P2-342: CEREBROVASCULAR HEMODYNAMICS AND GAIT VELOCITY DURING A COGNITIVE TASK (DUAL TASK GAIT): RACIAL DIFFERENCES IN MIDLIFE

Background: Changes in gait velocity have been identified in the literature between concussed and non-concussed individuals. Concussed patients demonstrate slower gait speed; the gait velocity cost has not been evaluated as extensively. Hypothesis: Hypothesis 1: Dual-task gait velocity cost will decrease at time of clearance compared to initial testing. Hypothesis 2: Subjects with a SRC will demonstrate greater decreases in gait velocity costs than those with non-SRC. Hypothesis 3: Symptom severity will be positively correlated to dual-task gait costs within the first 5 days after concussion. Methods: Patients evaluated for concussion in primary care sports medicine clinic within five days of injury were recruited between October 2017 and May 2019. The mechanism of injury was documented and used to classify sport-related (SRC) versus non sport-related (non-SRC) concussion. A standard concussion evaluation was performed at each visit to assess history, symptoms, neurocognitive, neuromuscular and vestibular dysfunction. Dual-task walking trials were incorporated with a cognitive task such as reciting the months of the year in reverse order or spelling words backwards. During the walking trials, gait velocity was measured using an Xsens MVN BIOMCH system (Xsens Technologies BV, Enschede, The Netherlands). A two-way mixed ANOVA with one within-subjects factor (time) and one between-groups factor (mechanism of injury) was used to determine if dual-task gait velocity costs differed over time and between those with a SRC versus those with a non-SRC. A Pearson’s product-moment correlation was used to assess the relationship between symptom severity scores and dual-task gait costs at initial visit. Results: There was no statistically significant interaction between the mechanism of injury and time on gait velocity cost, F(1, 79) = .033, p = .86. The main effect of time showed a statistically significant difference in mean gait velocity cost from initial to clearance, F(1, 79) = 6.19, p = 0.015, generalized η2 = .0.013. There was no main effect of mechanism of injury in mean gait velocity costs, F(1, 79) = 0.800, p = 0.374, generalized η2 = 0.008. There was a statistically significant, small positive correlation between symptom severity and dual-task gait velocity costs, r = .30, p < .007, with symptom severity explaining 9 % of the variation in dual-task gait velocity costs. Conclusion: The gait velocity cost demonstrates a statistically significant change from the time of injury to clearance in concussion patients. A small but significant relationship also exists between symptom severity and gait velocity cost.

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The 2-Min Walk Test Detects Dual-Task Deficits in Individuals With Parkinson’s Disease

Journal of Aging and Physical Activity ◽

10.1123/japa.2018-0264 ◽

2019 ◽

Vol 27 (6) ◽

pp. 843-847 ◽

Cited By ~ 1

Author(s):

Anson B. Rosenfeldt ◽

Amanda L. Penko ◽

Andrew S. Bazyk ◽

Matthew C. Streicher ◽

Tanujit Dey ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Cognitive Task ◽

The Self ◽

Effective Model ◽

Gait Velocity ◽

Walk Test ◽

Minimal Clinical Important Difference ◽

Task Conditions

The aim of this project was to (a) evaluate the potential of the 2-min walk test to detect declines in gait velocity under dual-task conditions and (b) compare gait velocity overground and on a self-paced treadmill in Parkinson’s disease (PD). In total, 23 individuals with PD completed the 2-min walk test under single- and dual-task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single- to dual-task conditions overground (1.32 ± 0.22 to 1.10 ± 0.25 m/s; p < .001) and on the self-paced treadmill (1.24 ± 0.21 to 1.05 ± 0.25 m/s; p < .001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2-min walk test coupled with a cognitive task provides an effective model of identifying dual-task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.

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A Proposal for Complex Gait Evaluation Using Dual-Task Gait Termination Time

Journal of Sport Rehabilitation ◽

10.1123/jsr.2020-0080 ◽

2020 ◽

pp. 1-6

Author(s):

Rachel S. Johnson ◽

Kendall H. Scott ◽

Robert C. Lynall

Keyword(s):

Dual Task ◽

Repeated Measures ◽

Cognitive Task ◽

Mean Difference ◽

Clinical Population ◽

Gait Velocity ◽

Cross Sectional ◽

Gait Termination ◽

Health Related ◽

Termination Time

Context: Gait termination time (GTT) has been used to predict falls in older adults but has not been explored in the sport rehabilitation setting. The incorporation of a concurrent cognitive task as a complex measure of gait in this clinical population could lead to better health-related outcomes. Objective: To compare the effect of planned and unplanned gait termination with and without a concurrent cognitive task on reaction time (RT), gait velocity, and GTT. Design: Cross-sectional. Setting: Laboratory. Participants: Twenty young adults (females 60.0%, age 20.1 [0.9] y, height 169.5 [8.8] cm, mass 67.4 [10.8] kg). Intervention: Participants completed 6 planned and 6 unplanned gait termination trials on an instrumented gait mat with and without a cognitive task. Main Outcome Measures: The authors measured RT (s), gait velocity (m/s), GTT (s), and normalized GTT (s2/m). A 2 (motor) × 2 (cognitive) repeated-measures analysis of variance (α = .05) was used; significant interaction effects were explored using Bonferroni-corrected t tests (α < .008). Results: Participants walked more slowly during dual-task trials compared with single-task trials (F1,19 = 4.401, P = .050). Participants walked significantly more slowly with a cognitive task during planned (P < .001, mean difference = −0.184 m/s, 95% CI, −0.256 to −0.111) and unplanned (P = .001, mean difference = −0.111 m/s, 95% CI, −0.173 to −0.050) gait termination. Participants walked significantly more slowly (P < .001, mean difference = −0.142 m/s, 95% CI, −0.210 to −0.075) when performing the most difficult task, unplanned termination with a cognitive task, than when performing the least difficult task, planned termination with no cognitive task. We observed a cognitive task main effect such that adding a cognitive task increased RT (F1,19 = 16.375, P = .001, mean difference = −0.118 s, 95% CI, −0.178 to −0.057) and slowed normalized GTT (F1,19 = 5.655, P = .028, mean difference = −0.167 s2/m, 95% CI, −0.314 to −0.020). Conclusions: Overall, participants displayed more conservative gait strategies and slower RT, normalized GTT, and gait velocity as task difficulty increased. More investigation is needed to truly understand the clinical meaningfulness of these measures in athletic injuries.

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Gait and Quiet-Stance Performance Among Adolescents After Concussion-Symptom Resolution

Journal of Athletic Training ◽

10.4085/1062-6050-52.11.23 ◽

2017 ◽

Vol 52 (12) ◽

pp. 1089-1095 ◽

Cited By ~ 22

Author(s):

Justin Berkner ◽

William P. Meehan ◽

Christina L. Master ◽

David R. Howell

Keyword(s):

Dual Task ◽

Stride Length ◽

Inertial Sensor ◽

Cognitive Task ◽

Gait Velocity ◽

Control Group ◽

Quiet Stance ◽

Symptom Scale ◽

Single Task ◽

Symptom Resolution

Context: Concussions affect a large number of US athletes each year. Returning an athlete to activity once self-reported symptoms have resolved can be problematic if unrecognized neurocognitive and balance deficits persist. Pairing cognitive and motor tasks or cognitive and quiet-stance tasks may allow clinicians to detect and monitor these changes postconcussion. Objective: To prospectively examine adolescent athletes' gait and quiet-stance performance while concurrently completing a cognitive task acutely after concussion and after symptom resolution. Design: Case-control study. Setting: Sport concussion clinic. Patients or Other Participants: Thirty-seven athletes (age = 16.2 ± 3.1 years; 54% female) were diagnosed with a concussion, and their performance was compared with that of a group of 44 uninjured control participants (age = 15.0 ± 2.0 years; 57% female). Intervention: Participants diagnosed with a concussion completed a symptom inventory and single- and dual-task gait and quiet-stance evaluations within 21 days of injury and then again after symptom resolution. Gait and postural-control measurements were quantified using an inertial sensor system and analyzed using multivariate analyses of covariance. Main Outcome Measure(s): Post-Concussion Symptom Scale, single-task and dual-task gait measures, quiet-stance measures, and cognitive task performance. Results: At the initial postinjury examination, single-task gait stride length (1.16 ± 0.14 versus 1.25 ± 0.13 m, P = .003) and dual-task gait stride length (1.02 ± 0.13 m versus 1.10 ± 0.13 m, P = .011) for the concussion group compared with the control group, respectively, were shorter. After symptom resolution, no single-task gait differences were found, but the concussion group demonstrated slower gait velocity (0.78 ± 0.15 m/s versus 0.92 ± 0.14 m/s, P = .005), lower cadence (92.5 ± 12.2 steps/min versus 99.3 ± 7.8 steps/min, P < .001), and a shorter stride length (0.99 ± 0.15 m versus 1.10 ± 0.13 m, P = .003) during dual-task gait than the control group. No between-groups differences were detected during quiet stance at either time point. Conclusions: Acutely after concussion, single-task and dual-task stride-length alterations were present among youth athletes compared with a control group. Although single-task gait alterations were not detected after symptom resolution, dual-task gait differences persisted, suggesting that dual-task gait alterations may persist longer after concussion than single-task gait or objective quiet-stance alterations. Dual-task gait assessments may, therefore, be a useful component in monitoring concussion recovery after symptom resolution.

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Association of Affect and Gait Performance in Dual-Task Walking in Non-Demented Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.920 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 287-287

Author(s):

Deepan Guharajan ◽

Roee Holtzer

Keyword(s):

Older Adults ◽

Negative Affect ◽

Positive Affect ◽

Dual Task ◽

Task Demands ◽

Gait Velocity ◽

Positive And Negative Affect ◽

Increased Risk ◽

Aging Populations ◽

Task Conditions

Abstract Aging populations are at increased risk to experience mobility disability, which is associated with falls, frailty, and mortality. Previous studies have not examined the concurrent associations of both positive and negative affect with gait velocity. We examined whether individual differences in positive and negative affect predicted dual-task performance decrements in velocity in a dual-task (DT) paradigm in non-demented older adults. We hypothesize that positive affect would be associated with lower DT costs, and negative affect would be associated with higher DT costs. Participants (N = 403; mean age, = 76.22 (6.55); females = 56%) completed the Positive and Negative Affect Schedule (PANAS) and a DT paradigm that involved three task conditions: Single-Task-Walk (STW), Alpha (cognitive interference requiring participants to recite alternate letters of the alphabet), and Dual-Task-Walk (DTW) requiring participant to perform the two single tasks concurrently. Gait velocity was assessed via an instrumented walkway. As expected, results of a linear mixed effects model (LME) showed a significant decline in gait velocity (cm/s) from STW to DTW (estimate = -11.79; 95%CI = -12.82 to -10.77). LME results further revealed that negative affect was associated with greater decline in gait velocity from STW to DTW (ie., worse DT cost) (estimate = -0.38; 95%CI = -0.73 to -0.03). Positive affect did not, however, predict DT costs in gait velocity (estimate = -0.09; 95%CI = -0.23 to 0.05). These findings suggest that increased negative affect interferes with the allocation of attentional resources to competing task demands inherent in the DT paradigm.

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

BioMed Research International ◽

10.1155/2016/1205469 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Magdalena Hagner-Derengowska ◽

Krystian Kałużny ◽

Wojciech Hagner ◽

Anna Kałużna ◽

Bartosz Kochański ◽

...

Keyword(s):

Postmenopausal Women ◽

Dual Task ◽

Gait Speed ◽

System Analysis ◽

Cognitive Task ◽

Cognitive Tests ◽

Smart System ◽

Time Space ◽

Gait Parameters ◽

Support Phase

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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Gait Variability and Complexity during Single and Dual-Task Walking on Different Surfaces in Outdoor Environment

Sensors ◽

10.3390/s21144792 ◽

2021 ◽

Vol 21 (14) ◽

pp. 4792

Author(s):

Denisa Nohelova ◽

Lucia Bizovska ◽

Nicolas Vuillerme ◽

Zdenek Svoboda

Keyword(s):

Dual Task ◽

Inertial Sensor ◽

Cognitive Task ◽

Real Life ◽

Gait Pattern ◽

Gait Variability ◽

Outdoor Environment ◽

Manual Task ◽

Lower Trunk ◽

Trunk Acceleration

Nowadays, gait assessment in the real life environment is gaining more attention. Therefore, it is desirable to know how some factors, such as surfaces (natural, artificial) or dual-tasking, influence real life gait pattern. The aim of this study was to assess gait variability and gait complexity during single and dual-task walking on different surfaces in an outdoor environment. Twenty-nine healthy young adults aged 23.31 ± 2.26 years (18 females, 11 males) walked at their preferred walking speed on three different surfaces (asphalt, cobbles, grass) in single-task and in two dual-task conditions (manual task—carrying a cup filled with water, cognitive task—subtracting the number 7). A triaxial inertial sensor attached to the lower trunk was used to record trunk acceleration during gait. From 15 strides, sample entropy (SampEn) as an indicator of gait complexity and root mean square (RMS) as an indicator of gait variability were computed. The findings demonstrate that in an outdoor environment, the surfaces significantly impacted only gait variability, not complexity, and that the tasks affected both gait variability and complexity in young healthy adults.

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Modifications in Prefrontal Cortex Oxygenation in Linear and Curvilinear Dual Task Walking: A Combined fNIRS and IMUs Study

Sensors ◽

10.3390/s21186159 ◽

2021 ◽

Vol 21 (18) ◽

pp. 6159

Author(s):

Valeria Belluscio ◽

Gabriele Casti ◽

Marco Ferrari ◽

Valentina Quaresima ◽

Maria Sofia Sappia ◽

...

Keyword(s):

Prefrontal Cortex ◽

Dual Task ◽

Near Infrared ◽

Cognitive Task ◽

Real Life ◽

Motor Task ◽

Hemoglobin Concentration ◽

Cortical Activation ◽

Functional Near Infrared Spectroscopy ◽

Gait Quality

Increased oxygenated hemoglobin concentration of the prefrontal cortex (PFC) has been observed during linear walking, particularly when there is a high attention demand on the task, like in dual-task (DT) paradigms. Despite the knowledge that cognitive and motor demands depend on the complexity of the motor task, most studies have only focused on usual walking, while little is known for more challenging tasks, such as curved paths. To explore the relationship between cortical activation and gait biomechanics, 20 healthy young adults were asked to perform linear and curvilinear walking trajectories in single-task and DT conditions. PFC activation was assessed using functional near-infrared spectroscopy, while gait quality with four inertial measurement units. The Figure-of-8-Walk-Test was adopted as the curvilinear trajectory, with the “Serial 7s” test as concurrent cognitive task. Results show that walking along curvilinear trajectories in DT led to increased PFC activation and decreased motor performance. Under DT walking, the neural correlates of executive function and gait control tend to be modified in response to the cognitive resources imposed by the motor task. Being more representative of real-life situations, this approach to curved walking has the potential to reveal crucial information and to improve people’ s balance, safety, and life’s quality.

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Postural control during dual task in adolescent cochlear implant users under on/off-device conditions

Auditory and Vestibular Research ◽

10.18502/avr.v30i3.6532 ◽

2021 ◽

Author(s):

Zahra Nadimi ◽

Mansoureh Adel Ghahraman ◽

Ghassem Mohammadkhani ◽

Reza Hoseinabadi ◽

Shohreh Jalaie ◽

...

Keyword(s):

Postural Control ◽

Cochlear Implant ◽

Vestibular System ◽

Dual Task ◽

Cognitive Task ◽

Normal Hearing ◽

Hearing Impaired ◽

Caloric Test ◽

Vestibular Disorders ◽

Control Performance

Background and Aim: Vestibular system has several anatomical connections with cognitive regions of the brain. Vestibular disorders have negative effects on cognitive performance. Hearing-impaired patients, particularly cochlear implant users, have concomitant vestibular disorders. Previous studies have shown that attention assigned to postural control decreases while performing a cognitive task (dual task) in hearing-impaired children. Since the vestibular system and postural control performance develop around 15−16 years of age, the aim of this study was to compare postural control performance during dual task in adolescent boys with normal hearing and cochlear implant (CI) users with congenital hearing-impairment. Methods: Postural control was assessed in twenty 16−19 year old cochlear implant boys and 40 normal hearing peers with force plate. The main outcomes were displacement in posterior- anterior and medial-lateral planes, and mean speed with and without cognitive task and under on/off-device conditions. Caloric test was performed for CI users in order to examine the peripheral vestibular system. Results: Ninety-five percent of CI users showed caloric weakness. There were no significant differences in postural control parameters between groups. All performances deteriorated in the foam pad condition compared to the hard surface in all groups. Total mean velocity significantly increased during dual task in normal hearing group and in CI users with off-device. Conclusion: Although CI users had apparent vestibular disorders, their postural control in both single and dual-task conditions was identical to the normal peers. These effects can be attributed to the vestibular compensation that takes place during growing. Keywords: Balance; postural control; dual task; congenital hearing loss; cochlear implant

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Do Functionally Fit Elderly Community-Dwelling Subjects Have Enough Time to Safely Cross the Road?

PROMET - Traffic&Transportation ◽

10.7307/ptt.v25i1.1247 ◽

1970 ◽

Vol 25 (1) ◽

pp. 55-62 ◽

Cited By ~ 1

Author(s):

Darija Rugelj ◽

Marija Tomšič ◽

France Sevšek

Keyword(s):

Dual Task ◽

Walking Speed ◽

Community Dwelling ◽

Urban Traffic ◽

Gait Velocity ◽

Dual Task Condition ◽

Traffic Lights ◽

The Road ◽

Spatio Temporal ◽

Task Conditions

Elderly people are the most vulnerable group in urban traffic and a large proportion of them are as pedestrians victims of traffic accidents. The majority of these happen while crossing the road. Crossing a busy road at an intersection with traffic lights or without them is a typical dual task condition requiring a motor task i.e. walking and a cognitive task such as monitoring traffic. The purpose of present study was to compare the walking speed and the related spatio-temporal gait variables of fallers and non-fallers in three walking conditions against the speeds required by regulations in Slovenia for safe street crossing. To assess the spatio-temporal characteristics of gait we used a 7m instrumented walkway.The general results showed that the spatio-temporal gait parameters did not differ between the two groups at the self-selected speed. But as soon as a constraint, such as fast walking speed, was imposed on the subjects the differences between the groups became evident. Fallers demonstrated a significantly slower mean gait velocity and shorter stride length while the cadence and the base of support did not differ between the two groups. In dual task conditions the difference between the two groups reached 25 percent. The fallers group gait velocity dropped to 0.99 m/s. The observed walking speed was slower than considered by the guidelines for the design of traffic light equipped road crossing.In conclusion, the results of walking speed under dual task conditions could be a useful parameter for planning of optimal pedestrian crossing in urban areas. These results will serve for the design of a population based study in Ljubljana.

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