The University of Nebraska at Omaha, USA.
The University of Nebraska at Omaha, USA.
Gait Posture. 2023 Sep;106:28-33. doi: 10.1016/j.gaitpost.2023.08.013. Epub 2023 Aug 23.
Individuals with Chronic Ankle Instability (CAI) demonstrate altered gait mechanics, impaired proprioception, and decreased postural control. In addition, individuals with CAI have been found to have complex neurophysiological changes, including during dual-task perturbations. However, the results of studies on whether cognitive tasks affect postural control are inconclusive.
Do individuals with CAI have worse dual-task performance compared to healthy controls?
We searched 4 electronic databases (PubMed, MEDLINE, Cumulative Index of Nursing and Allied Health Literature, and SPORTDiscus) from inception to October 2022. Search terms consisted of: ("dual-task*" OR "dual task*" OR dual-task OR Multitask* OR Multi-task* OR attention OR cognit*) AND (balance OR "postural control" OR "postural sway" OR kinetics OR kinematics OR gait) NOT (concussion OR "traumatic brain injury") combined using the operator "AND" ("ankle sprain" OR "ankle instability" OR CAI). Studies were included if the physical task was postural control or gait, and if they compared control and CAI groups.
A total of 9 studies were included in the systematic-review portion, 5 of which were included in the meta-analysis. Due to assessing multiple types of dual-tasks, 10 effects were assessed for meta-analysis across postural control studies. A random-effects model for the control group in the mediolateral direction indicated a significant overall Fisher's Z mean effect size (Δ = 0.732, p = 0.029) with high heterogeneity between studies (Q=76.61; I = 88.25% P < 0.001). There were no significant differences between dual-tasking in the CAI group individually or when comparing control to CAI groups.
The results of our study indicate that cognitive loading did not affect the postural control except for the control group in the mediolateral direction. Variations in dual-task results may be due to the difficulty of the task as well as the heterogeneity of CAI groups.
慢性踝关节不稳定（CAI）患者表现出步态力学改变、本体感觉受损和姿势控制能力下降。此外，CAI 患者还存在复杂的神经生理变化，包括在双重任务干扰下。然而，关于认知任务是否会影响姿势控制的研究结果尚无定论。
与健康对照组相比，CAI 患者的双重任务表现是否更差？
我们从 2022 年 10 月前开始在 4 个电子数据库（PubMed、MEDLINE、Cumulative Index of Nursing and Allied Health Literature 和 SPORTDiscus）中进行搜索。搜索词包括：（“双重任务*”或“双重任务*”或双重任务或多任务或多任务或注意力或认知*）和（平衡或“姿势控制”或“姿势摆动”或动力学或运动学或步态）而不是（脑震荡或“创伤性脑损伤”），使用运算符“AND”进行组合。如果物理任务是姿势控制或步态，并且比较了对照组和 CAI 组，则将研究纳入系统评价部分。共有 9 项研究被纳入系统评价部分，其中 5 项研究被纳入荟萃分析。由于评估了多种类型的双重任务，因此对姿势控制研究进行了 10 项效应荟萃分析。控制组的随机效应模型在横向方向上显示出显著的总体 Fisher Z 均值效应大小（Δ=0.732，p=0.029），但研究之间存在高度异质性（Q=76.61；I=88.25%，P<0.001）。在 CAI 组中进行双重任务时，或者在将对照组与 CAI 组进行比较时，没有发现显著差异。
我们的研究结果表明，除了横向控制组外，认知负荷并没有影响姿势控制。双重任务结果的差异可能是由于任务的难度以及 CAI 组的异质性造成的。
