Citation

Kao PC, Pierro MA. Gait Posture 2021; 92: 167-175.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.gaitpost.2021.11.030

PMID

34856525

Abstract

BACKGROUND: Cognitive-walking interference is manifested when simultaneously performing a cognitive task while walking. However, majority of the dual-task walking paradigms incorporated relatively short testing trials and were focused on posing a cognitive challenge by adding a secondary cognitive task but not introducing walking perturbations. RESEARCH QUESTION: How do healthy young adults adapt to concurrent cognitive challenges and walking perturbations in terms of task prioritization and adaptation strategies to control walking stability? METHODS: Eighteen healthy young participants walked with and without (1) continuous treadmill platform sways (Perturbed and Unperturbed walking), and (2) performing one of the cognitive tasks: visual and auditory Stroop tasks, Clock task, Paced Auditory Serial Addition Test (PASAT), and walk only. Primary outcome measures included cognitive task performance, mediolateral dynamic margins of stability (MOS(ML)), M-L local dynamic stability, stride time variability and the dual-task interference (DTI) on these measures.

RESULTS: Gait adjustments made during Perturbed walking did not improve walking stability but instead, showing more local instability and greater gait variability (all p < 0.001) than Unperturbed walking. Participants increased average MOS(ML) during Clock and PASAT compared to Walk Only for both Perturbed and Unperturbed walking (THSD, p < 0.05). Participants had significantly less DTI on stride time variability during Unperturbed walking than during Perturbed walking (p < 0.001). Participants also had significantly greater DTI on PASAT performance during Perturbed than during Unperturbed walking (THSD, p < 0.05) SIGNIFICANCE: Participants prioritized the walking task under a more challenging walking condition although the adjustments made during Perturbed walking were not sufficient to maintain a similar level of walking stability as Unperturbed walking. Adjustments to the cognitive-walking challenges were differed by the type of cognitive tasks. The current findings suggest that cognitive tasks involving both working memory and information processing or visuospatial recognition or attention have greater impact on gait especially during the perturbed walking condition.

Language: en

Keywords

Cognitive-walking interference; Dual-task; Dynamic stability; Gait; Perturbations