Kayabınar Büşra, Bulut Numan, Alemdaroğlu-Gürbüz İpek, Yılmaz Öznur
Yalova University, Faculty of Health Science, Physiotherapy and Rehabilitation Department, Yalova Üniversitesi Merkez Kampüs Çınarcık Yolu üzeri 3.km Tıp Fakültesi Binası, Yalova, Turkey.
Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Physiotherapy and Rehabilitation Department, Talatpaşa Bulvarı, Altındağ, Ankara 06100, Turkey.
Res Dev Disabil. 2025 May;160:104973. doi: 10.1016/j.ridd.2025.104973. Epub 2025 Mar 18.
The aim of this study is to investigate the variations in dual-task performance between children with Duchenne Muscular Dystrophy (DMD) and their typically developed peers. Simultaneously, we explored the impact of psychosocial features and functional parameters on dual-task performance in children with DMD.
A total of 45 children with DMD and 49 typically developed peers were included in the study. After recording the demographic information of the children, the motor-motor and cognitive-motor dual-task performances of all children were assessed by adding motor (carrying a half-filled bottle of water in both hands) and cognitive tasks (mental practice and memory) to the 10 Meter Walk Test (10MWT). Then Brooke Lower Extremity Functional Classification (BLEFC), 6-Minute Walk Test (6MWT), North Star Ambulatory Assessment (NSAA), Gait Assessment Scale for Duchenne Muscular Dystrophy (DMD-GAS), Four Square Step Test (FSST), Modified Mini-Mental State Examination (MMSE), Pediatric Quality of Life Inventory (PedsQL)-Neuromuscular Module, and Pediatric Fear of Falling Questionnaire (Ped-FOF) were assessed for motor performance, ambulation levels, walking abilities, balance, cognitive levels, quality of life, and fear of falling, respectively.
In our study, a significant difference was found between the dual-task performances of children with DMD and their typically developed peers, with typically developed children performing better in motor-motor, cognitive motor/mental, and cognitive motor/memory tasks (p < 0.001). Relationships were identified between the dual-task performances of DMD children and the 6MWT (r: -0.715; -0.651; -0.641; respectively), NSAA (r: -0.669; -0.434; -0.451; respectively) DMD-GAS (r: -0.626; -0.409; -0.424; respectively), FSST (r: 0.747; 0.534; 0.503; respectively), PedsQL-Neuromuscular Module (parent report) (r: -0.432; -0.340; -0.357; respectively), and Ped-FOF (r: 0.512; 0.449; 0.436; respectively), (p < 0.05).
Our study indicated that dual-task performance in children with DMD is lower than that of their peers, and it is related to the children's motor skills, ambulation levels, and psychosocial features. These findings suggest that incorporating assessments and approaches for dual-task performance into rehabilitation programs aimed at preserving or improving motor functions, ambulation levels, and quality of life may be important for a holistic approach to managing the disease.
本研究旨在调查杜氏肌营养不良症(DMD)患儿与其发育正常的同龄人在执行双重任务时的表现差异。同时,我们探讨了心理社会特征和功能参数对DMD患儿双重任务表现的影响。
本研究共纳入45名DMD患儿和49名发育正常的同龄人。在记录患儿的人口统计学信息后,通过在10米步行测试(10MWT)中增加运动任务(双手各拿一瓶半满的水)和认知任务(心理练习和记忆),评估所有患儿的运动-运动和认知-运动双重任务表现。然后分别使用布鲁克下肢功能分级(BLEFC)、6分钟步行测试(6MWT)、北极星动态评估(NSAA)、杜氏肌营养不良症步态评估量表(DMD-GAS)、四方步测试(FSST)、简易精神状态检查表修订版(MMSE)、儿童生活质量量表(PedsQL)-神经肌肉模块以及儿童跌倒恐惧问卷(Ped-FOF)评估运动表现、步行能力、行走能力、平衡能力、认知水平、生活质量和跌倒恐惧。
在我们的研究中,发现DMD患儿与其发育正常的同龄人在双重任务表现上存在显著差异,发育正常的儿童在运动-运动、认知运动/心理和认知运动/记忆任务中表现更好(p < 0.001)。确定了DMD患儿的双重任务表现与6MWT(相关系数分别为:-0.715;-0.651;-0.641)、NSAA(相关系数分别为:-0.669;-0.434;-0.451)、DMD-GAS(相关系数分别为:-0.626;-0.409;-0.424)、FSST(相关系数分别为:0.747;0.534;0.503)、PedsQL-神经肌肉模块(家长报告)(相关系数分别为:-0.432;-0.340;-0.357)以及Ped-FOF(相关系数分别为:0.512;0.449;0.436)之间的关系(p < 0.05)。
我们的研究表明,DMD患儿的双重任务表现低于同龄人,且与患儿的运动技能、步行能力和心理社会特征有关。这些发现表明,将双重任务表现的评估和方法纳入旨在维持或改善运动功能、步行能力和生活质量的康复计划中,对于全面管理该疾病可能很重要。