Word Association Test (COWAT task). Under dual-task conditions, participants performed a motor task and a cognitive task simultaneously. The movement accuracy, defined as the percent of movement trajectories within the annulus per total movement trajectories, were measured on motor tasks, and the number of correct answers were recorded on cognitive tasks. Results: Results of two-sample t statistic showed that the movement accuracy of the stroke group was lower than that of the control group, in particular under single-motor conditions (Circle: stroke 84.9±11.2% vs control 93.1±5.1%, p=0.094; Cross: stroke 77.2±13.2% vs control 88.6±8.2%, p=0.062). No significant difference was found between the control and stroke groups under single-cognitive task conditions. The control group showed no significant changes in the number of correct answers and movement accuracies between single and dual tasks. On the other hand, the stroke group showed significantly decreased movement accuracy for the Cross task compared to the Circle task (p=0.006). The stroke group’s number of correct answers in the S7 task were significantly decreased when S7 was performed together with the Cross task (10.0±5.3 vs 8.1±4.5, p=0.008). Their movement accuracy was also significantly reduced under dual-task conditions (single 77.2±13.2%, dual (COWAT+Cross) 74.6±12.4, p=0.034). Conclusions: This study confirmed that cognitive-motor interference is evident for stroke patients when they performed a cognitive task and a motor task simultaneously, such that performance in one or both of the dual tasks is worse as compared to that of each single task.

scholarly journals Differences in Dual Task Performance After Robotic Upper Extremity Rehabilitation in Hemiplegic Stroke Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Kuem Ju Lee ◽  
Gyulee Park ◽  
Joon-Ho Shin
Keyword(s):  
Task Performance ◽  
Cognitive Performance ◽  
Dual Task ◽  
Motor Performance ◽  
Motor Task ◽  
Robotic Rehabilitation ◽  
Task Effects ◽  
Dual Task Performance ◽  
Upper Extremity Rehabilitation ◽  
Task Conditions

Background: Cognitive–motor interference is a phenomenon in which the concomitant performance of cognitive and motor tasks results in poorer performance than the isolated performance of these tasks. We aimed to evaluate changes in dual-task performance after robotic upper extremity rehabilitation in patients with stroke-induced hemiplegia.Methods: This prospective study included patients with left upper limb weakness secondary to middle cerebral artery stroke who visited a rehabilitation hospital. Participants performed a total of 640 robot-assisted planar reaching movements during a therapist-supervised robotic intervention that was conducted five times a week for 4 weeks. Cognitive and motor performance was separately evaluated in single- and dual-task conditions. The digit span test and Controlled Oral Word Association Test (COWAT) were used to assess cognitive performance, whereas motor performance was evaluated through kinematic assessment of the motor task.Results: In single-task conditions, motor performance showed significant improvement after robotic rehabilitation, as did the scores of the COWAT subdomains of animal naming (p &lt; 0.001), supermarket item naming (p &lt; 0.06), and phonemes (p &lt; 0.05). In dual-task conditions, all motor task performance variables except mean velocity showed improvement after robotic rehabilitation. The type of cognitive task did not affect the dual-task effect, and there were no significant differences in the dual-task effects of motor, cognitive, or the sum of motor and cognitive performance after robotic rehabilitation.Conclusion: Post-stroke robotic rehabilitation has different effects on motor and cognitive function, with more consistent effects on motor function than on cognitive function. Although motor and cognitive performance improved after robotic rehabilitation, there were no changes in the corresponding dual-task effects.

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