Attentional costs of visually guided walking: Effects of age, executive function and stepping-task demands

Mazaheri, Masood; Roerdink, Melvyn; Bood, Robert Jan; Duysens, Jacques; Beek, Peter J.; Peper, C. E.

doi:10.1016/j.gaitpost.2014.03.183

Cited by 50 publications

(44 citation statements)

References 29 publications

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“…Finally we did not take any measures of attention. Given that some studies have shown that walking to external cues (particularly visual, as opposed to auditory, cues) requires greater attention than unconstrained walking [17,18], future studies should examine the influence of altered attention and cognitive/executive function following stroke on performance of target stepping tasks.…”

Section: Discussionmentioning

confidence: 99%

“…Further, stroke survivors have been shown to have difficulties making medial-lateral step corrections [10] and deficits in adjusting foot-placement are exacerbated under time pressure [5,6,10]. In healthy older and younger adults target stepping paradigms to test the ability to adapt and control footplacement have shown discriminatory power for age and been associated with falls risk and cognitive function [16][17][18][19][20]. Control and adaptability of footfall location may therefore be a mechanistic component facilitating overall gait adaptability; especially given that foot placement adjustments are one of the most effective mechanisms for dynamic balance control during walking [10] and many falls have been reported due to misplaced step [4].…”

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confidence: 99%

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A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

et al. 2016

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Background:Although there is evidence that stroke survivors have reduced gait adaptability, the underlying mechanisms and the relationship to functional recovery are largely unknown. We explored the relationships between walking adaptability and clinical measures of balance, motor recovery and functional ability in stroke survivors. Methods:Stroke survivors (n=42) stepped to targets, on a 6m walkway, placed to elicit step lengthening, shortening and narrowing. The number of targets missed during six walks (3 targeting with paretic limb and 3 with non-paretic) and target stepping speed was recorded. Fugl-Meyer scores (FM), Berg Balance Scale (BBS), self-selected walking speed (SWWS) and single support (SS) and step length (SL) symmetry (using GaitRite when not walking to targets) were also assessed. Stepwise multiple-linear regression was used to model the relationships between: total targets missed, number missed with paretic and non-paretic legs, target stepping speed, and each clinical measure. Results:Regression revealed a significant model for each outcome variable that included only one independent variable. Targets missed by the paretic limb, was a significant predictor of FM(F(1,40)=6.54, p=0.014,). Speed of target stepping was a significant predictor of each of BBS(F(1,40)=26.36, p<0.0001), SSWS(F(1,40)=37.00, p<0.0001) and SS asymmetry (F(1,38)=5.57, p=.006). No variables were significant predictors of SL asymmetry. Discussion: Speed of target stepping was significantly predictive of SS symmetry, BBS and SSWS and paretic targets missed predicted FM, suggesting that fast target stepping requires good balance and temporal symmetry of gait and accurate stepping demands good paretic leg function. The relationships between these parameters indicate gait adaptability is a clinically meaningful target for measurement and treatment of functionally adaptive walking ability in stroke survivors. Keywords: gait, adaptability, stroke, visionGait adaptability and functional mobility in stroke Background:

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

et al. 2016

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“…cognitive impairments [8] and elevated visuomotor demands [9][10][11][12] are associated with increased attentional costs of walking. Few studies [13,14], however, have specifically addressed how balance control affects the attentional costs of walking, especially in older adults.…”

Section: Introductionmentioning

confidence: 99%

“…Few studies [13,14], however, have specifically addressed how balance control affects the attentional costs of walking, especially in older adults. Pertinent evidence comes primarily from experiments with base-of-support manipulations, showing that attentional costs are higher during walking than during standing or sitting [9,10,13,14]. Although balance requirements may change over the gait cycle, inconsistent results have been reported regarding the attentional costs for specific phases in the gait cycle [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…With these manipulations, we created conditions with higher and lower balance demands, respectively. The attentional costs associated with these conditions were assessed with vibrotactile stimulus-response reaction times (RT) [9,10]. We expected that higher balance demands (as evoked by walking with a narrow base of support) would increase the attentional costs of walking, particularly in older adults.…”

Section: Introductionmentioning

confidence: 99%

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