Motl Robert W, Sosnoff Jacob J, Dlugonski Deirdre, Pilutti Lara A, Klaren Rachel, Sandroff Brian M
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States.
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States.
Gait Posture. 2014 Mar;39(3):870-4. doi: 10.1016/j.gaitpost.2013.11.023. Epub 2013 Dec 14.
Performing a cognitive task while walking results in a reduction of walking performance among persons with MS. To date, very little is known about correlates of this dual task cost (DTC) of walking in MS.
We examined walking performance, cognitive processing speed, and symptoms of fatigue, depression, anxiety, and pain as correlates of DTC of walking in MS.
82 persons with MS undertook a 6-min walk test (6MWT) and completed the Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), Short-form of the McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale (HADS), and self-reported Expanded Disability Status Scale (SR-EDSS). The participants completed 4 trials of walking at a self-selected pace on an electronic walkway that recorded spatiotemporal parameters of gait. The first 2 trials were performed without a cognitive task, whereas the second 2 trials were completed while performing a modified Word List Generation task.
There were significant and large declines in gait performance with the addition of a cognitive task for velocity (p<.001, η2=.52), cadence (p<.001, η2=.49), and step length (p<.001, η2=.23). 6MWT and SDMT scores correlated with DTC for velocity (r=-.41, p<.001 and r=-.32, p<.001, respectively) and step length (r=-.45, p<.001 and r=-.37, p<.001, respectively); there were no significant associations between FSS, SF-MPQ, and HADS scores with the DTC of walking. Regression analyses indicated that 6MW, but not SDMT, explained variance in DTC for velocity (ΔR2=.11, p<.001) and step length (ΔR2=.13, p<.001), after controlling for SR-EDSS scores.
Walking performance might be a target of interventions for reducing the DTC of walking in MS.
对于患有多发性硬化症（MS）的人来说，在行走时执行认知任务会导致行走能力下降。迄今为止，对于MS患者行走的这种双重任务成本（DTC）的相关因素知之甚少。
我们研究了行走能力、认知处理速度以及疲劳、抑郁、焦虑和疼痛症状，将其作为MS患者行走DTC的相关因素。
82名MS患者进行了6分钟步行测试（6MWT），并完成了符号数字模态测试（SDMT）、疲劳严重程度量表（FSS）、麦吉尔疼痛问卷简表（SF-MPQ）、医院焦虑抑郁量表（HADS）以及自我报告的扩展残疾状态量表（SR-EDSS）。参与者在电子步道上以自选速度完成4次步行试验，该步道记录步态的时空参数。前2次试验在无认知任务的情况下进行，而后2次试验在执行修改后的单词列表生成任务时完成。
添加认知任务后，步态表现出现显著且大幅下降，速度（p<.001，η2=.52）、步频（p<.001，η2=.49）和步长（p<.001，η2=.23）均如此。6MWT和SDMT分数与速度（分别为r=-.41，p<.OO1和r=-.32，p<.001）以及步长（分别为r=-.45，p<.001和r=-.37，p<.001）的DTC相关；FSS、SF-MPQ和HADS分数与行走的DTC之间无显著关联。回归分析表明，在控制SR-EDSS分数后，6MW（而非SDMT）可解释速度（ΔR2=.11，p<.001）和步长（ΔR2=.13，p<.001）的DTC变异。
行走能力可能是降低MS患者行走DTC干预措施的目标。
