Effect of task difficulty on dual-task cost during dual-task walking in people with multiple sclerosis

IF 2.2 3区医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2024-09-19 DOI:10.1016/j.gaitpost.2024.09.003

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Abstract

Background

Cognitive-motor dual-task walking results a decrease in walking performance of patients with multiple sclerosis (PwMS) and it is known as dual-task cost (DTC). However, there is a lack of evidence about the effects of dual-tasks with hierarchical difficulty on DTC in PwMS.

Research question

This study aimed to investigate the effect of task difficulty on DTC during cognitive-motor dual-task walking in people with multiple sclerosis (PwMS).

Methods

32 PwMS and 32 healthy controls were included. The 6-meter walking test (6-Meter WT) with comfortable speed was used as single-task walking condition. For dual-task conditions, walking tasks and cognitive tasks at two difficulty levels (simple and difficult) were combined and DTC for four cognitive-motor dual-task walking conditions as simple motor-simple cognitive (SM-SC), simple motor-difficult cognitive (SM-DC), difficult motor-simple cognitive (DM-SC) and difficult motor-difficult cognitive (DM-DC) were calculated. The 6-Meter WT was used also for simple dual-task walking task. The 6-Meter WT was applied by walking in a narrow base condition for creating a difficult dual-task walking task. For cognitive task difficulty, participants were asked to count backwards by 3 as simple cognitive task and by 7 as difficult cognitive task.

Results

DTC was higher in PwMS than control subjects. DTC in all conditions were different (SM-SC<SM-DC<DM-SC<DM-DC). DTC was higher in PwMS than control subjects in three conditions and was similar SM-SC condition. In addition, DTC in all conditions (SM-SC<SM-DC<DM-SC<DM-DC) were different in both PwMS and control subjects.

Conclusion

The results suggest that task difficulty affects the magnitude of DTC during cognitive-motor dual-task walking in PwMS. Moreover, difficult walking tasks combined with simple cognitive tasks result greater DCT on walking than simple walking tasks combined with difficult cognitive tasks.

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任务难度对多发性硬化症患者双任务行走成本的影响

研究背景认知-运动双任务行走会导致多发性硬化症患者（PwMS）行走能力下降，被称为双任务成本（DTC）。本研究旨在调查多发性硬化症患者（PwMS）在认知-运动双任务步行过程中任务难度对 DTC 的影响。32名多发性硬化症患者和32名健康对照组患者在单任务步行条件下进行了舒适速度的6米步行测试（6米WT）。在双任务条件下，将行走任务和两种难度（简单和困难）的认知任务相结合，计算简单运动-简单认知（SM-SC）、简单运动-困难认知（SM-DC）、困难运动-简单认知（DM-SC）和困难运动-困难认知（DM-DC）四种认知-运动双任务行走条件下的 DTC。6 米加权平均值也用于简单的双任务步行任务。在狭窄的基础条件下行走时，采用 6 米加权平均值来完成困难的双任务行走任务。在认知任务难度方面，简单认知任务要求参与者倒数 3，困难认知任务要求倒数 7。所有条件下的 DTC 都不同（SM-SC<SM-DC<DM-SC<DM-DC）。在三种条件下，PwMS 的 DTC 均高于对照组受试者，且 SM-SC 条件下的 DTC 相似。此外，在所有条件下（SM-SC<SM-DC<DM-SC<DM-DC），PwMS 和对照组受试者的 DTC 都不同。此外，与简单的行走任务和困难的认知任务相结合相比，困难的行走任务和简单的认知任务相结合会导致更大的行走 DCT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.