Manual and Cognitive Dual Tasks Contribute to Fall-Risk Differentiation in Posturography Measures

2016 ◽  
Vol 32 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Renee Beach Sample ◽  
Kurt Jackson ◽  
Allison L. Kinney ◽  
Wiebke S. Diestelkamp ◽  
Senia Smoot Reinert ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Postural Sway ◽  
Cognitive Task ◽  
Sample Entropy ◽  
Scaling Exponent ◽  
Confidence Ellipse ◽  
Nonlinear Analyses ◽  
Severe Injuries ◽  
Manual Task

Falls occur in 33% of older adults each year, some leading to moderate to severe injuries. To reduce falls and fall-related injuries, it is important to identify individuals with subtle risk factors elevating their likelihood of falling. The objective of this study was to determine how postural sway measures differed between fallers and nonfallers under standard and dual-task conditions. Quietstanding posturography measures were collected from 150 older adults during standard, cognitive, manual, and cognitive+manual tasks, and analyzed through traditional and nonlinear analyses. Of the traditional measures, M/L sway range and 95% confidence ellipse sway area showed statistically significant differences in all 4 test conditions between fallers and nonfallers. Although the manual dual task showed the most stable balance, effect sizes demonstrated larger differences between fallers and nonfallers. Nonlinear analysis revealed M/L sample entropy and M/L α-scaling exponent differentiating between fallers and nonfallers, with the cognitive task demonstrating larger differences. Based on the results, it is recommended to: (1) apply M/L sway range and 95% confidence ellipse area, (2) use the manual task to differentiate between fallers and nonfallers when using traditional analyses, and (3) use the cognitive task and M/L alpha and M/L sample entropy when using nonlinear analyses.

scholarly journals The Cortical Dynamics of Dual-Task Standing in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 72-73
Author(s):  
Melike Kahya ◽  
On-Yee Lo ◽  
Junhong Zhou ◽  
Alvaro Pascual-Leone ◽  
Lewis Lipsitz ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Postural Sway ◽  
Cognitive Task ◽  
Quiet Standing ◽  
Power Ratio ◽  
Alpha Band ◽  
Dual Tasking ◽  
Band Power ◽  
Beta Power

Abstract In older adults, the extent to which performing a cognitive task when standing diminishes postural control is predictive of future falls and cognitive decline. The cortical control of such “dual-tasking,” however, remains poorly understood. Electroencephalogram (EEG) studies have demonstrated that the level of attention and cognitive inhibitory activity during cognitive task performance can be quantified by changes in brain activity in specific frequency bands; namely, an increase in theta/beta ratio and a decrease in alpha-band power, respectively. We hypothesized that in older adults, dual-tasking would increase theta/beta ratio and decrease alpha-band power, and, that greater alpha-band power during quiet standing would predict worse dual-task performance. To test this hypothesis, we recorded postural sway and EEG (32-channels) in 30 older adults without overt disease as they completed trials of standing, with and without verbalized serial subtractions, on four separate visits. Postural sway speed, as well as absolute theta/beta power ratio and alpha-band power, were calculated. The theta/beta power ratio and alpha-band power demonstrated high test-retest reliability during quiet and dual-task standing across visits (intra-class correlation coefficients >0.70). Compared with quiet standing, dual-tasking increased theta/beta power ratio (p<0.0001) and decreased alpha-band power (p=0.002). Participants who exhibited greater alpha-band power during quiet standing demonstrated a greater dual-task cost (i.e., percent increase, indicative of worse performance) to postural sway speed (r=0.3, p=0.01). These results suggest that in older adults, dual-tasking while standing increases EEG-derived metrics related to attention, and, that greater cognitive inhibitory activity during quiet standing is associated with worse dual-task standing performance.

scholarly journals The Effect of a Verbal Cognitive Task on Postural Sway Does Not Persist When the Task Is Over

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8428
Author(s):  
Kayla Bohlke ◽  
Xiaonan Zhu ◽  
Patrick J. Sparto ◽  
Mark S. Redfern ◽  
Caterina Rosano ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Dual Task ◽  
Temporal Dynamics ◽  
Postural Sway ◽  
Cognitive Task ◽  
Descriptive Analysis ◽  
Peak Frequency ◽  
Entropy Rate ◽  
Frequency Peak

Dual-task balance studies explore interference between balance and cognitive tasks. This study is a descriptive analysis of accelerometry balance metrics to determine if a verbal cognitive task influences postural control after the task ends. Fifty-two healthy older adults (75 ± 6 years old, 30 female) performed standing balance and cognitive dual-tasks. An accelerometer recorded movement from before, during, and after the task (reciting every other letter of the alphabet). Thirty-six balance metrics were calculated for each task condition. The effect of the cognitive task on postural control was determined by a generalized linear model. Twelve variables, including anterior–posterior centroid frequency, peak frequency and entropy rate, medial-later entropy rate and wavelet entropy, and bandwidth in all directions, exhibited significant differences between baseline and cognitive task periods, but not between baseline and post-task periods. These results indicate that the verbal cognitive task did alter balance, but did not bring about persistent effects after the task had ended. Traditional balance measurements, i.e., root mean square and normalized path length, notably lacked significance, highlighting the potential to use other accelerometer metrics for the early detection of balance problems. These novel insights into the temporal dynamics of dual-task balance support current dual-task paradigms to reduce fall risk in older adults.

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

Sensors ◽  
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.

Effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions

2019 ◽  
Author(s):  
Hamid Allahverdipour ◽  
Iman Dianat ◽  
Galavizh Mameh ◽  
mohammad Asghari Jafarabadi
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Cognitive Task ◽  
Dynamic Balance ◽  
The Elderly ◽  
Static Balance ◽  
Timed Up And Go ◽  
Task Conditions ◽  
And Control ◽  
Single Versus

Abstract Background: The aim of this study was to evaluate the effects of cognitive and physical loads on dynamic and static balance of older adults under single, dual and multi-task conditions. Methods: The effects of single versus combined (dual-task and multi-task) cognitive (to speak out the name of the weekdays in a reverse order) and physical (with three levels including handling weights of 1kg, 2kg and 3kg in each hand) loads on dynamic and static balance of 42 older adults (21 males and 21 females), aged ≥ 60 years were studied. Dynamic and static balance measures were evaluated using the Timed Up and Go (TUG) and stabilometer (sway index) tests, respectively. Results: The TUG speed of female participants was generally slower than that of male participants. Cognitive task influenced the participants’ dynamic balance during the dual-task conditions, while the static balance was not affected in this phase. The dynamic and static balance measures were more influenced when performing the multi-tasks than when doing the dual-tasks. The effects of various levels of physical demand on the dynamic balance varied greatly under dual- and multi-task conditions. Conclusions: The findings add to the understanding of the factors influencing the elderly balance and control under cognitive and physical functioning.

scholarly journals PREFRONTAL CORTICAL ACTIVITY DIFFERENCES WHILE DUAL-TASK WALKING IN OLDER ADULTS WITH IMPAIRED MOBILITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S793-S794
Author(s):  
Manuel E Hernandez
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Near Infrared ◽  
Local Community ◽  
Cognitive Task ◽  
Mobility Impairment ◽  
Functional Near Infrared Spectroscopy ◽  
Mobility Impairments ◽  
Prefrontal Cortical ◽  
Walking Difficulty

Abstract Mobility impairments are prevalent in older adults. Whereas walking had traditionally been viewed as an autonomous process, evidence over the last decade has shown that cognitive processes such as attention and executive function have a significant impact on gait function in older adults. However, the exact neural mechanisms underlying difficulties in the control of mobility in older adults remains an open question. We examine the changes in the executive control of mobility in older adults with mobility impairments using functional near-infrared spectroscopy, as operationalized by performance in the community balance and mobility scale (CB&M). We hypothesized that prefrontal cortical (PFC) activity increases would be higher in older adults with mobility impairments, compared with older adults without mobility impairment, as dual-task walking difficulty increased. Older adults with (n=10, mean±SD age: 77±8 years, 8 females, CB&M= 58±12) and without mobility impairment (n=14, mean±SD age: 63±9 years, 11 females, CB&M= 87±6) were recruited from the local community. Dual-task walking was performed at a comfortable pace, while the difficulty of the concurrent cognitive task was increased using the modified Stroop test. PFC activity was measured using measures of oxygenated hemoglobin across the PFC. Older adults with mobility impairments demonstrated disproportionate increases in PFC activity, in comparison to those without mobility impairments, as the difficulty of the concurrent cognitive task increased (P<.001), even after controlling for age. In conclusion, these data suggest that older adults with mobility impairments may require greater attentional resources than those without mobility impairments when concurrently performing thinking and walking tasks.

scholarly journals The Effect of Different Types of Walking on Dual-Task Performance and Task Prioritization among Community-Dwelling Older Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maayan Agmon ◽  
Einat Kodesh ◽  
Rachel Kizony
Keyword(s):  
Older Adults ◽  
Task Performance ◽  
Dual Task ◽  
Cognitive Task ◽  
Community Dwelling ◽  
Cognitive Tasks ◽  
Dual Task Performance ◽  
Different Types ◽  
Task Prioritization ◽  
Community Dwelling Older Adults

Background. The ability to safely conduct different types of walking concurrently with a cognitive task (i.e., dual task) is crucial for daily life. The contribution of different walking types to dual-task performance has not yet been determined, nor is there agreement on the strategies that older adults use to divide their attention between two tasks (task prioritization).Objectives. To compare the effect of walking in three different directions (forward, backward, and sideways) on dual-task performance and to explore the strategies of older adults to allocate their attention in response to different motor task demands.Design. A cross-sectional study.Subjects. Thirty-two (22 female) community-dwelling older adults (aged72.7±5.7years).Methods. Subjects randomly conducted single and dual task: walking to three directions separately, cognitive tasks separately, and combination of the two.Results. Walking forward was the least demanding task, during single (FW < BW, SW) (P<.001) and dual tasks (FW < BW < SW) (P<.001). The calculation of DTC revealed the same pattern (P<.001). DTC of the cognitive tasks was not significantly different among the three walking types.Conclusions. The decline mainly in the motor performance during dual task indicates that participants prioritized the cognitive task. These findings challenge the “posture first” paradigm for task prioritization.

scholarly journals Falls Risk and Simulated Driving Performance in Older Adults

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
John G. Gaspar ◽  
Mark B. Neider ◽  
Arthur F. Kramer
Keyword(s):  
Older Adults ◽  
Task Performance ◽  
Dual Task ◽  
Response Times ◽  
Cognitive Task ◽  
Driving Performance ◽  
Unexpected Events ◽  
Falls Risk ◽  
Simulated Driving ◽  
Dual Task Performance

Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance.

scholarly journals How Older Adults Cope with Cognitive Complexity and Environmental Constraints during Dual-Task Walking: The Role of Executive Function Involvement

2019 ◽  
Vol 16 (10) ◽  
pp. 1835 ◽  
Author(s):  
Roberta Forte ◽  
Caterina Pesce ◽  
Angela Di Baldassarre ◽  
John Shea ◽  
Claudia Voelcker-Rehage ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Executive Function ◽  
Cognitive Performance ◽  
Dual Task ◽  
Cognitive Complexity ◽  
Cognitive Task ◽  
Activity Level ◽  
Environmental Constraints

This cross-sectional study investigated the interactive dual-task (DT) effects of executive function demands and environmental constraints on older adults’ walking and the moderating role of habitual physical activity (PA). Locomotor performance under different environmental constraints (flat versus obstructed walking) and cognitive performance with different executive function involvement (backward counting versus random number generation) were assessed under single-task (ST) and DT conditions in 135 participants (mean age 68.1 ± 8.4). The weekly number of daily steps was measured. Reciprocal DT effects of walking on cognitive performance and of the cognitive task on gait performance were computed and submitted to analyses of covariance with age, PA level, and cognitive functioning as covariates, followed by linear regressions with PA level as predictor. Cognitive task demands and environmental constraints individually and jointly affected gait variability (p = 0.033, ηp2 = 0.08) and executive function performance (p = 0.009, ηp2 = 0.09). Physical activity level predicted a low but significant percentage of variance of DT effects on gait only in flat walking (R2 = 0.04, p = 0.027). Results suggest that older individuals may adopt variable task prioritization in dual tasking depending on the type of executive function involvement and the environmental constraints on walking. Their DT ability was slightly affected by habitual PA.

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