scholarly journals Reduced Sway During Dual Task Balance Performance Among People With Stroke at 6 and 12 Months After Discharge From Hospital

2009 ◽  
Vol 23 (8) ◽  
pp. 847-854 ◽  
Author(s):  
Dorit Hyndman ◽  
Ruth M. Pickering ◽  
Ann Ashburn

Background. Cognitive motor interference has been linked to poor recovery and falls. Little is known about recovery of dual-task balance ability poststroke. Methods. In this experimental study, postural sway was examined while standing on a force plate in preferred stance, with feet together, and with eyes closed, at 6 and 12 months postdischarge from hospital. Sway was assessed in isolation and while participants performed a cognitive (shopping list) task. Results . Seventy-six people with stroke (mean age 67 years; range, 21-91 years) took part. Fifty-four completed both assessments. When compared with the single task, sway during the dual-task condition was significantly lower in both the medial lateral (ML) and anterior posterior (AP) directions (both P < .0001). Sway in both directions was influenced by the difficulty of the balance task (both P < .0001). There was a trend of reduced sway at the 12-month assessment compared with the 6-month assessment: significant only in the ML direction ( P = .0056). Repeat fallers swayed more than non—repeat fallers, with increases of 48% and 44% in the ML ( P = .0262) and AP ( P = .0134) directions, respectively. No significant variation in the dual-task reduction in sway was found: the dual-task effect was remarkably consistent over all the conditions tested, particularly in the AP direction. Conclusions. Sway decreased under dual-task conditions and changed as the difficulty of the balance task changed. Stroke fallers swayed more than nonfallers and there was evidence of a reduction in sway over time, particularly in the ML direction.

2011 ◽  
Vol 20 (3) ◽  
pp. 296-310 ◽  
Author(s):  
Luke M. Ross ◽  
Johna K. Register-Mihalik ◽  
Jason P. Mihalik ◽  
Karen L. McCulloch ◽  
William E. Prentice ◽  
...  

Context:Recent evidence has revealed deficiencies in the ability to divide attention after concussion.Objective:To examine the effects of a single vs a dual task on cognition and balance in healthy subjects and to examine reliability of 2 dual-task paradigms while examining the overall feasibility of the tasks.Design:Pretest–posttest experimental design.Setting:Sports medicine research laboratory.Patients:30 healthy, recreationally active college students.Intervention:Subjects performed balance and cognitive tasks under the single- and dual-task conditions during 2 test sessions 14 d apart.Main Outcome Measures:The procedural reaction-time (PRT) test of the Automated Neuropsychological Assessment Metrics (eyes-closed tasks) and an adapted Procedural Auditory Task (PAT; eyes-open tasks) were used to assess cognition. The NeuroCom Sensory Organization Test (SOT) and the Balance Error Scoring System (BESS) were used to assess balance performance. Five 2-way, within-subject ANOVAs and a paired-samples t test were used to analyze the data. ICCs were used to assess reliability across 2 test sessions.Results:On the SOT, performance significantly improved between test sessions (F1,29 = 35.695, P < .001) and from the single to the dual task (F1,29 = 9.604, P = .004). On the PRT, performance significantly improved between test sessions (F1,29 = 57.252, P < .001) and from the single to the dual task (F1,29 = 7.673, P = .010). No differences were seen on the BESS and the PAT. Reliability across test sessions ranged from moderate to poor for outcome measure.Conclusions:The BESS appears to be a more reliable and functional tool in dual-task conditions as a result of its increased reliability and clinical applicability. In addition, the BESS is more readily available to clinicians than the SOT.


Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S6.1-S6 ◽  
Author(s):  
Meng Ni ◽  
Joseph Hazzard ◽  
Pamela Smith

BackgroundDual-task, performing a balance task and a cognitive task simultaneously, has been used as sport-related concussion assessment tool. However, the effect of dual task on balance performance remains controversial. Also, the fluctuation of hormone across menstrual cycle on balance and dual-task performance has not been fully examined.ObjectiveTo examine (1) the effect of dual task on balance performance, (2) the interaction of female sex hormonal level, balance, and dual-task performance.DesignA cohort study.SettingA laboratory of concussion research and services.ParticipantsA group of 49 healthy female college-aged students (age = 21.6 ± 2.0 years).Main outcome measuresThe Stability Evaluation Test (SET) protocol, Balance error scoring system (BESS) test and postural sway velocity (deg/sec) by using VSR SPORT force plate. Three auditory mathematics questions were given for each condition of the SET test. Two single-task conditions were provided, including balance only and math only. Balance test and math questions were given simultaneously during the dual-task condition.ResultsThere was no significantly statistically difference in BESS or sway velocity between single and dual task. However, the performance of math calculation is better in dual-task comparing to the single task (math only), with an 8%–12% higher rate of accuracy, but it didn't reach a statistical significance. The rate of accuracy during the dual task didn't vary among menstrual phases.ConclusionsBalance performance was maintained under dual-task conditions and fluctuation of female sex hormones across the menstrual cycle may not affect working memory and executive function. These findings are potentially clinically applicable to detecting balance deficits and cognitive alterations in female concussed individuals. Future studies are needed to investigate the underlying mechanism of balance maintenance and attention dividend under dual-task conditions.


2021 ◽  
pp. 036354652199870
Author(s):  
Mark Matthews ◽  
William Johnston ◽  
Chris M. Bleakley ◽  
Richard J. Davies ◽  
Alan T. Rankin ◽  
...  

Background: Sports-related concussion is a worldwide problem. There is a concern that an initial concussion can cause prolonged subclinical disturbances to sensorimotor function that increase the risk of subsequent injury. The primary aim of this study was to examine whether a history of sports-related concussion has effects on static and dynamic balance performance in adolescent rugby players. Hypothesis: Dynamic balance would be worse in players with a history of concussion compared with those with no history of concussion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male adolescent rugby players aged 14 to 18 years from 5 schools were recruited before the start of the 2018-2019 playing season. Participants completed questionnaires and physical tests, including dynamic Y balance and single-leg static balance (eyes closed) tests, while performing single and dual tasks. Dynamic balance was assessed using inertial sensor instrumentation. Dependent variables were normalized reach distance and the sample entropy (SEn) of the 3 axes ( x, y, and z). Results: Of the 195 participants, 100 reported a history of concussion. Those with a history of concussion demonstrated higher SEn in all directions, with highest values during anterior (standardized mean difference [SMD], 0.4; 95% CI, 0.0-0.7; P = .027) and posteromedial (SMD, 0.5; 95% CI, 0.2-0.9; P = .004) reach directions compared with those with no history. There was no difference between groups (concussion history vs control) in traditional Y balance reach distances in the anterior or posteromedial directions or single-leg static balance during both single- ( P = .47) and dual-task ( P = .67) conditions. Conclusion: Adolescent rugby union athletes with a history of concussion had poorer dynamic balance during performance tasks compared with healthy controls. Static single-leg balance tests, either single or dual task, may not be sensitive enough to detect sensorimotor deficits in those with a history of concussion.


1970 ◽  
Vol 25 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Darija Rugelj ◽  
Marija Tomšič ◽  
France Sevšek

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.


Author(s):  
Hamid Allahverdipour ◽  
Iman Dianat ◽  
Galavizh Mameh ◽  
Mohammad Asghari Jafarabadi

Objective The aim of this study is to examine the effects of cognitive and physical loads on dynamic and static balance performance of healthy older adults under single-, dual-, and multi-task conditions. Background Previous studies on postural control in older adults have generally used dual-task methodology, whereas less attention has been paid to multi-task performance, despite its importance in many daily and occupational activities. Method 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 1, 2, and 3 kg in each hand) loads on dynamic and static balance performance of 42 older adults (21 males and 21 females) aged ≥60 years were examined. 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. Age had no effect on balance performance measures. Under dual-task conditions, cognitive load decreased the dynamic balance performance, while the physical task levels had no effect. The dual-task conditions had no impact on the static balance performance. The effects of cognitive and physical loads on dynamic balance performance varied under dual- and multi-task conditions. Conclusion The findings highlight differences between dual- and multi-task protocols and add to the understanding of balance performance in older adults under cognitive and physical loads. Application The present study highlights differences between dual- and multi-task methodologies that need to be considered in future studies of balance and control in older adults.


2020 ◽  
Vol 10 (6) ◽  
pp. 1979 ◽  
Author(s):  
Qipeng Song ◽  
Wei Sun ◽  
Cui Zhang ◽  
Min Mao ◽  
Li Li

Falls during stair negotiation have become one of the leading causes of accidental death. The effects of a concurrent cognitive or manual dual-task paradigm on dynamic gait stability remain uncertain. How much dynamic gait stability is influenced by gait velocity is also not clear. A total of 16 healthy young females descended a staircase under three different walking conditions: descend stairs only (single task), descend stairs while performing subtraction (cognitive dual-task), and descend stairs while carrying a glass of water (manual dual-task). An eight-camera Vicon motion analysis system and a Kistler force plate embedded into the third step of the staircase were used synchronously to collect kinematic and kinetic data. Gait velocity decreased and dynamic gait stability increased with both cognitive and manual dual-task conditions. The center of mass–center of pressure inclination angle increased with gait velocity but decreased with the manual dual-task condition compared to the single-task condition. Changes in gait velocity caused by the dual-task paradigm can partially explain the effects of dual-task dynamic gait stability. The influence of gait velocity should be considered in the assessment of dual-task effects.


2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 174-180 ◽  
Author(s):  
Susan M Linder ◽  
Mandy Miller Koop ◽  
Sarah Ozinga ◽  
Zachary Goldfarb ◽  
Jay L Alberts

Abstract Research Objective Dual-task performance, in which individuals complete two or more activities simultaneously, is impaired following mild traumatic brain injury. The aim of this project was to develop a dual-task paradigm that may be conducive to military utilization in evaluating cognitive-motor function in a standardized and scalable manner by leveraging mobile device technology. Methods Fifty healthy young adult civilians (18–24 years) completed four balance stances and a number discrimination task under single- and dual-task conditions. Postural stability was quantified using data gathered from iPad’s native accelerometer and gyroscope. Cognitive task difficulty was manipulated by presenting stimuli at 30, 60, or 90 per minute. Performance of cognitive and balance tasks was compared between single- and dual-task trials. Results Cognitive performance from single- to dual-task paradigms showed no significant main effect of balance condition or the interaction of condition by frequency. From single- to dual-task conditions, a significant difference in postural control was revealed in only one stance: tandem with eyes closed, in which a slight improvement in postural stability was observed under dual-task conditions. Conclusion The optimal dual-task paradigm to evaluate cognitive-motor performance with minimal floor and ceiling effects consists of tandem stance with eyes closed while stimuli are presented at a rate of one per second.


2020 ◽  
Vol 24 (1) ◽  
pp. 19-23
Author(s):  
Juhi K. Bharnuke ◽  
Rajani P. Mullerpatan ◽  
Claire Hiller

Indian classical dance involves a constant change of the base of support from stance to low jumps and spins along with intricate footwork. Graceful movement of the torso, shifting from side to side and turning around the axis of the spine, challenges balance. Yet, balance performance remains unexplored in Indian classical dancers. Therefore, the present study aimed to compare the standing balance of 36 active female dancers (18 to 25 years of age) who had performed Indian classical dance for a minimum of 10 years with 36 healthy age-matched women not involved in regular physical activity. Balance was evaluated in static and dynamic conditions of single and dual-limb stance on a force plate using center-of-pressure trajectory and the Star Excursion Balance Test (SEBT). Dancers demonstrated better balance on both instrumented and non-instrumented outcome variables: wide base of support with eyes open and with eyes closed; for 30-second single limb stance with eyes open and with eyes closed; for 13-second dual task in single limb stance; and for 22-second dual task in wide base of support. The SEBT revealed significantly better balance performance of dancers in the three directions tested: anterior, posteromedial, and posterolateral. There was also a strength component of the study on which the dancers achieved significantly higher scores than controls for the three muscle groups tested (gastrocsoleus, gluteus medius, and quadriceps), which can be attributed to their training. These findings can be used to recommend classical dance training to achieve the dual purpose of deriving better balance and stronger bodies and maintaining the Indian dance heritage.


Author(s):  
G. Posa ◽  
D. Farkasinszky ◽  
T. Margithazi ◽  
E. Nagy

AbstractPurposeThe objective of this pilot study was to compare the effects of two parallel balance trainings on postural sway and balance confidence. The study was performed in different contexts with stable vs. unstable base of support and balance confidence was measured with a scale modified for young adults with higher functional level.Materials/methodsTwenty healthy female physiotherapist students volunteered for the study and took part in a six-week balance training intervention. They were randomly assigned to two groups training on different support surfaces. Postural sway was recorded under various conditions: on different surfaces (firm, foam) and with different visual conditions (eyes open (EO), eyes closed (EC)). Modified Activities-specific Balance Confidence (mABC) scale was self-evaluated.ResultsBoth types of training caused a significant improvement in the mABC scores. The sway path increased after the training in the less challenging balance situations. We found a tendency of decreasing sway path only in the more challenging balance situations, that is standing on foam mounted on force plate with EC.ConclusionsConsidering the improved balance confidence in the case of both groups, we suggest that an increase in sway path after balance training may be the behavioural sign of the higher confidence in the less challenging balance situations.


2019 ◽  
Vol 7 (3) ◽  
pp. 374-388 ◽  
Author(s):  
Peter Leinen ◽  
Thomas Muehlbauer ◽  
Stefan Panzer

The present study investigated if accumulated, advanced, regular soccer practice (balance-demanding exercise) compared to regular swim practice (non-balance–demanding exercise) induces a more pronounced functional specialization in postural control. Therefore, single-leg balance performance in sub-elite young soccer players (under 13 [U13]: n = 16; U15: n = 18; U19: n = 15), and sub-elite young swimmers (U13: n = 7; U15: n = 4; U19: n = 5) was tested in different balance task conditions (i.e., static and dynamic balance on firm and foam surface). All athletes practiced 3–10 times per week. Single-leg balance of the dominant and non-dominant leg was measured using a force plate. The standard deviation of the center of pressure displacements in anterior-posterior and medio-lateral directions were used as dependent variables. Irrespective of age groups and type of sport, the results failed to indicate significant leg differences in single-leg balance performance. The soccer players showed significant better single-leg balance performance in anterior-posterior direction in the dynamic balance test on the firm and foam surface compared to the swimmers. Functional specialization was accompanied by the type of sport but not by accumulated practice.


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