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认知与运动双重任务对有和无跌倒史的健康对照者和多发性硬化症患者时空步态参数的影响。

Effects of cognitive versus motor dual-task on spatiotemporal gait parameters in healthy controls and multiple sclerosis patients with and without fall history.

机构信息

Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Mult Scler Relat Disord. 2017 Nov;18:8-14. doi: 10.1016/j.msard.2017.09.002. Epub 2017 Sep 9.

Abstract

BACKGROUND

The purpose of the current study was to compare the effects of cognitive or motor tasks on gait performance between healthy controls and multiple sclerosis (MS) patients with and without fall history.

METHODS

The investigation included MS patients with fall history (n = 25) and without fall history (n = 25) and matched healthy controls (n = 25). Participants walked at their preferred speed on a motorized treadmill under three walking conditions in a randomized order: walking only, walking while performing a concurrent cognitive task (counting backward aloud by 3s), and walking while performing a concurrent motor task (carrying a tray with glasses).

RESULTS

The findings showed that in patients with MS, regardless of fall history, spatiotemporal gait parameters were different compared to healthy controls. In contrast to average gait parameters, variability in stride length and stride time could discriminate between MS fallers and non-fallers. Simultaneous performance of cognitive task and walking resulted in higher dual-task costs (DTC) in gait performance compared to the motor dual-task. However, the pattern of change was not different among the three groups. All participants responded to the cognitive task challenges by increasing stride length and decreasing cadence and stride length variability while maintaining cognitive task performance.

CONCLUSIONS

The findings may reflect successful adaptation of locomotor system to preserve cognitive task performance under cognitive dual-task condition. Future studies should examine more complex concurrent cognitive and motor tasks to better understand the dual-task-related gait changes and their contribution to falls in patients with MS.

摘要

背景

本研究旨在比较认知或运动任务对有和无跌倒史的多发性硬化症(MS)患者与健康对照者步态表现的影响。

方法

研究纳入了有跌倒史(n=25)和无跌倒史(n=25)的 MS 患者以及匹配的健康对照者(n=25)。参与者以他们的习惯速度在电动跑步机上行走,在随机顺序下进行三种行走条件:仅行走、行走时进行同步认知任务(大声倒计数 3s)、行走时进行同步运动任务(用托盘端着玻璃杯)。

结果

研究结果显示,MS 患者无论是否有跌倒史,与健康对照者相比,时空步态参数均存在差异。与平均步态参数相比,步长和步时的变异性可以区分 MS 跌倒者和非跌倒者。与运动双重任务相比,同时进行认知任务和行走会导致更高的双重任务成本(DTC)。然而,这种变化模式在三组之间没有差异。所有参与者通过增加步长、降低步频和步长变异性来应对认知任务的挑战,同时保持认知任务的表现。

结论

这些发现可能反映了运动系统的成功适应,以在认知双重任务条件下保持认知任务的表现。未来的研究应检查更复杂的同步认知和运动任务,以更好地理解与双重任务相关的步态变化及其对 MS 患者跌倒的贡献。

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