Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL.
Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY.
Arch Phys Med Rehabil. 2014 Aug;95(8):1498-503. doi: 10.1016/j.apmr.2014.03.007. Epub 2014 Mar 26.
OBJECTIVE: To examine cognitive motor interference (CMI) during walking using a simple, standardized, and well-refined alphabet dual-task (DT) paradigm in individuals with multiple sclerosis (MS) in whom cognitive and walking impairment often co-occur. DESIGN: A single time point, cross-sectional study. SETTING: A university clinical laboratory. PARTICIPANTS: Individuals with MS (N=61; mean age ± SD, 50.8±9.3 y) performed 4 walking trials over a 4.6-m walkway to determine gait parameters. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Gait parameters were assessed over 4 walking trials. The first 2 walks involved the single task (ST) of walking only; the second 2 walks involved participants performing the DT of reciting alternate letters of the alphabet while walking. The gait parameters recorded during the ST and DT walks were used to compute a dual-task cost (DTC) of walking (% change in gait parameter between ST and DT walks) as a metric of CMI. RESULTS: Our multivariate analysis with univariate follow-ups indicated CMI during walking based on slower velocity (ηp(2)=.59; F=84.6; P<.001) and cadence (ηp(2)=.46; F=51.6; P<.001), shorter step length (ηp(2)=.38; F=36; P<.001), and increased step time (ηp(2)=.34; F=31; P<.001) and double-support time (ηp(2)=.31; F=27.3; P<.001) in DT versus ST conditions. The DTC of walking for the gait parameters was not correlated with clinical (disability, disease duration) and demographic (eg, education, age) factors (all |r|≤.240). CONCLUSIONS: The alphabet DT paradigm is easily administered and well refined. We highlight its ability and acceptability to determine CMI during walking in people with MS, independent of disease status.
目的:在患有多发性硬化症(MS)的个体中,使用简单、标准化和完善的字母双重任务(DT)范式检查行走时的认知运动干扰(CMI),因为这些个体通常同时存在认知和行走障碍。
设计:单次时间点、横断面研究。
地点:大学临床实验室。
参与者:61 名 MS 患者(平均年龄±标准差,50.8±9.3 岁)在 4.6 米的步行道上进行了 4 次步行试验以确定步态参数。
干预措施:不适用。
主要观察指标:在 4 次步行试验中评估步态参数。前 2 次行走只涉及单任务(ST),即仅行走;后 2 次行走涉及参与者在行走时背诵字母表的交替字母。在 ST 和 DT 行走期间记录的步态参数用于计算行走的双重任务成本(DTC)(步态参数在 ST 和 DT 行走之间的变化百分比)作为 CMI 的度量。
结果:我们的多元分析结合单变量随访表明,基于速度较慢(ηp(2)=.59;F=84.6;P<.001)和步频(ηp(2)=.46;F=51.6;P<.001)、步长较短(ηp(2)=.38;F=36;P<.001)、步时增加(ηp(2)=.34;F=31;P<.001)和双支撑时间增加(ηp(2)=.31;F=27.3;P<.001),DT 条件下的 CMI 导致与 ST 条件相比,在 DT 条件下的字母 DT 范式很容易进行且经过良好的完善。我们强调了它在确定多发性硬化症患者行走时的 CMI 的能力和可接受性,独立于疾病状态。
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