1Institute of Health & Wellbeing,University of Glasgow,Glasgow,United Kingdom.
2Institute for Applied Health Research,Glasgow Caledonian University,Glasgow,United Kingdom.
J Int Neuropsychol Soc. 2018 Mar;24(3):247-258. doi: 10.1017/S1355617717000947. Epub 2017 Sep 22.
People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance.
This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined.
A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale.
No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p=.007), but not a stable surface (p=.679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho=0.527; p=.001) and depression (rho=0.451; p=.007).
RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties. (JINS, 2018, 24, 247-258).
患有复发缓解型多发性硬化症（RRMS）的患者在进行认知任务与行走相结合的双重任务时，步态会出现不成比例的下降。然而，对于认知需求对平衡的影响，研究相对较少。
本研究旨在探讨：（1）RRMS 患者在双重任务条件下的姿势稳定性是否会出现不成比例的下降，与健康对照组相比；（2）双重任务的下降是否与日常双重任务困难有关。还研究了情绪、疲劳和疾病严重程度对双重任务的影响。
共有 34 名 RRMS 患者和 34 名匹配的对照组在单任务和双重任务条件下完成认知（数字跨度）和平衡（在稳定和不稳定表面上的压力中心移动）任务。日常双重任务使用双重任务问卷进行测量。情绪通过医院焦虑和抑郁量表进行测量。疲劳通过改良疲劳指数量表进行测量。
组间在年龄、性别、受教育年限、估计的发病前智商或基线数字跨度方面无差异。与对照组相比，RRMS 患者在不稳定表面的双重任务条件下，姿势稳定性明显下降（p=0.007），而在稳定表面上则无明显差异（p=0.679）。平衡下降评分与日常双重任务困难或疲劳无相关性。稳定表面平衡下降评分与焦虑水平（rho=0.527；p=0.001）和抑郁水平（rho=0.451；p=0.007）显著相关。
RRMS 导致双重任务困难，影响挑战性条件下的平衡，这可能导致步态困难和跌倒的风险增加。焦虑/抑郁与双重任务下降之间的关系表明，情绪因素可能导致双重任务困难。（JINS，2018，24，247-258）。
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