Malcay Ofir, Grinberg Yevgenia, Berkowitz Shani, Hershkovitz Leora, Kalron Alon
Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.
Gait Posture. 2017 Sep;57:211-216. doi: 10.1016/j.gaitpost.2017.06.024. Epub 2017 Jun 23.
During the last decade, numerous studies have confirmed a coupling between walking performance and cognition in people with multiple sclerosis (PwMS). Our aim was to provide new insights into a walking-cognitive dual-task (DT) in PwMS. We tested the DT phenomenon by controlling the walking speed using an instrumented treadmill. Thirty PwMS (20 women) with a mean age 40.1 (SD=12.0) participated in the study. Twenty-one healthy subjects served as controls. Each subject completed a sequence of tests: a) Normal walking (ST) - the participant walked on the instrumented treadmill at a comfortable walking speed for 1min; b) Cognitive evaluation (ST) - subjects performed two cognitive tests while seated; c) DT cognitive tests performed while walking on the treadmill at the identical speed performed during normal walking. Outcome measures were spatio-temporal parameters of gait (mean and variability), the Word List Generation Test (WLG) and the Serial-3 Subtraction Test. MS participants significantly decreased their cadence while increasing their stride length during the DT condition compared to the ST condition. Non-significant differences were observed for the WLG and Serial-3 Subtraction Cognitive Tests between the ST condition and the DT condition in both the MS and healthy groups. In terms of gait variability parameters, MS subjects demonstrated a 2 to 3-fold greater gait variability compared to the healthy controls. Non-significant differences in gait variability parameters were observed between the ST and DT conditions in both the MS and control groups. This study provides new insights into the DT phenomenon in the MS population.
在过去十年中，大量研究证实了多发性硬化症患者（PwMS）的步行能力与认知之间存在关联。我们的目的是深入了解PwMS患者的步行 - 认知双重任务（DT）。我们使用带仪器的跑步机控制步行速度来测试DT现象。30名平均年龄为40.1岁（标准差 = 12.0）的PwMS患者（20名女性）参与了该研究。21名健康受试者作为对照。每个受试者完成一系列测试：a）正常步行（ST）——参与者在带仪器的跑步机上以舒适的步行速度行走1分钟；b）认知评估（ST）——受试者坐着进行两项认知测试；c）在跑步机上以与正常步行相同的速度行走时进行DT认知测试。结果测量指标为步态的时空参数（平均值和变异性）、单词列表生成测试（WLG）和连续减3测试。与ST条件相比，MS参与者在DT条件下显著降低了步频，同时增加了步幅。在MS组和健康组中，ST条件和DT条件下的WLG和连续减3认知测试均未观察到显著差异。就步态变异性参数而言，与健康对照组相比，MS受试者的步态变异性高2至3倍。在MS组和对照组中，ST和DT条件下的步态变异性参数均未观察到显著差异。本研究为MS人群的DT现象提供了新的见解。
