Young and old adults prioritize dynamic stability control following gait perturbations when performing a concurrent cognitive task

Mersmann, Falk; Böhm, Sebastian; Bierbaum, Stefanie; Dietrich, Ralf; Arampatzis, Adamantios

doi:10.1016/j.gaitpost.2012.08.005

Cited by 38 publications

(33 citation statements)

References 28 publications

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“…Such deterioration in cognitive cost was not significantly impacted by stroke. Our results are comparable to previous findings from healthy young and older populations, which suggest that the central nervous system prioritizes reactive balance control by sacrificing processing of cognitive task under DT performance (motor-related cognitive interference) (Plummer et al 2013), even for perturbations eliciting response latencies of ϳ150 ms (Brauer et al 2002;Maki et al 2001;Mersmann et al 2013;Redfern et al 2002).…”

Section: Discussionsupporting

confidence: 89%

“…For example, in the study by Melzer and Oddsson (2004), significant cognitive-motor interference within the intentional balance control system was observed with a decrement in both motor (longer postural reactions times and smaller center of mass excursions) and cognitive (higher reaction times or errors on the secondary task) performance under DT conditions. Reactive balance tasks albeit demonstrate a motor-related cognitive interference (no change in balance performance but decline in cognitive performance) (Mersmann et al 2013). Although traditionally reactive balance control was considered to be automatic and thus independent of cognitive processing (Dietz and Berger 1984), studies in the past decade have demonstrated the presence of cognitive-motor interference on reactive balance control (recovery from perturbations) (Maki and McIlroy 2007).…”

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confidence: 99%

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Effect of dual tasking on intentional vs. reactive balance control in people with hemiparetic stroke

Subramaniam

Hui-Chan

Bhatt

2014

Journal of Neurophysiology

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To examine the effect of a cognitive task on intentional vs. reactive balance control in people with hemiparetic stroke (PwHS). Community-dwelling PwHS (n = 10) and healthy, age-similar controls performed two tests, which included the Limits of Stability Test (intentional control) and the Motor Control Test (reactive control), under single-task (ST) and dual-task (DT) conditions (addition of a cognitive task). Cognitive ability was measured on a word list generation task by recording the number of words enumerated in sitting (ST; for cognition) and during the balance tasks. The difference in response time between the ST and DT, defined as the "balance cost" was obtained [(ST - DT)/ST × 100] and compared between tests and across groups. The "cognitive cost" was similarly defined and compared. For both groups, the response time under DT condition was significantly greater for intentional than the reactive balance control task, leading to a higher balance cost for this task (P < 0.05). However, the cognitive cost was significantly greater for the intentional than the reactive balance control task for only the PwHS. DT significantly affected intentional than reactive balance control for PwHS. The significant decrease in both balance and cognitive performance under DT compared with ST conditions during intentional balance control suggests sharing of attentional resources between semantic memory and intentional balance control. Decreased performance on the cognitive task only during the reactive balance test indicates possible central nervous system's prioritization of reactive balance control over cognition.

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Effect of dual tasking on intentional vs. reactive balance control in people with hemiparetic stroke

Subramaniam

Hui-Chan

Bhatt

2014

Journal of Neurophysiology

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“…As a result, gait freezes, postural imbalance, error-prone movements, and eventually, falls, occur (see above; see also Uemura et al, 2011). Humans prioritize gait and movement control over other tasks (“posture first”; Li et al, 2001; Mersmann et al, 2013), and thus measures of gait, posture, movement speed and errors serve as an indirect measure of attentional resource limitation.…”

Section: Dual Task-associated Falls In Subjects With Low Cholinergic mentioning

confidence: 99%

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Sarter

Albin

Kucinski

et al. 2014

Experimental Neurology

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Falls are a major source of hospitalization, long-term institutionalization, and death in older adults and patients with Parkinson’s disease (PD). Limited attentional resources are a major risk factor for falls. In this review, we specify cognitive–behavioral mechanisms that produce falls and map these mechanisms onto a model of multi-system degeneration. Results from PET studies in PD fallers and findings from a recently developed animal model support the hypothesis that falls result from interactions between loss of basal forebrain cholinergic projections to the cortex and striatal dopamine loss. Striatal dopamine loss produces inefficient, low-vigor gait, posture control, and movement. Cortical cholinergic deafferentation impairs a wide range of attentional processes, including monitoring of gait, posture and complex movements. Cholinergic cell loss reveals the full impact of striatal dopamine loss on motor performance, reflecting loss of compensatory attentional supervision of movement. Dysregulation of dorsomedial striatal circuitry is an essential, albeit not exclusive, mediator of falls in this dual-system model. Because cholinergic neuromodulatory activity influences cortical circuitry primarily via stimulation of α4β2* nicotinic acetylcholine receptors, and because agonists at these receptors are known to benefit attentional processes in animals and humans, treating PD fallers with such agonists, as an adjunct to dopaminergic treatment, is predicted to reduce falls. Falls are an informative behavioral endpoint to study attentional–motor integration by striatal circuitry.

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“…The ability to counteract perturbations and maintain stability is a good indicator of the health of neuromuscular and motor control functions (Hur et al, 2010;Mersmann et al, 2013;Oliveira et al, 2012). Previous research has mainly focused on load carriage of solid, stable items to induce a perturbation.…”

Section: Introductionmentioning

confidence: 99%

Effect of stable and unstable load carriage on walking gait variability, dynamic stability and muscle activity of older adults

Walsh

Low

Arkesteijn

2018

Journal of Biomechanics

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Load carriage perturbs the neuromuscular system, which can be impaired due to ageing. The ability to counteract perturbations is an indicator of neuromuscular function but if the response is insufficient the risk of falls will increase. However, it is unknown how load carriage affects older adults. Fourteen older adults (65 ± 6 years) attended a single visit during which they performed 4 min of walking in 3 conditions, unloaded, stable backpack load and unstable backpack load. During each walking trial, 3-dimensional kinematics of the lower limb and trunk movements and electromyographic activity of 6 lower limb muscles were recorded. The local dynamic stability (local divergence exponents), joint angle variability and spatio-temporal variability were determined along with muscle activation magnitudes. Medio-lateral dynamic stability was lower (p = 0.018) and step width (p = 0.019) and step width variability (p = 0.015) were greater in unstable load walking and step width variability was greater in stable load walking (p = 0.009) compared to unloaded walking. However, there was no effect on joint angle variability. Unstable load carriage increased activity of the Rectus Femoris (p = 0.001) and Soleus (p = 0.043) and stable load carriage increased Rectus Femoris activity (p = 0.006). These results suggest that loaded walking alters the gait of older adults and that unstable load carriage reduces dynamic stability compared to unloaded walking. This can potentially increase the risk of falls, but also offers the potential to use unstable loads as part of fall prevention programmes.

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Young and old adults prioritize dynamic stability control following gait perturbations when performing a concurrent cognitive task

Cited by 38 publications

References 28 publications

Effect of dual tasking on intentional vs. reactive balance control in people with hemiparetic stroke

Effect of dual tasking on intentional vs. reactive balance control in people with hemiparetic stroke

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Effect of stable and unstable load carriage on walking gait variability, dynamic stability and muscle activity of older adults

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