持续性脑震荡症状成年人的双重任务成本。
Dual task cost in adults with persistent concussion symptoms.
机构信息
Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA.
Department of Kinesiology, Iowa State University, Ames, IA, USA.
出版信息
Gait Posture. 2023 Mar;101:120-123. doi: 10.1016/j.gaitpost.2023.02.008. Epub 2023 Feb 11.
BACKGROUND
Persistent concussion symptoms (PCS) negatively affects common activities of daily living including deficits in both single and dual-task (DT) gait. DT gait deficits are present post-concussion; however, task prioritization and the effects of differing cognitive challenge remain unexplored in the PCS population.
RESEARCH QUESTION
The purpose of this study was to investigate single and dual-task gait performance in individuals with persistent concussion symptoms and to identify task priorization strategies during DT trials.
METHODS
Fifteen adults with PCS (age: 43.9+11.7 y.o.) and 23 healthy control participants (age: 42.1+10.3 y.o.) completed five trials of single task gait followed by fifteen trials of dual task gait along a 10-m walkway. The cognitive challenges consisted of five trials each of visual stroop, verbal fluency, and working memory cognitive challenges. Groups were compared on DT cost stepping characteristics with independent samples t-test or Mann-Whitney U tests.
RESULTS
There were significant overall gait Dual Task Cost (DTC)difference between groups for gait speed (p = 0.009, d=0.92) and step length (p = 0.023, d=0.76). Specific to each DT challenge, PCS participants were slower during Verbal Fluency (0.98 + 0.15 m/s and 1.12 + 0.12 m/s, p = 0.008; d=1.03), Visual Stroop (1.06 + 0.19 m/s and 1.20 + 0.12 m/s, p = 0.012, d=0.88), and Working Memory (1.02 + 0.15 m/s and 1.16 + 0.14 m/s, p = 0.006, d=0.96). There were significant cognitive DTC differences between groups for WM accuracy (p = 0.008, d=0.96), but not for VS accuracy (p = 0.841, d=0.061) or VF total words (p = 0.112, d=0.56).
SIGNIFICANCE
The PCS participants displayed a posture-second strategy whereby gait performance generally decreased in the absence of cognitive changes. However, during the Working Memory DT, PCS participants had a mutual interference response whereby both motor and cognitive performance decreased suggesting the cognitive task plays a key role in the DT gait performance of PCS patients.
背景
持续性脑震荡症状（PCS）会对日常活动产生负面影响，包括单任务和双任务（DT）步态的缺陷。脑震荡后存在 DT 步态缺陷；然而，在 PCS 人群中，任务优先级和不同认知挑战的影响仍未得到探索。
研究问题
本研究的目的是调查具有持续性脑震荡症状的个体的单任务和双任务步态表现，并确定 DT 试验中的任务优先级策略。
方法
15 名患有持续性脑震荡症状的成年人（年龄：43.9+11.7 岁）和 23 名健康对照组参与者（年龄：42.1+10.3 岁）在 10 米步行道上完成了五次单任务步态试验，然后完成了十五次双任务步态试验。认知挑战包括五次视觉斯特鲁普、言语流畅性和工作记忆认知挑战。使用独立样本 t 检验或曼-惠特尼 U 检验对组间 DT 成本步态特征进行比较。
结果
组间步态双任务成本（DTC）在步态速度（p=0.009，d=0.92）和步长（p=0.023，d=0.76）方面存在显著差异。具体到每个 DT 挑战，PCS 参与者在言语流畅性（0.98+0.15m/s 和 1.12+0.12m/s，p=0.008；d=1.03）、视觉斯特鲁普（1.06+0.19m/s 和 1.20+0.12m/s，p=0.012，d=0.88）和工作记忆（1.02+0.15m/s 和 1.16+0.14m/s，p=0.006，d=0.96）方面较慢。组间在 WM 准确性（p=0.008，d=0.96）方面存在显著的认知 DTC 差异，但在 VS 准确性（p=0.841，d=0.061）或 VF 总单词（p=0.112，d=0.56）方面没有差异。
意义
PCS 参与者表现出一种姿势优先策略，即认知无变化时，步态表现一般下降。然而，在工作记忆 DT 中，PCS 参与者表现出相互干扰的反应，即运动和认知表现都下降，这表明认知任务在 PCS 患者的 DT 步态表现中起着关键作用。
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