Biomechanical and neurocognitive performance outcomes of walking with transtibial limb loss while challenged by a concurrent task

Pruziner, Alison L.; Shaw, Emma P.; Rietschel, Jeremy C.; Hendershot, Brad D.; Miller, Matthew W.; Wolf, Erik; Hatfield, Bradley D.; Dearth, Christopher L.; Gentili, Rodolphe J.

doi:10.1007/s00221-018-5419-8

Cited by 22 publications

(55 citation statements)

References 66 publications

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“…The current experimental analyses did not include a control group of uninjured participants for two reasons. First, prior work revealed similar responses to cognitive-motor challenge in both individuals with and without TT LL, which justifies a parsimonious approach to compare individuals with TT LL and TF LL without the inclusion of uninjured individuals as a control (Pruziner et al, 2019). Second, the inclusion of uninjured participants introduces a potential confound that could bias 986 E.P.…”

Section: Participantsmentioning

confidence: 87%

“…To minimize any transient effects that were present at the beginning or end of the task (e.g., task adjustment and fatigue), EEG data collected between 3 and 6 min during each experimental condition were extracted for the analysis of EEG spectral power. Under the assumption that the EEG was relatively stable from segment to segment, the data were processed, segmented within a given experimental condition (e.g., seated performing the low demand cognitive task) and averaged across the segments (Borghini et al, 2017;Holm et al, 2009;Pruziner et al, 2019;Shaw et al, 2018). Specifically, the 3 min blocks of data were low-pass filtered at 50 Hz with a Fig.…”

Section: Electrophysiological Data Collection and Signal Processingmentioning

confidence: 99%

“…Thus, the behavioral outcome may not always be indicative of the level of mental workload required to maintain performance under varying levels of challenge (Alderman et al, 2015;Murray & Janelle, 2007). The only study published to date to examine mental workload via electroencephalography (EEG) during dual-task walking in individuals with lower LL compared uninjured individuals to those with transtibial (TT) LL (Pruziner et al, 2019). Generally, the research conducted on the mental workload of walking with a prosthetic device has compared individuals with lower LL to uninjured individuals, but has not directly compared individuals with varying levels of amputation.…”

Section: Introductionmentioning

confidence: 99%

“…EEG has been successfully employed for mental workload assessment during cognitive-motor performance, including dual-task walking (Gevins & Smith, 2003;Marcar et al, 2014;Murray & Janelle, 2007;Pruziner et al, 2019;Shaw et al, 2018). While EEG theta power is positively related to mental workload, and likely reflects the recruitment of attentional-related processes (e.g., working memory and action monitoring), EEG alpha power is inversely related to cortical activation, which reflects the level of inhibition of nonessential neural processes.…”

Section: Introductionmentioning

confidence: 99%

“…Collectively, several derivatives of the EEG reflect critical cortical processes associated with mental workload impacted by the varying demands of diverse tasks (Beurskens et al, 2016;De Sanctis et al, 2014;Malcolm et al, 2015). Namely, an increase in cognitive-motor demand under varying motor performance conditions (i.e., seated vs. walking) has been associated with increased theta and decreased alpha power, indicative of an elevation of mental effort recruited to maintain cognitive-motor performance (Pruziner et al, 2019;Shaw et al, 2018). Although changes in theta and alpha power have typically been employed as primary metrics to assess the modulation of mental workload, gamma spectral power was also evaluated in the present investigation as an exploratory analysis due to its association with sensory processing, selective attention, and working memory (Basar-Eroglu et al 1996;Howard et al, 2003;Michels et al, 2010;Pascalis and Ray, 1998).…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Mental Workload in Individuals with Transtibial and Transfemoral Lower Limb Loss during Dual-Task Walking under Varying Demand

Shaw

Rietschel

Hendershot

et al. 2019

J Int Neuropsychol Soc

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Objectives: This study aimed to evaluate the influence of lower limb loss (LL) on mental workload by assessing neurocognitive measures in individuals with unilateral transtibial (TT) versus those with transfemoral (TF) LL while dual-task walking under varying cognitive demand. Methods: Electroencephalography (EEG) was recorded as participants performed a task of varying cognitive demand while being seated or walking (i.e., varying physical demand). Results: The findings revealed both groups of participants (TT LL vs. TF LL) exhibited a similar EEG theta synchrony response as either the cognitive or the physical demand increased. Also, while individuals with TT LL maintained similar performance on the cognitive task during seated and walking conditions, those with TF LL exhibited performance decrements (slower response times) on the cognitive task during the walking in comparison to the seated conditions. Furthermore, those with TF LL neither exhibited regional differences in EEG low-alpha power while walking, nor EEG high-alpha desynchrony as a function of cognitive task difficulty while walking. This lack of alpha modulation coincided with no elevation of theta/alpha ratio power as a function of cognitive task difficulty in the TF LL group. Conclusions: This work suggests that both groups share some common but also different neurocognitive features during dual-task walking. Although all participants were able to recruit neural mechanisms critical for the maintenance of cognitive-motor performance under elevated cognitive or physical demands, the observed differences indicate that walking with a prosthesis, while concurrently performing a cognitive task, imposes additional cognitive demand in individuals with more proximal levels of amputation.

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Section: Participantsmentioning

confidence: 87%

Section: Electrophysiological Data Collection and Signal Processingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Comparison of Mental Workload in Individuals with Transtibial and Transfemoral Lower Limb Loss during Dual-Task Walking under Varying Demand

Shaw

Rietschel

Hendershot

et al. 2019

J Int Neuropsychol Soc

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The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

Omaña

Madou

Montero‐Odasso

et al. 2021

PM&R

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Objective: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA). Literature Survey: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020). Methodology: Inclusion criteria: participants were adults with transtibial, kneedisarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. Methodological quality of reporting was examined using the Downs and Black Scale. A meta-analysis was unable to be performed owing to substantial participant and protocol heterogeneity among the studies included. Synthesis: Of 3950 articles screened, 22 met inclusion criteria. Four assessed dual-task balance and 18 dual-task gait. During single-task standing, PLLA demonstrated higher sway distance and sway velocity than controls (CN); however, a greater dual-task effect was observed only for sway velocity. Gait pace, rhythm, variability, asymmetry, and postural control were observed to be worse in PLLA relative to CN during single-task. Dual-task gait testing resulted in a disproportionally reduced pace and rhythm and increased asymmetry in PLLA compared to CN. Conclusions: People with lower limb amputations have impaired balance and gait, which is affected by dual-task to a greater degree compared to healthy adults. An examination of how PLLA-specific factors such as level of amputation, reason for amputation, and experience with a prosthesis affect dual-task performance has not yet been thoroughly explored. Future research should continue to characterize the cognitive-mobility link to better understand the challenges associated with the use of a prosthesis.

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Cerebral cortical networking for mental workload assessment under various demands during dual-task walking

et al. 2019

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Biomechanical and neurocognitive performance outcomes of walking with transtibial limb loss while challenged by a concurrent task

Cited by 22 publications

References 66 publications

A Comparison of Mental Workload in Individuals with Transtibial and Transfemoral Lower Limb Loss during Dual-Task Walking under Varying Demand

A Comparison of Mental Workload in Individuals with Transtibial and Transfemoral Lower Limb Loss during Dual-Task Walking under Varying Demand

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

Cerebral cortical networking for mental workload assessment under various demands during dual-task walking

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