scholarly journals The Effects of Different Types of Dual Tasking on Balance in Healthy Older Adults

2021 ◽  
Vol 11 (9) ◽  
pp. 933
Author(s):  
Graça Monteiro de Barros ◽  
Filipe Melo ◽  
Josefa Domingos ◽  
Raul Oliveira ◽  
Luís Silva ◽  
...  

Numerous of our daily activities are performed within multitask or dual task conditions. These conditions involve the interaction of perceptual and motor processes involved in postural control. Age-related changes may negatively impact cognition and balance control. Studies identifying changes related to dual-task actions in older people are need. This study aimed to determine the effects of different types of dual-tasking on the balance control of healthy older adults. The sample included 36 community-living older adults, performing two tests—a sway test and a timed up-and-go test—in three conditions: (a) single motor task; (b) dual motor task; and (c) dual motor task with cognitive demands. Cognitive processes (dual-task and cognition) affected static balance, increasing amplitude (p < 0.001) and frequency (p < 0.001) of the center of mass displacements. Dynamic balance revealed significant differences between the single motor condition and the other two conditions during gait phases (p < 0.001). The effect of dual-tasking in older adults suggests that cognitive processes are a main cause of increased variability in balance and gait when under an automatic control. During sit-to-stand, turning, and turn-to-sit movements under dual-tasking, the perceptive information becomes the most important focus of attention, while any cognitive task becomes secondary.

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maayan Agmon ◽  
Einat Kodesh ◽  
Rachel Kizony

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.


2016 ◽  
Vol 28 (2) ◽  
pp. 275-281 ◽  
Author(s):  
Brad Manor ◽  
Junhong Zhou ◽  
Azizah Jor'dan ◽  
Jue Zhang ◽  
Jing Fang ◽  
...  

Dual tasking (e.g., walking or standing while performing a cognitive task) disrupts performance in one or both tasks, and such dual-task costs increase with aging into senescence. Dual tasking activates a network of brain regions including pFC. We therefore hypothesized that facilitation of prefrontal cortical activity via transcranial direct current stimulation (tDCS) would reduce dual-task costs in older adults. Thirty-seven healthy older adults completed two visits during which dual tasking was assessed before and after 20 min of real or sham tDCS targeting the left pFC. Trials of single-task standing, walking, and verbalized serial subtractions were completed, along with dual-task trials of standing or walking while performing serial subtractions. Dual-task costs were calculated as the percent change in markers of gait and postural control and serial subtraction performance, from single to dual tasking. Significant dual-task costs to standing, walking, and serial subtraction performance were observed before tDCS (p < .01). These dual-task costs were less after real tDCS as compared with sham tDCS as well as compared with either pre-tDCS condition (p < .03). Further analyses indicated that tDCS did not alter single task performance but instead improved performance solely within dual-task conditions (p < .02). These results demonstrate that dual tasking can be improved by modulating prefrontal activity, thus indicating that dual-task decrements are modifiable and may not necessarily reflect an obligatory consequence of aging. Moreover, tDCS may ultimately serve as a novel approach to preserving dual-task capacity into senescence.


Author(s):  
L. Kannan ◽  
T. Bhatt

Purpose: To examine the feasibility and effectiveness of dual task (DT) exergaming to improve volitional balance control in older adults with mild cognitive impairment (MCI). Methods: Ten older adults with MCI were examined at baseline (week-0) and post-training (week-5) on volitional balance control (maximum excursion of center of gravity, MXE [%]) while performing cognitive task (auditory clock test or letter number sequencing task) and on the NIH-motor and cognitive toolboxes. DT exergaming training lasted for 12 sessions which consisted of performing explicit cognitive tasks while playing the Wii-Fit balance games. Results: From pre- to post-training, MXE improved (p<0.05); however, cognitive accuracy (cognitive task) remained the same (p>0.05). Improvement in NIH motor and cognitive toolbox tests was observed post-training (p<0.05). Conclusion: DT exergaming was associated to improvements in balance control under attention-demanding conditions in MCI. Future studies may focus on examining the efficacy of such training.


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    


2021 ◽  
Vol 12 ◽  
Author(s):  
Alex Rizzato ◽  
Antonio Paoli ◽  
Marta Andretta ◽  
Francesca Vidorin ◽  
Giuseppe Marcolin

The aim of this study was to investigate if the combination of static and dynamic postural balance assessments gives more accurate indications on balance performance among healthy older adults. We also aimed at studying the effect of a dual-task condition on static and dynamic postural balance control. Fifty-seven healthy older adults (age = 73.2 ± 5.0 year, height = 1.66 ± 0.08 m, and body mass = 72.8 ± 13.8 kg) completed the study. Static and dynamic balance were assessed both in single-task and dual-task conditions through a force plate and an oscillating platform. The dominant handgrip strength was also measured with a dynamometer. Pearson’s correlation revealed non-statistically significant correlations between static and dynamic balance performance. The dual-task worsened the balance performance more in the dynamic (+147.8%) than in the static (+25.10%, +43.45%, and +72.93% for ellipse area, sway path, and AP oscillations, respectively) condition (p &lt; 0.001). A weak correlation was found between dynamic balance performance and handgrip strength both in the single (p &lt; 0.05; r = −0.264) and dual (p &lt; 0.05; r = −0.302) task condition. The absence of correlations between static and dynamic balance performance suggests including both static and dynamic balance tests in the assessment of postural balance alterations among older adults. Since cognitive-interference tasks exacerbated the degradation of the postural control performance, dual-task condition should also be considered in the postural balance assessment.


2020 ◽  
Vol 34 (8) ◽  
pp. 702-710
Author(s):  
Daniel S. Peterson ◽  
Jordan S. Barajas ◽  
Linda Denney ◽  
Shyamal H. Mehta

Introduction. Reactive movements in response to a loss of balance are altered in people with Parkinson’s disease (PD) and are critical for fall prevention. Further, falls are more common while attention is divided. Although divided attention has been shown to impact postural responses in healthy older adults, the impact of dividing attention on reactive balance, and the natural prioritization across postural and cognitive tasks in people with PD is largely unknown. Objectives. To characterize (1) the impact of a secondary cognitive task on reactive postural control and (2) the prioritization across stepping and cognitive tasks in people with PD. Methods. Sixteen people with PD and 14 age-matched controls underwent step-inducing, support-surface perturbations from stance, with and without an auditory Stroop secondary cognitive task. Cognitive, neuromuscular, and protective stepping performance were calculated for single and dual task scenarios. Results. In PD and control participants, cognitive reaction times ( P = .001) and muscle onset latency ( P = .007), but not protective step outcomes ( P > .12 for all) were worse during dual tasking compared with single-task scenarios. Both PD and control groups prioritized the protective stepping task over the cognitive task. Overall, people with PD exhibited worse first-step margin of stability (a measure of protective step performance) than controls ( P = .044). Conclusion. This study provides preliminary evidence that people with PD, like age-matched controls, exhibit cognitive and neuromuscular, but not protective step, dual-task interference. The lack of dual-task interference on step performance indicates a postural prioritization for PD and healthy older adults during dual-task protective stepping.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 72-73
Author(s):  
Melike Kahya ◽  
On-Yee Lo ◽  
Junhong Zhou ◽  
Alvaro Pascual-Leone ◽  
Lewis Lipsitz ◽  
...  

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 &gt;0.70). Compared with quiet standing, dual-tasking increased theta/beta power ratio (p&lt;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.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 287-288
Author(s):  
Jeffrey Hausdorff ◽  
Nofar Schneider ◽  
Marina Brozgol ◽  
Pablo Cornejo Thumm ◽  
Nir Giladi ◽  
...  

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p&lt;0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p&gt;0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 523-523
Author(s):  
Pei-Chun Kao ◽  
Michaela Pierro

Abstract To develop effective fall prevention intervention, it is necessary to understand how older adults respond to challenges that demand cognitive-motor dual-tasking capability, an important capability in the daily lives. The purpose of this study is to investigate how older adults adjust their motor responses when encountering cognitive and walking perturbations simultaneously. We recorded kinematic data as subjects walked on a treadmill with or without 1) continuous random-amplitude treadmill platform sways (Perturbed vs. No-perturbed walking); and 2) each of the four cognitive tasks: Paced Auditory Serial Addition test (PASAT), clock test, visual color-word incongruent test (V-stroop), and auditory pitch-word incongruent test (A-stroop). We computed dynamic margins of stability (MOS), gait variability, and short-term local divergence exponent (LDE) of the trunk motion (local stability). Data of ten older subjects (age: 72.2±4.9) show that cognitive performance did not differ between standing, Perturbed or No-perturbed walking. Subjects demonstrated significantly greater local instability and variability in step measures, joint angle and MOS during Perturbed than No-perturbed walking (p&lt;0.001). During dual-task conditions, subjects walked with significantly larger medio-lateral MOS (MOSML) compared to walking only, especially during early phase of the trial. During Perturbed walking, subjects had significantly larger MOSML during PASAT and Vstroop than walking only. Our data showed that subjects tried to increase their dynamic MOS during Perturbed walking or a cognitive task more difficult or taxing visual attention. However, the adjustments do not sustain throughout the trial. These findings suggest older adults tend to prioritize cognitive over walking tasks even when encountering walking perturbations.


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