Dual task cost of cognition is related to fall risk in patients with multiple sclerosis: a prospective study

Etemadi, Yasaman

doi:10.1177/0269215516637201

Cited by 53 publications

(68 citation statements)

References 46 publications

(85 reference statements)

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“…Although there was significant between-group differences in the dual-task test variables, in terms of prediction and after the adjustment of disability, gender, and BMI; these variable did not yield to a significant prediction. Regarding the predictive validity of DTC of laboratory gait measures, only the DTC of traditional gait parameters including gait speed and stride length were investigated previously in PwMS (Etemadi, 2016). In a study by Etemadi, gait was assessed through an electronic walkway and only the DTC of walking speed was found to be predictive of the future falls in PwMS (Etemadi, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the predictive validity of DTC of laboratory gait measures, only the DTC of traditional gait parameters including gait speed and stride length were investigated previously in PwMS (Etemadi, 2016). In a study by Etemadi, gait was assessed through an electronic walkway and only the DTC of walking speed was found to be predictive of the future falls in PwMS (Etemadi, 2016). Regarding other patient's populations, in a longitudinal study by Fino, the effect of dual taking on the LDS of walking was assessed in 5 patients with cerebral concussion (Fino, 2016).…”

Section: Discussionmentioning

confidence: 99%

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Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study

Tajali

Mehravar

Negahban

et al. 2019

Clinical Biomechanics

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Background: Falling is a significant problem in patients with multiple sclerosis (MS) and the majority of falls occur during dynamic activities. Recently, there have been evidences focusing on falls and local stability of walking based on dynamic system theory in the elderly as well as patients with cerebral concussion. However, in patient with MS, this relationship has not been fully investigated. The aim of this study was to investigate local stability of walking as a risk factor for falling in patients with MS. Methods: Seventy patients were assessed while walking at their preferred speed on a treadmill under single and dual task conditions. A cognitive task (backward counting) was used to assess the importance of dual tasking to fall risk. Trunk kinematics were collected using a cluster marker over the level of T 7 and a 7-camera motion capture system. To quantify local stability of walking, maximal finite-time Lyapunov exponent was calculated from a 12-dimensional state space reconstruction based on 3-dimensional trunk linear and angular velocity time series. Participants were classified as fallers (≥1) and non-fallers based on their prospective fall occurrence. Findings: 30 (43%) participants recorded ≥1 falls and were classified as fallers. The results of multiple logistic regression analysis revealed that short-term local dynamic stability in the single task condition (P < 0.05, odds ratio = 2.214 (1.037-4.726)) was the significant fall predictor. Interpretation: The results may indicate that the assessment of local stability of walking can identify patients who would benefit from gait retraining and fall prevention programs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study

Tajali

Mehravar

Negahban

et al. 2019

Clinical Biomechanics

View full text Add to dashboard Cite

show abstract

“…The effects of specific cognitive deficits on risk of falls in MS patients have previously been explored (Kalron, 2014). Moreover, various studies have shown that dual tasking effects are greater among the MS population compared with healthy individuals (Hamilton et al, 2009;Negahban et al, 2011), nonetheless, the evidence on its association with future falls is still controversial (Etemadi, 2016;Wajda et al, 2013;Wajda and Sosnoff, 2015). In a recent study by Etemadi et al, it was found that DTC of walking speed was predictive of future falls in MS patients (Etemadi, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, participants were asked to perform aloud backward counting (serial 3 subtraction task), while walking as fast as possible, then, the mean time required for the 2 trials was calculated. The dual task cost of performance was calculated as follows: (single task-dual task) / (single task) ×100 (Etemadi, 2016).…”

Section: Methodsmentioning

confidence: 99%

Predicting falls among patients with multiple sclerosis: Comparison of patient-reported outcomes and performance-based measures of lower extremity functions

Tajali

Yazdi

Negahban

et al. 2017

Multiple Sclerosis and Related Disorders

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“…This CMI is often quantified by the dual task cost (DTC), which is the percentage of change in dual task performance relative to single-task performance [6]. Difficulties with cognitive-motor dual tasking have been related to higher risks of falls and lower quality of life in MS [9,10], this highlights the importance for rehabilitation strategies targeting CMI.…”

Section: Introductionmentioning

confidence: 99%

Structured Cognitive-Motor Dual Task Training Compared to Single Mobility Training in Persons with Multiple Sclerosis, a Multicenter RCT

Veldkamp

Baert

Kalron

et al. 2019

JCM

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The aim was to compare the effectiveness of dual-task training (DTT) compared to single mobility training (SMT) on dual-task walking, mobility and cognition, in persons with Multiple Sclerosis (pwMS). Forty pwMS were randomly assigned to the DTT or SMT groups. The DTT-group performed dual-task exercises using an interactive tablet-based application, while the SMT-group received conventional walking and balance exercises. Both interventions were supervised and identical in weeks (8) and sessions (20). Nine cognitive-motor dual-task conditions were assessed at baseline, after intervention and at 4-weeks follow-up (FU). The dual-task cost (DTC), percentage change of dual-task performance compared to single-task performance, was the primary outcome. Mobility and cognition were secondarily assessed. Mixed model analyses were done with group, time and the interaction between group and time as fixed factors and participants as random factors. Significant time by group interactions were found for the digit-span walk and subtraction walk dual-task conditions, with a reduction in DTC (gait speed) for the DTT maintained at FU. Further, absolute dual-task gait speed during walking over obstacles only improved after the DTT. Significant improvements were found for both groups in various motor and cognitive measures. However, the DTT led to better dual-task walking compared to the SMT.

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Dual task cost of cognition is related to fall risk in patients with multiple sclerosis: a prospective study

Abstract: The dual task cost of cognition was related to fall, which should be considered as a target for falls evaluation and prevention strategies.

Cited by 53 publications

References 46 publications

Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study

Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis: A prospective cohort study

Predicting falls among patients with multiple sclerosis: Comparison of patient-reported outcomes and performance-based measures of lower extremity functions

Structured Cognitive-Motor Dual Task Training Compared to Single Mobility Training in Persons with Multiple Sclerosis, a Multicenter RCT

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