The Role of Dual Tasking in the Assessment of Gait, Cognition and Community Reintegration of Veterans with Mild Traumatic Brain Injury

Leland, Azadeh; Tavakol, Kamran; Scholten, Joel; Mathis, Debra; Maron, David J.; Bakhshi, Simin

doi:10.5455/msm.2017.29.251-256

Cited by 17 publications

(8 citation statements)

References 37 publications

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“…This process is also a form of top-down attention. Disorders affecting divided attention often slow down the gait and simultaneously reduce the attention span of patients with mTBI (37). Current research shows that divided attention is associated with the dorsolateral prefrontal cortex and anterior cingulate gyrus (28).…”

Section: Divided Attentionmentioning

confidence: 99%

Multiple component analysis of attention early after complicated mild traumatic brain injury: a pilot study

Zhang²,

Wang³

2020

J Rehabil Med

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Patients with mild traumatic brain injury generally have a good prognosis. However, some patients develop attention deficit, which affects their life and work. This study evaluated the components of attention in patients with traumatic brain injury. The results show that patients with complicated mild traumatic brain injury had significant deficits in attention span, divided attention, shifting attention and information processing speed. Thus, clinicians should take into consideration these aspects of attention in treating patients with traumatic brain injury, in order to provide early rehabilitation interventions that may reduce the adverse effects of these deficits on life and work. Objective: To analyse disorders and components of attention in patients with complicated mild traumatic brain injury. This information is needed to en able clinical workers to evaluate and provide training for attention deficits in patients with mild traumatic brain injury. Design: Randomized controlled trial. Setting: In-patient and community recruitment. Participants: In-patients with mild traumatic brain injury (n = 44) and community-recruited healthy subjects (n = 45). Outcome measures: All participants used a battery of attention tests including the Digit Span Test (DST), Digit Cancellation Test (D-CAT1 and D-CAT2), Symbol Digit Modalities Test (SDMT), and the Paced Auditory Serial Addition Test (PASAT). Results: There were no differences in the results of the D-CAT between the patient and control groups (p > 0.05); however, there were significant differences in the DST, SDMT and PASAT (p < 0.01). Conclusion: Patients with mild traumatic brain injury were found to have normal sustained attention and selective attention, but impaired attention span, divided attention, shifting attention and information processing speed, requiring clinical workers to focus more on these deficits.

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Section: Divided Attentionmentioning

confidence: 99%

Multiple component analysis of attention early after complicated mild traumatic brain injury: a pilot study

Zhang²,

Wang³

2020

J Rehabil Med

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“…While the stride time, stance time, and swing time demonstrated an increase during the dual-task, their changes during single-task (ST) walking were moderate or relatively low (Howcroft et al, 2014 ). Compared with the single task, the dual task participants exhibited a greater loss in the gait and stride length, while the change in the stride velocity was relatively low (Leland et al, 2017 ). On the other hand, high-level gait disorders include frontal ataxia, psychogenic motor disorder, a disproportionate increase in immobility, and fear of walking (Pirker and Katzenschlager, 2017 ).…”

Section: Pathologymentioning

confidence: 99%

Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery

Liu

Sun

2022

Front. Aging Neurosci.

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The motoric cognitive risk (MCR) syndrome is a pre-dementia condition, marked by the enhanced risk for Alzheimer's disease (AD) and vascular dementia, together with falls, disability, and abnormal movements. The research studies revealed the distinct neurological and non-neurological clinical gait irregularities during dementia and accelerated functional decline, such as postural and balance impairments, memory loss, cognitive failure, and metabolic dysfunctions. The disabling characteristics of MCR comprise altered afferent sensory and efferent motor responses, together with disrupted visual, vestibular, and proprioceptive components. The pathological basis of MCR relates with the frontal lacunar infarcts, white matter hyperintensity (WMH), gray matter atrophy in the pre-motor and pre-frontal cortex, abnormal cholinergic functioning, inflammatory responses, and genetic factors. Further, cerebrovascular lesions and cardiovascular disorders exacerbate the disease pathology. The diagnosis of MCR is carried out through neuropsychological tests, biomarker assays, imaging studies, questionnaire-based evaluation, and motor function tests, including walking speed, dual-task gait tests, and ambulation ability. Recovery from MCR may include cognitive, physical, and social activities, exercise, diet, nutritional supplements, symptomatic drug treatment, and lifestyle habits that restrict the disease progression. Psychotherapeutic counseling, anti-depressants, and vitamins may support motor and cognitive improvement, primarily through the restorative pathways. However, an in-depth understanding of the association of immobility, dementia, and cognitive stress with MCR requires additional clinical and pre-clinical studies. They may have a significant contribution in reducing MCR syndrome and the risk for dementia. Overall, the current review informs the vital connection between gait performance and cognition in MCR and highlights the usefulness of future research in the discernment and treatment of dementiating illness.

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“…Dual-tasking (DT) is defined as the concurrent performance of motor-motor or motor-cognitive tasks that would have interference with each other. (Leland et al, 2017) For instance, reading while walking or simultaneously texting and walking or shopping down the aisle in a store are examples of motor-cognitive dual tasks. This platform uses the same concept of dual-task training.…”

Section: Chapter 5: Development Of Computerized Game-aided Rehabilitation (Cgr) Platformmentioning

confidence: 99%

Innovative Game-Aided Rehabilitation Platform for Rehabilitation of Balance in Children With Cerebral Palsy

2019

CMR

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Introduction: Cerebral Palsy (CP) is one of the leading causes of disability globally. Children with CP often develop imbalance and gait abnormality resulting in mobility limitations. Early intervention with intensive, repetitive, task-oriented practice is the key to functional independence. However, often these intensive programs lack motivation and engagement that results in low adherence and discontinuation of physiotherapy. To address this gap, an innovative, computerized game-aided rehabilitation (CGR) platform is designed for dual-task balance training. This platform provides an integrated approach to assess and treat the balance and executive cognitive functions in young children with CP. Methodology: For the known-group validity, 50 participants (25 TD and 25 CP affected children) were recruited. Comparisons were made between the two groups for DTI and task performances to evaluate the group differences. For the pilot intervention study, 16 children with CP were recruited who were randomized into two groups viz. Conventional balance training group (CBG) and Experimental group (XG). Both group received their respective therapy thrice a week for 12 weeks. The primary outcome measures were (Peabody Developmental Motor Scale-2, Gross Motor Function Classification-88, and Pediatric Balance Scale) and CGR assessment measures [COP Analysis, Visuo-Motor (VM) tracking, and Cognitive Game (CG)].Semi-structured interview were conducted for XG participant's parents to explore their views regarding the use of CGR.iii Results: The TD group was engaged in DT whereas the CP group was struggling with balance control. For the intervention study, participants in the XG demonstrated greater improvements in all clinical and CGR outcome measures whereas the CBG demonstrated a decline in VM tracking a CG performance post-intervention. The XG parents conveyed their children's problems, their expectations, their challenges, and the positive effects of CGR balance training. Conclusion:The CGR assessment was able to differentiate between the TD and CP children's DT functional performance. The CGR balance training was found to be feasible and engaging for balance training in children with CP. The substantial improvement of balance and gross motor functions in the XG more than the CBG illustrates the effectiveness of the CGR balance training and provides baseline evidence for commencing a full-scale RCT.

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The Role of Dual Tasking in the Assessment of Gait, Cognition and Community Reintegration of Veterans with Mild Traumatic Brain Injury

Cited by 17 publications

References 37 publications

Multiple component analysis of attention early after complicated mild traumatic brain injury: a pilot study

Multiple component analysis of attention early after complicated mild traumatic brain injury: a pilot study

Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery

Innovative Game-Aided Rehabilitation Platform for Rehabilitation of Balance in Children With Cerebral Palsy

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