双耳分听对健康老年人双重任务状态下步态各领域的影响：一项探索性观察研究。
Effects of dichotic listening on gait domains of healthy older adults during dual-tasking: An exploratory observational study.
机构信息
Department of Psychology, University of Tromsø, The Arctic University of Norway; Tromsø, Norway.
Department of Psychology, University of Tromsø, The Arctic University of Norway; Tromsø, Norway.
出版信息
Hum Mov Sci. 2021 Feb;75:102720. doi: 10.1016/j.humov.2020.102720. Epub 2020 Nov 28.
BACKGROUND
Identification of the cognitive mechanisms behind gait changes in aging is a prime endeavor in gerontology and geriatrics. For this reason, we have implemented a new dual-task paradigm where an auditory attentional task is performed during over-ground walking. Dichotic listening assesses spontaneous attention and voluntary attention directed to right and left-ear. The uniqueness of dichotic listening relies on its requirements that vary in difficulty and recruitment of resources from whole brain to one brain hemisphere. When used in dual-tasking, asymmetric effects on certain gait parameters have been reported.
OBJECTIVES
The present study aims to acquire a more global understanding on how dichotic listening affects gait domains. Specifically, we aimed to understand how spontaneous vs lateralized auditory attention altered the Principal Component Analysis (PCA) structure of gait in healthy older adults.
METHODS
Seventy-eight healthy older adults (mean age: 71.1 years; 44 women and 34 men) underwent the Bergen dichotic listening test while walking. As this study only focuses on the effects of the cognitive task on gait, only dual-task costs for gait were calculated and entered into the PCA analyses. We explored the PCA structure for the effects on bilateral gait parameters (i.e., both limbs together) as well as on lateralized gait parameters (i.e, separate parameters by limb). We first established gait domains during single-task walking. Then, dual-task cost scores for gait were entered in a series of PCAs.
RESULTS
Results from the PCAs for bilateral gait parameters showed limited alterations on gait structure. In contrast, PCAs for lateralized data demonstrated modifications of the gait structure during dichotic listening. The PCAs corresponding for all dichotic listening conditions showed different factor solutions ranging between 4 and 6 factors that explained between 73.8% to 80% of the total variance. As a whole, all conditions had an impact on "pace", "pace variability" and "base of support variability" domains. In the spontaneous attention condition, a six-factor solution explaining 78.3% of the variance showed asymmetrical disruptions on the PCA structure. When attention was focused to right-ear, a five-factor solution explaining 89% of the variance and similar to baseline was found. When attention was directed to left-ear, a four-factor solution explaining 73.8% of the variance was found with symmetrical impact on all factors.
CONCLUSIONS
These findings demonstrate for the first time that specific facets of attentional control affects gait domains both symmetrically and asymmetrically in healthy older adults.
背景
识别衰老过程中步态变化背后的认知机制是老年医学和老年病学的首要任务。出于这个原因，我们实施了一种新的双重任务范式，即在地面行走过程中执行听觉注意力任务。双耳分听评估自发注意力和指向右耳和左耳的有意注意力。双耳分听的独特之处在于它的要求，这些要求在难度上有所不同，并从整个大脑到一个大脑半球招募资源。当在双重任务中使用时，已经报道了对某些步态参数的不对称影响。
目的
本研究旨在更全面地了解双耳分听如何影响步态领域。具体来说，我们旨在了解自发注意力与侧化听觉注意力如何改变健康老年人步态的主成分分析（PCA）结构。
方法
78 名健康老年人（平均年龄：71.1 岁；44 名女性和 34 名男性）在行走时接受了卑尔根双耳分听测试。由于本研究仅关注认知任务对步态的影响，仅计算步态的双重任务成本并将其输入 PCA 分析。我们探索了双侧步态参数（即四肢一起）和侧化步态参数（即肢体分别）的 PCA 结构。我们首先在单任务行走时建立步态域。然后，将步态的双重任务成本得分输入一系列 PCA。
结果
双侧步态参数的 PCA 结果显示步态结构的改变有限。相比之下，侧化数据的 PCA 显示了在双耳分听期间步态结构的变化。对应于所有双耳分听条件的 PCA 显示了不同的因子解决方案，范围在 4 到 6 个因子之间，解释了总方差的 73.8%至 80%。总的来说，所有条件都对“步速”、“步速变异性”和“支撑基础变异性”域有影响。在自发注意条件下，一个六因子解解释了 78.3%的方差，显示了 PCA 结构的不对称破坏。当注意力集中在右耳时，发现了一个五因子解，解释了 89%的方差，与基线相似。当注意力指向左耳时，发现了一个四因子解，解释了 73.8%的方差，对所有因子都有对称的影响。
结论
这些发现首次证明，注意力控制的特定方面在健康老年人中以对称和不对称的方式影响步态域。
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