患有持续性脑震荡症状的成年患者在步态起始过程中听觉双重任务成本增加。
Increased Auditory Dual Task Cost During Gait Initiation in Adult Patients With Persistent Concussion Symptoms.
作者信息
Bryk Kelsey N, Passalugo Scott, Shan Chou Li-, Reisman Darcy S, Hafer Jocelyn F, Semrau Jennifer A, Buckley Thomas A
机构信息
Department of Kinesiology and Applied Physiology, University of Delaware, DE; Biomechanics & Movement Sciences, University of Delaware, Newark, DE.
Iowa State University, Department of Human Sciences, Ames, IA.
出版信息
Arch Phys Med Rehabil. 2024 Dec;105(12):2262-2268. doi: 10.1016/j.apmr.2024.08.007. Epub 2024 Aug 24.
OBJECTIVE
To compare dual task cost (DTC) during gait initiation (GI) between a population of patients with persistent concussion symptoms (PCS) and age-matched healthy participants.
DESIGN
Cohort study.
SETTING
University research center.
PARTICIPANTS
A cohort sample including 15 participants with PCS (43.9±11.7y, 73.3% female) and 23 age-matched healthy participants (42.1±10.3y, 65.2% female) as controls.
INTERVENTIONS
Participants were tested on a single occasion where they performed 5 trials of single task and 5 trials of dual task GI with 12-camera motion capture and 3 force plates.
MAIN OUTCOME MEASURES
The dependent variables of interest were the DTC for the center of pressure (COP) displacement and velocity during the anticipatory postural adjustment (APA) phase, the COP-center of mass (COP-COM) separation, and the response accuracy during the auditory cognitive tasks.
RESULTS
There were significant group differences with worse DTC for the PCS participants in anterior (A)/posterior (P) displacement (PCS, -37.5±22.1%; Control, -9.7±39.2%; P=.016, d=0.874), APA medial (M)/lateral (L) velocity (PCS, -34.8±28.8%; Control, -17.0±40.21%; P=.041, d=0.866), and the peak COP-COM separation (PCS, -7.3±6.7%; Control, 0.6±6.5%; P=.023, d=1.200). There were no significant group differences in the APA A/P velocity (PCS, -38.8±33.1%; Control, -19.8±43.9%; P=.094), APA M/L displacement (PCS, -34.8±21.8%; Control, -10.6±25.3%; P=.313), or cognitive task performance (PCS, -2.7±10.8%; Control, -0.2±4.3%; P=.321).
CONCLUSIONS
PCS participants had greater (worse) DTC during both the planning and execution of the task, with large effect sizes (d>0.80). PCS participants also used a posture-second strategy whereby attentional resources were inappropriately allocated to the cognitive task. These deficits may challenge a patient's ability to complete activities of daily living and limit their functional independence.
目的
比较持续性脑震荡症状（PCS）患者群体与年龄匹配的健康参与者在步态起始（GI）过程中的双重任务成本（DTC）。
设计
队列研究。
地点
大学研究中心。
参与者
一个队列样本，包括15名PCS患者（43.9±11.7岁，73.3%为女性）和23名年龄匹配的健康参与者（42.1±10.3岁，65.2%为女性）作为对照。
干预措施
参与者接受单次测试，在此期间他们使用12台摄像机动作捕捉系统和3块测力板进行5次单任务GI试验和5次双任务GI试验。
主要观察指标
感兴趣的因变量包括预期姿势调整（APA）阶段压力中心（COP）位移和速度的DTC、COP与质心（COP-COM）的分离以及听觉认知任务期间的反应准确性。
结果
两组之间存在显著差异，PCS参与者在前后（A）/后（P）位移方面的DTC更差（PCS，-37.5±22.1%；对照组，-9.7±39.2%；P = 0.016，d = 0.874），APA内侧（M）/外侧（L）速度方面（PCS，-34.8±28.8%；对照组，-17.0±40.21%；P = 0.041，d = 0.866），以及COP-COM分离峰值方面（PCS，-7.3±6.7%；对照组，0.6±6.5%；P = 0.023，d = 1.200）。在APA A/P速度（PCS，-38.8±33.1%；对照组，-19.8±43.9%；P = 0.094）、APA M/L位移（PCS，-34.8±21.8%；对照组，-10.6±25.3%；P = 0.313）或认知任务表现（PCS，-2.7±10.8%；对照组，-0.2±4.3%；P = 0.321）方面，两组之间无显著差异。
结论
PCS参与者在任务规划和执行过程中都有更大（更差）的DTC，效应量较大（d>0.80）。PCS参与者还采用了姿势优先策略，即注意力资源被不适当地分配到认知任务上。这些缺陷可能会挑战患者完成日常生活活动的能力，并限制其功能独立性。
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