Does Inspiratory Threshold Loading and Visual Tasking Affect Visual Attention Accuracy?

Abstract

Objective: Dyspnea is commonly experienced in adults who are young and have different health conditions (asthma, obesity, panic disorders) and may impede not only physical exertion but also cognitive function such as visual attention. To test this, visual attention was evaluated using the Multiple Object Tracking Test (MOT) alone and combined with low or moderate inspiratory threshold loading (ITL).

Methods: Using a pretest-posttest design, we evaluated 25 participants who were healthy and 19 to 31 years old. Visual attention accuracy was quantified using the MOT, wherein participants tracked moving disks on a computer monitor. Participants performed 5 single or dual tasks in random order: MOT; low ITL of 20 cm H2O (ITL20); moderate ITL of 40 cm H2O (ITL40); dual task: MOT plus ITL20 (MOT + ITL20); and dual task: MOT plus ITL40 (MOT + ITL40). Dyspnea intensity measured with the Borg Dyspnea Scale and emotional response measured with the Self-Assessment Manikin (SAM) were evaluated at baseline and for single and dual tasks.

Results: Compared to single task MOT, dual tasks induced lower MOT scores with moderate loads (MOT + ITL40) resulting in lower scores than dual task low ITL (MOT + ITL20). Exertional dyspnea intensity and SAM affective measures increased during ITL and dual tasks compared to baseline. Moreover, higher dual task MOT scores were related to greater inspiratory muscle strength and to more positive affect evaluated by SAM.

Conclusions: Individuals experiencing inspiratory muscle loading and associated dyspnea demonstrated decreased visual attention accuracy, which was accentuated by higher inspiratory loads, lower respiratory muscle strength, and higher emotional response.

Impact: Although physical activity is often prescribed according to the musculoskeletal or cardiovascular stress, the cognitive interference of how dyspnea compromises cognitive function should be considered. The inability to attend to visual detail during added respiratory loads with associated dyspnea should be considered during assessment and treatment planning. A physical-cognitive approach to prescription of physical function may ensure more transferability to daily activities.