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Schmitter-Edgecombe M, Brown K, Chilton RC, Whiteley N, Greeley D. Naturalistic assessment of everyday multitasking in Parkinson's disease with and without mild cognitive impairment. Clin Neuropsychol 2024:1-21. [PMID: 38475659 DOI: 10.1080/13854046.2024.2325681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Objective: Multitasking is an essential part of everyday functioning often not formally assessed by traditional neuropsychological tests. Although individuals with Parkinson's disease (PD) experience both motor and cognitive difficulties, previous research has demonstrated more pronounced functional difficulties with the presence of mild cognitive impairment (PD-MCI). The current study compared individuals with PD-MCI, PD with normal cognition (PD-NC), and healthy controls on a naturalistic task of multitasking, the Day Out Task (DOT). Method: Participants were 38 healthy older adults (HOA), 23 individuals with PD-NC, and 15 individuals with PD-MCI. Participants completed a battery of neuropsychological tasks and the DOT. Informants also completed a self-reported questionnaire of participants' everyday executive functioning. Results: Compared to PD-NC and HOA, participants with PD-MCI were less accurate and efficient and took longer to complete the DOT. After controlling for motor performance, only DOT accuracy remained worse, with poorer accuracy resulted from more subtasks being left incomplete or being completed inaccurately by the PD-MCI group. DOT sequencing was a significant predictor of informant reported everyday dysexecutive symptoms. Conclusions: The findings highlight that individuals with PD-MCI are likely to experience difficulties completing complex everyday tasks due to both motor and cognitive impairments. Clinicians may therefore recommend strategies to support efficiency and accuracy in complex tasks of everyday functioning in treatment considerations.
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Affiliation(s)
| | - Katelyn Brown
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, CO, USA
| | | | - Nicole Whiteley
- Department of Psychology, Washington State University, Pullman, WA, USA
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Gomez-Alvaro MC, Leon-Llamas JL, Melo-Alonso M, Villafaina S, Domínguez-Muñoz FJ, Gusi N. Test-Retest Reliability of Isokinetic Strength in Lower Limbs under Single and Dual Task Conditions in Women with Fibromyalgia. J Clin Med 2024; 13:1288. [PMID: 38592707 PMCID: PMC10932145 DOI: 10.3390/jcm13051288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Previous research has established good test-retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed "poor" to "excellent" values for maximum peak torque in knee extension and "moderate" to "excellent" values for average. "Poor" to "excellent" reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from "moderate" to "excellent" for maximum and average values, and in knee flexion, it ranged from "poor" to "excellent" for maximum value and from "moderate" to "excellent" for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.
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Affiliation(s)
- Mari Carmen Gomez-Alvaro
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Juan Luis Leon-Llamas
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Maria Melo-Alonso
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Francisco Javier Domínguez-Muñoz
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Narcis Gusi
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (M.C.G.-A.); (J.L.L.-L.); (M.M.-A.); (S.V.); (F.J.D.-M.)
- Institute for Research and Innovation in Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
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Longhurst JK, Rider JV, Cummings JL, John SE, Poston B, Landers MR. Cognitive-motor dual-task interference in Alzheimer's disease, Parkinson's disease, and prodromal neurodegeneration: A scoping review. Gait Posture 2023; 105:58-74. [PMID: 37487365 DOI: 10.1016/j.gaitpost.2023.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/20/2022] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Cognitive-motor interference (CMI) is a common deficit in Alzheimer's (AD) disease and Parkinson's disease (PD) and may have utility in identification of prodromal neurodegeneration. There is lack of consensus regarding measurement of CMI resulting from dual task paradigms. RESEARCH QUESTION How are individuals with AD, PD, and prodromal neurodegeneration impacted by CMI as measured by dual-task (DT) performance? METHODS A systematic literature search was performed in six datasets using the PRISMA guidelines. Studies were included if they had samples of participants with AD, PD, or prodromal neurodegeneration and reported at least one measure of cognitive-motor DT performance. RESULTS 4741 articles were screened and 95 included as part of this scoping review. Articles were divided into three non-mutually exclusive groups based on diagnoses, with 26 articles in AD, 56 articles in PD, and 29 articles in prodromal neurodegeneration, and results presented accordingly. SIGNIFICANCE Individuals with AD and PD are both impacted by CMI, though the impact is likely different for each disease. We found a robust body of evidence regarding the utility of measures of DT performance in the detection of subtle deficits in prodromal AD and some signals of utility in prodromal PD. There are several key methodological challenges related to DT paradigms for the measurement of CMI in neurodegeneration. Overall, DT paradigms show good potential as a clinical method to probe specific brain regions, networks, and function; however, task selection and effect measurement should be carefully considered.
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Affiliation(s)
- Jason K Longhurst
- Department of Physical Therapy and Athletic Training, Saint Louis University, 3437 Caroline St. Suite, 1011 St. Louis, MO, USA.
| | - John V Rider
- School of Occupational Therapy, Touro University Nevada, Henderson, NV, USA; Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
| | | | - Samantha E John
- Department of Brain Health, University of Nevada, Las Vegas, NV, USA.
| | - Brach Poston
- Department of Kinesiology and Nutrition, University of Nevada, Las Vegas, NV, USA.
| | - Merrill R Landers
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
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Lin J, Lu J, Shu Z, Yu N, Han J. An EEG-fNIRS neurovascular coupling analysis method to investigate cognitive-motor interference. Comput Biol Med 2023; 160:106968. [PMID: 37196454 DOI: 10.1016/j.compbiomed.2023.106968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND AND OBJECTIVE The simultaneous execution of a motor and cognitive dual task may lead to the deterioration of task performance in one or both tasks due to cognitive-motor interference (CMI). Neuroimaging techniques are promising ways to reveal the underlying neural mechanism of CMI. However, existing studies have only explored CMI from a single neuroimaging modality, which lack built-in validation and comparison of analysis results. This work is aimed to establish an effective analysis framework to comprehensively investigate the CMI by exploring the electrophysiological and hemodynamic activities as well as their neurovascular coupling. METHODS Experiments including an upper limb single motor task, single cognitive task, and cognitive-motor dual task were designed and performed with 16 healthy young participants. Bimodal signals of electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) were recorded simultaneously during the experiments. A novel bimodal signal analysis framework was proposed to extract the task-related components for EEG and fNIRS signals respectively and analyze their correlation. Indicators including within-class similarity and between-class distance were utilized to validate the effectiveness of the proposed analysis framework compared to the canonical channel-averaged method. Statistical analysis was performed to investigate the difference in the behavior and neural correlates between the single and dual tasks. RESULTS Our results revealed that the extra cognitive interference caused divided attention in the dual task, which led to the decreased neurovascular coupling between fNIRS and EEG in all theta, alpha, and beta rhythms. The proposed framework was demonstrated to have a better ability in characterizing the neural patterns than the canonical channel-averaged method with significantly higher within-class similarity and between-class distance indicators. CONCLUSIONS This study proposed a method to investigate CMI by exploring the task-related electrophysiological and hemodynamic activities as well as their neurovascular coupling. Our concurrent EEG-fNIRS study provides new insight into the EEG-fNIRS correlation analysis and novel evidence for the mechanism of neurovascular coupling in the CMI.
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Affiliation(s)
- Jianeng Lin
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China
| | - Jiewei Lu
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China
| | - Zhilin Shu
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China
| | - Ningbo Yu
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen 518083, China.
| | - Jianda Han
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Engineering Research Center of Trusted Behavior Intelligence, Ministry of Education, Nankai University, Tianjin 300350, China; Tianjin Key Laboratory of Intelligent Robotics, Nankai University, Tianjin 300350, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen 518083, China.
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Kvist A, Bezuidenhout L, Johansson H, Albrecht F, Ekman U, Conradsson DM, Franzén E. Using functional near-infrared spectroscopy to measure prefrontal cortex activity during dual-task walking and navigated walking: A feasibility study. Brain Behav 2023; 13:e2948. [PMID: 36917560 PMCID: PMC10097069 DOI: 10.1002/brb3.2948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION While functional near-infrared spectroscopy (fNIRS) can provide insight into motor-cognitive deficits during ecologically valid gait conditions, the feasibility of using fNIRS during complex walking remains unknown. We tested the process and scientific feasibility of using an fNIRS device to measure cortical activity during complex walking tasks consisting of straight walking and navigated walking under single and dual-task (DT) conditions. METHODS Nineteen healthy people from 18 to 64 years (mean age: 45.7 years) participated in this study which consisted of three complex walking protocols: (i) straight walking, DT walking (walking while performing an auditory Stroop task) and single-task auditory Stroop, (ii) straight and navigated walking, and (iii) navigated walking and navigated DT walking. A rest condition (standing still) was also included in each protocol. Process feasibility outcomes included evaluation of the test procedures and participant experience during and after each protocol. Scientific feasibility outcomes included signal quality measures, and the ability to measure changes in concentration of deoxygenated and oxygenated hemoglobin in the prefrontal cortex. RESULTS All participants were able to complete the three protocols with most agreeing that the equipment was comfortable (57.9%) and that the testing duration was adequate (73.7%). Most participants did not feel tired (94.7%) with some experiencing pain (42.1%) during the protocols. The signal qualities were high for each protocol. Compared to the rest condition, there was an increase in oxygenated hemoglobin in the prefrontal cortex when performing dual-task walking and navigation. CONCLUSION We showed that our experimental setup was feasible for assessing activity in the prefrontal cortex with fNIRS during complex walking. The experimental setup was deemed acceptable and practicable. Signal quality was good during complex walking conditions and findings suggest that the different tasks elicit a differential brain activity, supporting scientific feasibility.
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Affiliation(s)
- Alexander Kvist
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Hanna Johansson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Franziska Albrecht
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Urban Ekman
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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Patelaki E, Foxe JJ, Mazurek KA, Freedman EG. Young adults who improve performance during dual-task walking show more flexible reallocation of cognitive resources: a mobile brain-body imaging (MoBI) study. Cereb Cortex 2023; 33:2573-2592. [PMID: 35661873 PMCID: PMC10016048 DOI: 10.1093/cercor/bhac227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION In young adults, pairing a cognitive task with walking can have different effects on gait and cognitive task performance. In some cases, performance clearly declines whereas in others compensatory mechanisms maintain performance. This study investigates the preliminary finding of behavioral improvement in Go/NoGo response inhibition task performance during walking compared with sitting, which was observed at the piloting stage. MATERIALS AND METHODS Mobile brain/body imaging (MoBI) was used to record electroencephalographic (EEG) activity, 3-dimensional (3D) gait kinematics and behavioral responses in the cognitive task, during sitting or walking on a treadmill. RESULTS In a cohort of 26 young adults, 14 participants improved in measures of cognitive task performance while walking compared with sitting. These participants exhibited walking-related EEG amplitude reductions over frontal scalp regions during key stages of inhibitory control (conflict monitoring, control implementation, and pre-motor stages), accompanied by reduced stride-to-stride variability and faster responses to stimuli compared with those who did not improve. In contrast, 12 participants who did not improve exhibited no EEG amplitude differences across physical condition. DISCUSSION The neural activity changes associated with performance improvement during dual tasking hold promise as cognitive flexibility markers that can potentially help assess cognitive decline in aging and neurodegeneration.
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Affiliation(s)
- Eleni Patelaki
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
- Department of Biomedical Engineering, University of Rochester, 201 Robert B. Goergen Hall Rochester, NY 14627, United States
| | - John J Foxe
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
| | - Kevin A Mazurek
- The Frederick J. and Marion A. Schindler Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Joseph Building 4-184W, 200 First Street SW, Rochester, MN 55905, United States
- Well Living Lab, Well Living Lab, Inc., 221 First Avenue SW, Rochester, MN 55902, United States
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Fritz NE, Kegelmeyer DA, Rao AK, Quinn L, Kloos AD. Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington's Disease. J Huntingtons Dis 2022; 11:435-453. [PMID: 36155527 PMCID: PMC9837690 DOI: 10.3233/jhd-220549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND In 2020, our group published physical therapy clinical practice guidelines (CPG) for people with Huntington's disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. OBJECTIVE To facilitate implementation of this CPG, we have developed guideline-based algorithms for physical therapy assessments and interventions and recommendations for therapists to overcome barriers to CPG implementation for people with HD. METHODS We conducted a literature review of papers that evaluated physical therapy interventions in individuals with HD (n = 26) to identify assessments for each of the primary movement impairment classifications, and then searched for papers (n = 28) that reported their clinometric/psychometric properties in HD. Assessments were evaluated using modified Movement Disorder Society Committee on Rating Scales criteria and other relevant criteria. RESULTS We identified a "core set" of physical therapy assessments for persons with HD, including the Six Minute Walk Test, Timed Up and Go Test, Berg Balance Scale, and the Medical Outcomes Study Short Form 36 (SF-36). We then developed guideline-based decision trees to assist in decision making and implementation of the CPG into practice for persons with HD across the continuum of care. Finally, we developed strategies for overcoming barriers to implementation, such as seeking specialized training in HD, engaging caretakers or family members to help the person with HD to exercise, and establishing clinical pathways that support early physical therapy referrals. CONCLUSION Knowledge translation documents such as this are essential to promoting implementation of the physical therapy CPGs into clinical practice.
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Affiliation(s)
- Nora E. Fritz
- Departments of Health Care Sciences and Neurology, Wayne State University, Detroit, MI, USA,Correspondence to: Nora Fritz, PhD, PT, DPT, NCS, Wayne State University, Departments of Health Care Sciences and Neurology, 259 Mack Avenue #2324, Detroit, MI 48201, USA. Tel.: +1 313 577 1096; E-mail:
| | - Deb A. Kegelmeyer
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Ashwini K. Rao
- Program in Physical Therapy, Department of Rehabilitative and Regenerative Medicine, G.H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA
| | - Anne D. Kloos
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Henning DA, Huisinga JM, Lynch S, Fritz NE. Cognition and proprioception in persons with multiple sclerosis and healthy controls: Nascent findings. Mult Scler Relat Disord 2022; 68:104372. [PMID: 36544319 DOI: 10.1016/j.msard.2022.104372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/24/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although proprioception and cognitive dysfunction are commonly associated with balance impairment and fall risk in persons with multiple sclerosis (MS), the relationship between cognitive functioning and a quantitative measure of proprioception has not been examined in MS. OBJECTIVE The primary goals of this study were to determine differences in vibratory sensation, a proxy measure of proprioception between persons with MS and healthy controls, examine relationships between cognition and vibration sensation, and determine the contribution of cognitive function and demographics to vibratory sensation between persons with MS and healthy controls. METHODS One hundred and twenty-two individuals with MS, aged 20-60, with Expanded Disability Status Scale (EDSS) scores ≤5.5 and 48 healthy controls completed reaction time testing, the Stroop test and lower extremity vibratory sensation. RESULTS Persons with MS performed significantly worse than controls on measures of vibratory sensation (p = 0.001), two-choice reaction time (p = 0.018), and Stroop Incongruent (p < 0.001) Relative Incongruent Score (RIS) (p = 0.047). In MS, average vibration was significantly related to age (p = 0.002), sex (p = 0.038), disease severity (EDSS; p < 0.001), years since diagnosis (p = 0.016), and Stroop Word (p = 0.041). A model with demographics; including age and disease severity, two-choice reaction time, and RIS explained 33.2% of the variance vibratory sensation in persons with MS. CONCLUSIONS These results provide early evidence for the relation between cognitive functioning and proprioception in persons with MS and add to prior work linking cognitive functioning, postural control and falls in persons with MS. This work provides a basis for future studies combining quantitative measures of proprioception and cognitive and postural control assessment to improve fall prediction.
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Affiliation(s)
- David A Henning
- Department of Health Care Sciences, Wayne State University, 259 Mack Avenue, #2324, Detroit, MI 48201, USA
| | - Jessie M Huisinga
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, KU Medical Center 3901 Rainbow Blvd / MS2002, Kansas City, KS 66160, USA
| | - Sharon Lynch
- Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Nora E Fritz
- Department of Health Care Sciences, Wayne State University, 259 Mack Avenue, #2324, Detroit, MI 48201, USA; Department of Neurology, Detroit Medical Center, University Health Center, Wayne State University, 8th floor 4201 St. Antoine, Detroit, MI 48201, USA.
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Cerebellar Contributions to Motor and Cognitive Control in Multiple Sclerosis ✰✰✰. Arch Phys Med Rehabil 2022; 103:1592-1599. [PMID: 34998712 DOI: 10.1016/j.apmr.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/25/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate relationships between specific cerebellar regions and common clinical measures of motor and cognitive function in persons with multiple sclerosis (PwMS). DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS Twenty-nine PwMS and 28 age- and sex-matched controls without multiple sclerosis (MS) (N=57). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Both diffusion and lobule magnetic resonance imaging analyses and common clinical measures of motor and cognitive function were used to examine structure-function relationships in the cerebellum. RESULTS PwMS demonstrate significantly worse motor and cognitive function than controls, including weaker strength, slower walking, and poorer performance on the Symbol Digit Modalities Test, but demonstrate no differences in cerebellar volume. However, PwMS demonstrate significantly worse diffusivity (mean diffusivity: P=.0003; axial diffusivity: P=.0015; radial diffusivity: P=.0005; fractional anisotropy: P=.016) of the superior cerebellar peduncle, the primary output of the cerebellum. Increased volume of the motor lobules (I-V, VIII) was significantly related to better motor (P<.022) and cognitive (P=.046) performance, and increased volume of the cognitive lobules (VI-VII) was also related to better motor (P<.032) and cognitive (P=.008) performance, supporting the role of the cerebellum in both motor and cognitive functioning. CONCLUSIONS These data highlight the contributions of the cerebellum to both motor and cognitive function in PwMS. Using novel neuroimaging techniques to examine structure-function relationships in PwMS improves our understanding of individualized differences in this heterogeneous group and may provide an avenue for targeted, individualized rehabilitation aimed at improving cerebellar dysfunction in MS.
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Jones U, Kegelmeyer DA, Kloos AD. Implementing Physiotherapy Huntington's Disease Guidelines in Clinical Practice. J Huntingtons Dis 2022; 11:307-311. [PMID: 35754283 DOI: 10.3233/jhd-220532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The recently published clinical practice guideline for physiotherapy practice for Huntington's disease (HD) should be integrated into practice to develop interventions that enable people with HD to achieve personalised goals. The European Huntington's Disease Network Physiotherapy Working Group aims to support and enable the use of best evidence in physiotherapy for the HD community. Successful implementation of the clinical practice guidelines requires an understanding of facilitators and barriers to therapist implementation. OBJECTIVE To explore facilitators and barriers to implementing recently published clinical recommendations that guide physiotherapy practice for HD. METHODS An online survey was distributed globally through HD networks. Data collected included demographic information and agreement/disagreement with a series of named facilitators and barriers to implementation of each of the six physiotherapy guideline recommendations. A consensus level of≥70% agreement was set as indicative of agreement/disagreement. RESULTS Thirty-two physiotherapists working in a range of settings responded. Support from colleagues (81-91% agreement), an individualised physiotherapy plan (72-88% agreement) and physiotherapist's expertise in HD (81-91% agreement) were reported as facilitators. The main barriers were behavioural (72-81% agreement) and cognitive (75-81% agreement) impairments and low motivation (72-78% agreement) in persons with HD. CONCLUSION Physiotherapists agree that their expertise in HD and support from colleagues facilitate the development of individualised treatment plans. Further work needs to develop creative ways in which barriers specific to the cognitive and behavioural aspects of HD can be managed to enable treatment plans to be implemented.
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Affiliation(s)
- Una Jones
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - Deborah A Kegelmeyer
- Division of Physical Therapy, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Anne D Kloos
- Division of Physical Therapy, College of Medicine, The Ohio State University, Columbus, OH, USA
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Biological Potential, Gastrointestinal Digestion, Absorption, and Bioavailability of Algae-Derived Compounds with Neuroprotective Activity: A Comprehensive Review. Mar Drugs 2022; 20:md20060362. [PMID: 35736165 PMCID: PMC9227170 DOI: 10.3390/md20060362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
Currently, there is no known cure for neurodegenerative disease. However, the available therapies aim to manage some of the symptoms of the disease. Human neurodegenerative diseases are a heterogeneous group of illnesses characterized by progressive loss of neuronal cells and nervous system dysfunction related to several mechanisms such as protein aggregation, neuroinflammation, oxidative stress, and neurotransmission dysfunction. Neuroprotective compounds are essential in the prevention and management of neurodegenerative diseases. This review will focus on the neurodegeneration mechanisms and the compounds (proteins, polyunsaturated fatty acids (PUFAs), polysaccharides, carotenoids, phycobiliproteins, phenolic compounds, among others) present in seaweeds that have shown in vivo and in vitro neuroprotective activity. Additionally, it will cover the recent findings on the neuroprotective effects of bioactive compounds from macroalgae, with a focus on their biological potential and possible mechanism of action, including microbiota modulation. Furthermore, gastrointestinal digestion, absorption, and bioavailability will be discussed. Moreover, the clinical trials using seaweed-based drugs or extracts to treat neurodegenerative disorders will be presented, showing the real potential and limitations that a specific metabolite or extract may have as a new therapeutic agent considering the recent approval of a seaweed-based drug to treat Alzheimer’s disease.
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Longhurst JK, Rider JV, Cummings JL, John SE, Poston B, Held Bradford EC, Landers MR. A Novel Way of Measuring Dual-Task Interference: The Reliability and Construct Validity of the Dual-Task Effect Battery in Neurodegenerative Disease. Neurorehabil Neural Repair 2022; 36:346-359. [PMID: 35387509 DOI: 10.1177/15459683221088864] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Decreased automaticity is common among individuals with neurodegenerative disease and is often assessed using dual-task (DT) paradigms. However, the best methods for assessing performance changes related to DT demands remain inconclusive. OBJECTIVE To investigate the reliability and validity of a novel battery of DT measures (DT Effect-Battery (DTE-B)) encompassing three domains: task-specific interference, task prioritization, and automaticity. METHODS Data for this retrospective cross-sectional study included 125 participants with Parkinson's disease (PD), 127 participants with Alzheimer's disease (AD), and 84 healthy older adults. Reliability analyses were conducted using a subset of each population. DTE-B measures were calculated from single and DT performance on the Timed Up and Go test and a serial subtraction task. Construct validity was evaluated via associations within the DTE-B and with theoretically supported measures as well as known-groups validity analyses. RESULTS Good to excellent reliability was found for DTE-B measures of task interference (motor and cognitive DT effects) (ICCs≥.658) and automaticity (combined DT effect (cDTE)) (ICCs≥.938). Evidence for convergent validity was found with associations within the hypothesized constructs. Known-groups validity analyses revealed differences in the DTE-B among the healthy group and PD and AD groups (ps≤.001), excepting task prioritization (ps≥.061). CONCLUSIONS This study provides evidence to support the DTE-B as a reliable measure of multiple constructs pertinent to DT performance. The cDTE demonstrated evidence to support its validity as a measure of automaticity. Further investigation of the utility of the DTE-B in both PD and AD, as well as other populations, is warranted.
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Affiliation(s)
- Jason K Longhurst
- 15994Saint Louis University, St. Louis, MO, USA.,59432University of Nevada, Las Vegas, NV, USA.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - John V Rider
- 15994Touro University Nevada, Henderson, NV, USA.,59432University of Nevada, Las Vegas, NV, USA
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Ma R, Zhào H, Wei W, Liu Y, Huang Y. Gait characteristics under single-/dual-task walking conditions in elderly patients with cerebral small vessel disease: Analysis of gait variability, gait asymmetry and bilateral coordination of gait. Gait Posture 2022; 92:65-70. [PMID: 34826695 DOI: 10.1016/j.gaitpost.2021.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/16/2021] [Accepted: 11/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Dual-task walking (DTW) is common in daily life and represents an ideal paradigm for elucidating gait irregularity. Under single-task walking (STW) and DTW conditions, the symmetric and bilaterally coordinated human gait pattern found in healthy individuals is absent in individuals with neurological ailments such as Parkinson's disease, Alzheimer's disease and post-stroke issues. Cerebral small vessel disease (CSVD) is a neuropathological and radiological issue that has been reported to be associated with cognitive and motor disorders. However, few gait analyses have focused on elderly individuals with CSVD under DTW conditions. RESEARCH QUESTION Are parameters of gait analysis helpful in elucidating gait abnormalities in elderly patients with CSVD under DTW conditions? METHODS A total of 46 elderly patients with CSVD (CSVD group) and 22 healthy, age-matched individuals (HE group) were recruited. Gait data were collected from both groups under STW and DTW conditions. Direct parameters and metrics reflecting gait variability, gait asymmetry, and bilateral coordination of gait in the two groups were compared. RESULTS Under STW conditions, elderly individuals with CSVD showed markedly shorter stride length, were slower, and had higher gait asymmetry (GA) and phase coordination index (PCI) than healthy controls after adjusting for age, sex and level of education. Under DTW conditions, there were statistically significant differences between the two groups in stride time, stride length, cadence, stride time variability, GA and PCI after adjusting for age, sex, and level of education. SIGNIFICANCE Reanalysis-generated parameters, such as gait variability, GA, and PCI, are biomarkers for gait dysfunction in elderly patients with CSVD. In this study, elderly individuals with CVSD showed abnormal gait features under both STW and DTW conditions.
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Affiliation(s)
- Rui Ma
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China; Department of Neurology, Emergency General Hospital, Beijing, 100028, China.
| | - Hóngyi Zhào
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China; Department of Neurology, NO 984 Hospital of PLA, Beijing, 100094, China.
| | - Wei Wei
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China.
| | - Yu Liu
- Department of Neurology, NO 984 Hospital of PLA, Beijing, 100094, China.
| | - Yonghua Huang
- Department of Neurology, the Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China.
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Effects of task prioritization on a postural-motor task in early-stage Parkinson's disease: EEG connectivity and clinical implication. GeroScience 2022; 44:2061-2075. [PMID: 35039998 DOI: 10.1007/s11357-022-00516-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 11/04/2022] Open
Abstract
Appropriate attentional resource allocation could minimize exaggerated dual-task interference due to basal ganglia dysfunction in Parkinson's disease (PD). Here, we assessed the electroencephalography (EEG) functional connectivity to investigate how task prioritization affected posture-motor dual-tasks in PD. Sixteen early-stage PD patients and 16 healthy controls maintained balance in narrow stance alone (single-posture task) or while separating two interlocking rings (postural dual-task). The participants applied a posture-focus or supraposture-focus strategy in the postural dual-task. Postural sway dynamics, ring-touching time, and scalp EEG were analyzed. Both groups exhibited smaller postural sway size, postural determinism, and ring-touching time with the supraposture-focus versus posture-focus strategy. PD patients exhibited higher mean inter-regional connectivity strength than control subjects in both single and dual-task postural conditions. To cope with dual-task interference, PD patients increased inter-regional connectivity (especially with the posture-focus strategy), while control subjects reduced inter-regional connectivity. The difference in mean connectivity strength between the dual-task condition with supraposture-focus and single-posture condition was negatively correlated to the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III total scores and hand-related sub-scores. Our findings suggest differential task prioritization effects on dual-task performance and cortical reorganization between early-stage PD and healthy individuals. Early-stage PD patients are advocated to use a supraposture-focus strategy during a postural dual-task. In addition, with a supraposture-focus strategy, PD patients with mild motor severity could increase compensatory inter-regional connectivity to cope with dual-task interference.
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15
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Kim H, Fraser S. Neural correlates of dual-task walking in people with central neurological disorders: a systematic review. J Neurol 2022; 269:2378-2402. [PMID: 34989867 DOI: 10.1007/s00415-021-10944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with central neurological disorders experience difficulties with dual-task walking due to disease-related impairments. The objective of this review was to provide a comprehensive examination of the neural correlates (structural/functional brain changes) of dual-task walking in people with Parkinson's disease (PD), multiple sclerosis (MS), stroke, and Alzheimer's disease (AD). METHODS A systematic review of the literature was conducted, following PRISMA guidelines, on Medline, Embase, and Scopus. Included studies examined the relationship between structural and functional brain imaging and dual-task walking performance in people with PD, MS, stroke, and AD. Articles that met the inclusion criteria had baseline characteristics, study design, and behavioral and brain outcomes extracted. Twenty-three studies were included in this review. RESULTS Most structural imaging studies (75%) found an association between decreased brain integrity and poor dual-task performance. Specific brain regions that showed this association include the striatum regions and hippocampus in PD and supplementary motor area in MS. Functional imaging studies reported an association between increased prefrontal activity and maintained (compensatory recruitment) or decreased dual-task walking performance in PD and stroke. A subset (n = 2) of the stroke papers found no significant correlations. Increased supplementary motor area activity was associated with decreased performance in MS and stroke. No studies on AD were identified. CONCLUSION In people with PD, MS, and stroke, several neural correlates of dual-task walking have been identified, however, the direction of the association between neural and performance outcomes varied across the studies. The type of cognitive task used and presentation modality (e.g., visual) may have contributed to these mixed findings.
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Affiliation(s)
- Hyejun Kim
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 7K4, Canada.
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16
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Muratori LM, Quinn L, Li X, Youdan G, Busse M, Fritz NE. Measures of postural control and mobility during dual-tasking as candidate markers of instability in Huntington's disease. Hum Mov Sci 2021; 80:102881. [PMID: 34583142 DOI: 10.1016/j.humov.2021.102881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Individuals with Huntington's disease (HD) have impairments in performing dual-tasks, however, there is limited information about the effects of changing postural and cognitive demands as well as which measures are best suited as markers of underlying motor-cognitive interference. METHODS Forty-three individuals with HD and 15 healthy controls (HC) completed single tasks of walking (Timed Up & Go (TUG), 7 m walk), standing (feet together, feet apart and foam surface) and seated cognitive performance (Stroop, Symbol Digit Modalities Test (SDMT), Delis-Kaplan Executive Function System (DKEFS) Sorting test) and dual cognitive-motor tasks while standing (+ Stroop) and walking (+ DKEFS, TUG cognitive). APDM Opal sensors recorded measures of postural sway and time to complete motor tasks. RESULTS Individuals with HD had a greater increase in standing postural sway compared to HC from single to dual-tasks and with changes to support surface. Both groups demonstrated a decrease in gait performance during the TUG cognitive, however, this difference was greater in people with HD compared to HC. While those with HD showed a greater dual-task motor cost compared to HC, both groups behaved similarly as condition complexity increased. CONCLUSIONS Standing postural sway is a more sensitive marker of instability than change in standard gait speed, particularly under dual-task conditions. The more complex TUG cognitive is a sensitive measure of walking dual-task performance. The results of this study provide insights about the nature of motor-cognitive impairments in HD and provide support for a distinction between static and dynamic postural control mechanisms during performance of dual-tasks.
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Affiliation(s)
- Lisa M Muratori
- Department of Physical Therapy, Stony Brook University, Stony Brook, NY 11794-8201, United States of America.
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Xueyao Li
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Gregory Youdan
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America.
| | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK.
| | - Nora E Fritz
- Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States of America.
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Bishnoi A, Hernandez ME. Dual task walking costs in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2021; 25:1618-1629. [PMID: 32757759 DOI: 10.1080/13607863.2020.1802576] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis (PROSPERO registration No CRD42020192121) is to review existing literature focusing on effects of different dual task paradigms on walking speed in older adults with and without Mild Cognitive Impairment. METHODS (1) Data Sources: PubMEd, Cumulative Index of Nursing and Allied Health, Cochrane library, and Web of Science. (2) Study Selection: The key terms searched included those associated with dual task, walking speed, executive function, older adults, and MCI. (3) Data Extraction: The search yielded 140 results with 20 studies meeting the inclusion criteria, which were rated by two independent reviewers using the Quality Assessment Tool. Descriptions of each study including the single and dual task protocol, outcome measure, and final outcomes were extracted. Meta-analysis was performed to evaluate the dual task effects on walking costs in older adults with and without MCI. RESULTS Meta-analysis revealed that there were significant differences in the dual task walking costs among older adults with or without MCI (p < .05). Pooled effect sizes of the serial subtraction (9.54; 95%CI, 3.93-15.15) and verbal fluency tasks (10.06; 95%CI, 6.26-15.65) showed that there are higher motor dual-task costs in older adults with MCI than age-matched controls. For quality assessment, all studies ranged from 12 to 16 in score, out of 18 (high quality). CONCLUSIONS In the studies included in this review, mental tracking tasks, consisting of serial subtraction and verbal fluency, were found to be the most sensitive in detecting MCI-related changes in older adults, and could serve an important role as a target measure for evaluating the efficacy of interventions aimed at improving cognitive and motor function in older adults.
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Affiliation(s)
- Alka Bishnoi
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Manuel E Hernandez
- Mobility and Fall Prevention Research Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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18
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Henning DA, Edwards EM, Ansara M, Fritz NE. Validating the walking while talking test to measure motor, cognitive, and dual-task performance in ambulatory individuals with multiple sclerosis. Mult Scler Relat Disord 2021; 54:103123. [PMID: 34246023 DOI: 10.1016/j.msard.2021.103123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/15/2021] [Accepted: 06/25/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Multiple Sclerosis (MS) is associated with demyelination of the central nervous system that negatively impacts both motor and cognitive function, resulting in difficulty performing simultaneous motor and cognitive tasks, or dual-tasks. Declines in dual-tasking have been linked with falls in MS; thus, dual-task assessment with the Walking While Talking Test (WWTT) is commonly utilized in the clinical setting. However, the validity and minimal detectable change (MDC) of the WWTT has not been established for persons with MS. The primary objective of the study was to establish the WWTT as a valid measure of dual-task function by examining concurrent validity with other motor, cognitive and dual-task measures, and to establish the MDC for both the simple and complex conditions of the WWTT. METHODS In a single visit, 38 adults (34 female, mean (SD) age 49.8(±9.1), Patient Determined Disease Steps (PDDS) mean 3, range 1-6) completed the WWTT simple (walk while reciting the alphabet) and complex (walk while reciting every other letter of the alphabet) conditions as well as a battery of cognitive and motor tests. Spearman correlations were used to examine concurrent validity. The sample was divided into low and high disability groups to determine the impact of disability severity on relationships among WWTT and cognitive and motor function. RESULTS Excellent concurrent validity (r ≥ 0.79; p < 0.001) was observed for the WWTT simple and complex with both motor (Timed Up-and-Go, Timed 25-Foot Walk, forward and backward walking velocity, Six-Spot Step Test) and dual-task measures (Timed Up-and-Go Cognitive). The WWTT-simple demonstrated moderate concurrent validity with measures of processing speed (Symbol Digit Modalities Test, p = 0.041) and was related to all motor and dual-task measures across disability levels. The WWTT complex was only related to complex motor tasks in the low disability group. Within the low disability group, WWTT was associated with processing speed (p = 0.045) and working memory (California Verbal Learning Test, p = 0.012). The MDC values were established for WWTT simple (6.9 s) and complex (8 s) conditions. DISCUSSION The WWTT is a quick, easy-to-administer clinical measure that captures both motor and cognitive aspects of performance for persons with MS. Clinicians should consider adding the WWTT to the evaluation of persons with MS to examine dual-task performance.
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Affiliation(s)
- David A Henning
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit MI, United States; Department of Health Care Sciences, Program in Physical Therapy, Wayne State University, Detroit MI, United States
| | - Erin M Edwards
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit MI, United States; Translational Neuroscience Program, Wayne State University, Detroit, MI, United States
| | - Melissa Ansara
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit MI, United States
| | - Nora E Fritz
- Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit MI, United States; Department of Health Care Sciences, Program in Physical Therapy, Wayne State University, Detroit MI, United States; Translational Neuroscience Program, Wayne State University, Detroit, MI, United States; Department of Neurology, Wayne State University, Detroit MI, United States.
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Cognitive-motor Interference in Individuals With a Neurologic Disorder: A Systematic Review of Neural Correlates. Cogn Behav Neurol 2021; 34:79-95. [PMID: 34074863 DOI: 10.1097/wnn.0000000000000269] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Performing a cognitive task and a motor task simultaneously is an everyday act that can lead to decreased performance on both tasks. OBJECTIVE To provide insight into the neural correlates associated with cognitive-motor dual tasking in individuals with a neurologic disorder. METHOD We searched the PubMed and Web of Science databases for studies that had been published up to January 16th, 2019. Studies investigating the neural correlates of cognitive-motor dual task performance in individuals with a variety of neurologic disorders were included, independently from whether the study included healthy controls. Clinical and imaging data were abstracted for the comparison between single tasks and a dual task in the individuals with a neurologic disorder and for the comparison between the healthy controls and the individuals with a neurologic disorder. RESULTS Eighteen studies met the inclusion criteria. Study populations included individuals with Parkinson disease, multiple sclerosis, mild cognitive impairment, Alzheimer disease, traumatic brain injury, and stroke. Neuroimaging types used to study the neural correlates of cognitive-motor dual tasking during upper limb or gait tasks included fMRI, functional near-infrared spectroscopy, EEG, and PET. CONCLUSION Despite large heterogeneity in study methodologies, some recurrent patterns were noted. Particularly, in neurologic patients, an already higher brain activation during single tasks was seen compared with healthy controls, perhaps compromising the patients' ability to further adapt brain activation with increasing load during dual tasking and resulting in reduced behavioral dual task performance.
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Baione V, Ferrazzano G, Celletti C, De Rosa M, Belvisi D, Fabbrini G, Galli M, Camerota F, Conte A. Attention-Demanding Cognitive Tasks Worsen Postural Control in Patients With Cervical Dystonia: A Case-Control Study. Front Neurol 2021; 12:666438. [PMID: 33889130 PMCID: PMC8056005 DOI: 10.3389/fneur.2021.666438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Patients with cervical dystonia (CD) show impaired postural control, balance, and gait, likely due to abnormal head postures and sensorimotor disturbances. However, until now no study has investigated whether attention-demanding activity worsens postural control and balance in CD patients. Objective: To investigate whether patients with CD show cognitive-motor interference (CMI), a specific kind of dual-task interference that occurs during the simultaneous execution of a cognitive and motor task. This information may be useful to determine whether performing activities of daily living worsens postural control and balance in CD patients. Methods: We performed a pilot case-control study. Twenty-two patients affected by CD and 19 healthy controls were enrolled in order to test CMI. Each subject was evaluated during the execution of a cognitive task while postural stability was assessed through a stabilometric platform. Results: CD patients showed impaired postural control compared to healthy controls, with instability increasing with increasing cognitive task complexity. No relationships were found between stabilometric parameters and clinical characteristics of CD. Conclusions: Our hypothesis is that CMI in CD patients derives from deranged network connectivity when activated simultaneously during the performance of two tasks that interfere with each other and “compete” for the same resources within the cognitive system.
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Affiliation(s)
- Viola Baione
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Gina Ferrazzano
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Rome, Italy
| | - Matteo De Rosa
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Daniele Belvisi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
| | - Giovanni Fabbrini
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
| | - Manuela Galli
- Department of Electronics, Information, and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Rome, Italy
| | - Antonella Conte
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Neuromed, Pozzilli, Italy
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21
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The patients' perspective on the perceived difficulties of dual-tasking: development and validation of the Dual-task Impact on Daily-living Activities Questionnaire (DIDA-Q). Mult Scler Relat Disord 2020; 46:102601. [PMID: 33296993 DOI: 10.1016/j.msard.2020.102601] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Everyday-life activities often require performing dual tasks (DT), with consequent possible occurrence of motor-cognitive or motor-motor interference. This could reduce quality of life, in particular in people with neurological diseases. However, there is lack of validated tools to assess the patients' perspective on DT difficulties in this population. Therefore, we developed the Dual-task Impact on Daily-living Activities-Questionnaire (DIDA-Q) and tested its psychometric properties in people with multiple sclerosis (PwMS). METHODS Items were generated based on existing scales, DT paradigms used in previous studies and the opinion of a multi-stakeholder group, including both experts and PwMS. Twenty DT constituted the preliminary version of the DIDA-Q which was administered to 230 PwMS. The psychometric properties of the scale were evaluated including internal consistency, validity and reliability. RESULTS Nineteen items survived after exploratory factor analysis, showing a three-factor solution which identifies the components mostly contributing to DT perceived difficulty (i.e., balance and mobility, cognition and upper-limb ability). The DIDA-Q appropriately fits the graded response model, with first evaluations supporting internal consistency (Cronbach's alpha=0.95), validity (70% of the hypotheses for convergent and discriminant constructs confirmed) and reliability (intraclass correlation coefficients=0.95) of this tool. CONCLUSION The DIDA-Q could be used in research and clinical settings to discriminate individuals with low vs. high cognitive-motor or motor-motor interference, and to develop and evaluate the efficacy of personalized DT rehabilitative treatments in PwMS.
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22
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Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS. Mult Scler Int 2020; 2020:6707414. [PMID: 32963832 PMCID: PMC7495208 DOI: 10.1155/2020/6707414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 11/30/2022] Open
Abstract
Background Individuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports. Methods All measures were collected in a single session. A 2 × 2 × 2 mixed model ANOVA was used to compare differences in forward and backward walking in single- and dual-task conditions between MS and healthy controls. Spearman correlations were used to examine relationships between gait and cognitive function, falls, and balance. Results Eighteen individuals with relapsing-remitting MS and 14 age- and sex-matched healthy controls participated. Backward walking velocity revealed significant differences between groups for both single-task (p = 0.015) and dual-task (p = 0.014) conditions. Persons with MS demonstrated significant differences between single- and dual-task forward and backward walking velocities (p = 0.023; p = 0.004), whereas this difference was only apparent in the backward walking condition for healthy controls (p = 0.004). In persons with MS, there were significant differences in double support time between single- and dual-task conditions in both backward (p < 0.001) and forward (p = 0.001) directions. More falls at six months were significantly associated with shorter backward dual-task stride length (r = −0.490; p = 0.046) and slower velocity (r = −0.483; p = 0.050). Conclusion Differences in MS and age- and sex-matched healthy controls are more pronounced during backward compared to forward walking under single- and dual-task conditions. Future work with a larger sample size is needed to validate the clinical utility of backward walking and dual-task assessments and mitigate the limited sensitivity of the current dual-task assessments that primarily rely upon forward walking.
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Lo J, Reyes A, Pulverenti TS, Rankin TJ, Bartlett DM, Zaenker P, Rowe G, Feindel K, Poudel G, Georgiou-Karistianis N, Ziman MR, Cruickshank TM. Dual tasking impairments are associated with striatal pathology in Huntington's disease. Ann Clin Transl Neurol 2020; 7:1608-1619. [PMID: 32794343 PMCID: PMC7480913 DOI: 10.1002/acn3.51142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Recent findings suggest that individuals with Huntington's disease (HD) have an impaired capacity to execute cognitive and motor tasks simultaneously, or dual task, which gradually worsens as the disease advances. The onset and neuropathological changes mediating impairments in dual tasking in individuals with HD are unclear. The reliability of dual tasking assessments for individuals with HD is also unclear. OBJECTIVES To evaluate differences in dual tasking performance between individuals with HD (presymptomatic and prodromal) and matched controls, to investigate associations between striatal volume and dual tasking performance, and to determine the reliability of dual tasking assessments. METHODS Twenty individuals with HD (10 presymptomatic and 10 prodromal) and 20 healthy controls were recruited for the study. Individuals undertook four single and dual task assessments, comprising motor (postural stability or force steadiness) and cognitive (simple or complex mental arithmetic) components, with single and dual tasks performed three times each. Participants also undertook a magnetic resonance imaging assessment. RESULTS Compared to healthy controls, individuals with presymptomatic and prodromal HD displayed significant deficits in dual tasking, particularly cognitive task performance when concurrently undertaking motor tasks (P < 0.05). The observed deficits in dual tasking were associated with reduced volume in caudate and putamen structures (P < 0.05),however, not with clinical measures of disease burden. An analysis of the reliability of dual tasking assessments revealed moderate to high test-retest reliability [ICC: 0.61-0.99] for individuals with presymptomatic and prodromal HD and healthy controls. CONCLUSIONS Individuals with presymptomatic and prodromal HD have significant deficits in dual tasking that are associated with striatal degeneration. Findings also indicate that dual tasking assessments are reliable in individuals presymptomatic and prodromal HD and healthy controls.
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Affiliation(s)
- Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Alvaro Reyes
- Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello, Viña del Mar, Chile
| | - Timothy S Pulverenti
- Department of Physical Therapy, College of Staten Island, The City University of New York, Staten Island, NY
| | - Timothy J Rankin
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Centre for Sleep Science, School of Human Sciences, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Danielle M Bartlett
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Pauline Zaenker
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Grant Rowe
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Kirk Feindel
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Govinda Poudel
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Nellie Georgiou-Karistianis
- School of Psychological Sciences and the Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Mel R Ziman
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Biomedical Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Travis M Cruickshank
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
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Júlio F, Ribeiro MJ, Morgadinho A, Sousa M, van Asselen M, Simões MR, Castelo-Branco M, Januário C. Cognition, function and awareness of disease impact in early Parkinson's and Huntington's disease. Disabil Rehabil 2020; 44:921-939. [PMID: 32620060 DOI: 10.1080/09638288.2020.1783001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose: Patients with Parkinson's and Huntington's Disease (PD and HD) present impairments in cognitively challenging everyday activities. This study contrasts these two basal ganglia disorders on the ability to perform daily life- like tasks and their level of awareness regarding the disease impact on function.Methods: 19 controls, 10 early-onset PD, 20 early stage PD, and 15 early manifest HD patients were compared in the "EcoKitchen," a virtual reality task with increasing executive load, the "Behavioural Assessment of Dysexecutive Syndrome battery - BADS," and "The Adults and Older Adults Functional Assessment Inventory - IAFAI," a self-report functional questionnaire. The EcoKitchen clinical correlates were investigated.Results: All clinical groups presented slower EcoKitchen performance than controls, however, only HD patients showed decreased accuracy. HD and PD patients exhibited reduced BADS scores compared to the other study participants. Importantly, on the IAFAI, PD patients signalled more physically related incapacities and HD patients indicated more cognitively related incapacities. Accordingly, the EcoKitchen performance was significantly associated with PD motor symptom severity.Conclusions: Our findings suggest differential disease impact on cognition and function across PD and HD patients, with preserved awareness regarding disease- related functional sequelae. These observations have important implications for clinical management, research and rehabilitation.Implications for rehabilitationPatients with early stage Parkinson's and Huntington's disease have diagnosis-specific impairments in the performance of executively demanding everyday activities and, yet, show preserved awareness about the disease impact on their daily life.An active involvement of patients in the rehabilitation process should be encouraged, as their appraisal of the disease effects can help on practical decisions about meaningful targets for intervention, vocational choices, quality-of-life issues and/or specific everyday skills to boost.The EcoKitchen, a non-immersive virtual reality task, can detect and quantify early deficits in everyday-like tasks and is therefore a valuable tool for assessing the effects of rehabilitation strategies on the functional cognition of these patients.Rehabilitation efforts in the mild stages of Parkinson's and Huntington's disease should be aware of greater time needs from the patients in the performance of daily life tasks, target executive skills, and give a more prominent role to patients in symptoms report and management.
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Affiliation(s)
- Filipa Júlio
- University of Coimbra, Faculty of Psychology and Education Sciences, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | - Maria J Ribeiro
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | | | - Mário Sousa
- Coimbra University Hospital, Coimbra, Portugal
| | - Marieke van Asselen
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal
| | - Mário R Simões
- University of Coimbra, Faculty of Psychology and Education Sciences, Coimbra, Portugal.,University of Coimbra, Faculty of Psychology and Education Sciences, Center for Research in Neuropsychology and Cognitive Behavioural Intervention (CINEICC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.,University of Coimbra, Institute of Nuclear Sciences Applied to Health (ICNAS), Coimbra, Portugal.,University of Coimbra, Faculty of Medicine, Coimbra, Portugal
| | - Cristina Januário
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Coimbra, Portugal.,Coimbra University Hospital, Coimbra, Portugal.,University of Coimbra, Faculty of Medicine, Coimbra, Portugal
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Shin D, Kang EK. Dual-task interference is related to attentional level in healthy farmers: An observational study. Medicine (Baltimore) 2020; 99:e20720. [PMID: 32629646 PMCID: PMC7337427 DOI: 10.1097/md.0000000000020720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Dual-task interference (DTI) is a decreased performance when conducting 2 tasks simultaneously, such as cognitive and motor tasks. This study aimed to identify the DTI-related factors with individually computerized interference and analyze the relative implications of decreasing DTI in healthy farmers.It followed 3 computerized experiments:The reaction time of correct releases (CRT) of BT1 in all tasks was measured, and the CRT ratios of DT were divided by the CRT values from CT and MT to obtain the DTI value. CRT during CT and MT was decreased compared to that during DT. The interference by CT (CRT of DT/CRT of MT × 100, CTI) was increased compared to the interference by MT (CRT of DT/CRT of CT×100, MTI). Additionally, comprehensive baseline characteristics, body composition, psycho-cognitive, and physical factors were assessed.Of a total of 54 participants, 16 are males (67.2 ± 8.9 years) and 38 females (62.5 ± 6.6 years). CTI showed significant correlations with age (r = 0.436, P < .001), farming period (r = 0.290, P = .033), score of the Mini-Mental State Examination in the Korean version of CERAD Assessment Packet (r = -0.329, P = .015), CRT of the Go/No-Go test (r = 0.67, P < .001), score of the short physical performance battery (r = -0.304, P = .026), and time of the timed up and go test (r = 0.364, P = .007). Regression analysis showed that the CRT of the Go/No-Go test (β = 0.558, P < .001) was the most explanatory factors for CTI.Based on the individualized DTI values quantified, interference during cognitive task was mostly related to CRT of Go/No-Go test, reflecting the attentional level. These results could suggest strategies for the active attentional training to reduce DTI and passive simplification and modification of lifestyles.
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Affiliation(s)
- Dabi Shin
- Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Eun Kyoung Kang
- Department of Rehabilitation Medicine, Kangwon National University Hospital
- Department of Rehabilitation Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
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Kahya M, Moon S, Ranchet M, Vukas RR, Lyons KE, Pahwa R, Akinwuntan A, Devos H. Brain activity during dual task gait and balance in aging and age-related neurodegenerative conditions: A systematic review. Exp Gerontol 2019; 128:110756. [PMID: 31648005 PMCID: PMC6876748 DOI: 10.1016/j.exger.2019.110756] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022]
Abstract
The aims of this systematic review were to investigate (1) real-time brain activity during DT gait and balance, (2) whether changes in brain activity correlate with changes in behavioral outcomes in older adults and people with age-related neurodegenerative conditions. PubMed, PsycINFO, and Web of Science were searched from 2009 to 2019 using the keywords dual task, brain activity, gait, balance, aging, neurodegeneration, and other related search terms. A total of 15 articles were included in this review. Functional near-infrared spectroscopy and electroencephalogram measures demonstrated that older adults had higher brain activity, particularly in the prefrontal cortex (PFC), compared to young adults during dual task gait and balance. Similar neurophysiological results were observed in people with age-related neurodegenerative conditions. Few studies demonstrated a relationship between increased brain activity and better behavioral outcomes. This systematic review supports the notion that aging and age-related neurodegenerative conditions are associated with neuronal network changes, resulting in increased brain activity specifically in the PFC. Further studies are warranted to assess the relationship between increased PFC activation during dual task gait and balance and behavioral outcomes to better optimize the rehabilitation interventions.
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Affiliation(s)
- Melike Kahya
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Sanghee Moon
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Maud Ranchet
- University of Lyon, IFSTTAR, TS2 LESCOT, Lyon, France.
| | - Rachel R Vukas
- A.R. Dykes Library of the Health Sciences, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Abiodun Akinwuntan
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
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Chen Z, Han J, Waddington G, Adams R, Witchalls J. Somatosensory perception sensitivity in voluntary postural sway movements: Age, gender and sway effect magnitudes. Exp Gerontol 2019; 122:53-59. [PMID: 31029824 DOI: 10.1016/j.exger.2019.04.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/22/2019] [Accepted: 04/21/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES 1) to develop a reliable device for assessing somatosensory perception sensitivity in voluntary postural sway movement, specifically a sway discrimination apparatus (SwayDA) for testing voluntary lateral sway discrimination sensitivity (VLSDS); 2) to explore the relationship between mobility performance and VLSDS in older adults, and 3) to determine the effects of age, gender and sway magnitude on VLSDS. METHODS First, eighteen healthy young adults (8 males, 10 females, age ranging from 22 to 70) were recruited for a test-retest reliability study. During the SwayDA test, the participants were asked to discriminate between four possible medial-lateral sway extents when moving away from neutral standing. For Objective 2, twenty-five older participants (9 males, 16 females, mean age 70.1) undertook both the SwayDA and the mobility tests. The mobility testing battery consisted of single task and cognitive dual task timed-up and-go tests, and the 5 times sit-to-stand test. Pearson's correlation was calculated between SwayDA scores and mobility performance. For Objective 3, 20 community-dwelling adults over 65 years old (10 males, 10 females, mean age 71.3) and 20 young volunteers (10 males, 10 females, mean age 23.6) were recruited to study the effects of age, gender and sway magnitude on VLSDS. To obtain a bias-free measure of VLSDS, the probability of correct response was considered as the true-positive judgment, while the probability of incorrect response was considered as false-positive judgment, and these were cumulated across the response values. A receiver operating characteristic (ROC) curve was then generated and the Area Under the ROC Curve (AUC) was used to measure VLSDS. RESULTS There was no significant difference in AUC scores between Day 1 and Day 8 (p > 0.05). ICC(3,1) reliability indices were 0.750 for sway to the left and 0.879 for sway to the right. Pearson's correlation revealed a significant correlation between the SwayDA sores and timed-up-and-go (TUG), cognitive dual task TUG, 5 times sit-to-stand test (r = -0.456, -0.522, and - 0.416 respectively, all p < 0.05). Factorial ANOVA showed age and gender main effects (F = 8.144, p < 0.01, and F = 8.806, p < 0.01, respectively), suggesting older adults and females had worse VLSDS. In addition, a significant difference was found between the young and older participants in the inner range of VLSDS (t = -2.875, p < 0.017), indicating that the decline of somatosensory perception of postural sway in older people may be magnitude-specific, and greatest for small deviations from upright stance. CONCLUSIONS The SwayDA has good to excellent test-retest reliability. The finding that VLSDS score was significantly correlated with mobility performance in older adults highlights the importance of somatosensory perception in postural control. More importantly, the significantly worse VLSDS in older people observed in the inner lateral movement range may represent a unique characteristic of neuromuscular degeneration associated with aging, which should be monitored and addressed in rehabilitation programs.
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Affiliation(s)
- Zhengquan Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jia Han
- School of Kinesiology, Shanghai University of Sport, Shanghai, China; Research Institute for Sport and Exercise, University of Canberra, ACT AUS 2601, Australia.
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, ACT AUS 2601, Australia
| | - Roger Adams
- Research Institute for Sport and Exercise, University of Canberra, ACT AUS 2601, Australia
| | - Jeremy Witchalls
- Research Institute for Sport and Exercise, University of Canberra, ACT AUS 2601, Australia
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Schott N. Dual-Task Performance in Developmental Coordination Disorder (DCD): Understanding Trade-offs and Their Implications for Training. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019. [DOI: 10.1007/s40474-019-00163-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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