Dataset Information

Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS.

ABSTRACT: Background:Individuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports. Methods:All measures were collected in a single session. A 2 × 2 × 2 mixed model ANOVA was used to compare differences in forward and backward walking in single- and dual-task conditions between MS and healthy controls. Spearman correlations were used to examine relationships between gait and cognitive function, falls, and balance. Results:Eighteen individuals with relapsing-remitting MS and 14 age- and sex-matched healthy controls participated. Backward walking velocity revealed significant differences between groups for both single-task (p = 0.015) and dual-task (p = 0.014) conditions. Persons with MS demonstrated significant differences between single- and dual-task forward and backward walking velocities (p = 0.023; p = 0.004), whereas this difference was only apparent in the backward walking condition for healthy controls (p = 0.004). In persons with MS, there were significant differences in double support time between single- and dual-task conditions in both backward (p < 0.001) and forward (p = 0.001) directions. More falls at six months were significantly associated with shorter backward dual-task stride length (r = -0.490; p = 0.046) and slower velocity (r = -0.483; p = 0.050). Conclusion:Differences in MS and age- and sex-matched healthy controls are more pronounced during backward compared to forward walking under single- and dual-task conditions. Future work with a larger sample size is needed to validate the clinical utility of backward walking and dual-task assessments and mitigate the limited sensitivity of the current dual-task assessments that primarily rely upon forward walking.

SUBMITTER: Edwards EM

PROVIDER: S-EPMC7495208 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS.

Edwards Erin M EM Kegelmeyer Deborah A DA Kloos Anne D AD Nitta Manon M Raza Danya D Nichols-Larsen Deborah S DS Fritz Nora E NE

Multiple sclerosis international 20200908

<h4>Background</h4>Individuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports.<h4>Methods</h4> ...[more]

PMID: 32963832

Similar Datasets

Project description:In the process of walking, attentional resources are flexibly allocated to deal with varying environmental constraints correlated with attentional control (AC). A dual-task paradigm was used to investigate the effects of AC on gait and inter-joint coordination. Fifty students volunteered to participate in this study. Based on the reaction time (RT) in the Stroop task, the top 15 participants were assigned to the High Attentional Control (HAC) group, while the last 15 participants were assigned to the Low Attentional Control (LAC) group. The participants in the two groups were randomly asked to perform three tasks: (i) single 2-back working memory task (ST 2-back); (ii) single walking task (ST walking); and (iii) dual task (DT). Cognitive outcomes and gait spatiotemporal parameters were measured. Continuous relative phase (CRP), derived from phase angles of two adjacent joints, was used to assess inter-joint coordination. The LAC group exhibited significant task effects regarding RT, correct rate (CR), step width, gait cycle, step time, forefoot contact times, heel-forefoot times, hip-knee mean absolute relative phase (MARP), and deviation phase (DP) in the stance and swing phases (p < 0.05). In the HAC group, significant task effects were only detected in RT and foot progression angle of the left foot (p < 0.05). Under the three task conditions, the LAC group exhibited a higher CR in ST, longer heel contact times, and longer heel-forefoot times when compared with the LAC group (p < 0.05). Compared with the LAC group, the HAC group exhibited significantly smaller (closer to zero) MARP and weaker hip-knee DP values in the swing phase across all gait conditions (p < 0.05). In the stance phase, the HAC group had smaller MARP (closer to zero) values when compared with the LAC group (p < 0.05). In conclusion, the ability to maintain gait control and modulate inter-joint coordination patterns in young adults is affected by the level of attentional control in accommodating gait disturbances. AC is correlated with the performance of motor control, which theoretically supports the competitive selection of athletes and fall prevention strategies for a specific population.

Project description:BackgroundWalking over obstacles requires precise foot placement while maintaining balance control of the center of mass (CoM) and the flexibility to adapt the gait patterns. Most individuals with incomplete spinal cord injury (iSCI) are capable of overground walking on level ground; however, gait stability and adaptation may be compromised. CoM control was investigated during a challenging target walking (TW) task in individuals with iSCI compared to healthy controls. The hypothesis was that individuals with iSCI, when challenged with TW, show a lack of gait pattern adaptability which is reflected by an impaired adaptation of CoM movement compared to healthy controls.MethodsA single-center controlled diagnostic clinical trial with thirteen participants with iSCI (0.3-24 years post injury; one subacute and twelve chronic) and twelve healthy controls was conducted where foot and pelvis kinematics were acquired during two conditions: normal treadmill walking (NW) and visually guided target walking (TW) with handrail support, during which participants stepped onto projected virtual targets synchronized with the moving treadmill surface. Approximated CoM was calculated from pelvis markers and used to calculate CoM trajectory length and mean CoM Euclidean distance TW-NW (primary outcome). Nonparametric statistics, including spearman rank correlations, were performed to evaluate the relationship between clinical parameter, outdoor mobility score, performance, and CoM parameters (secondary outcome).ResultsHealthy controls adapted to TW by decreasing anterior-posterior and vertical CoM trajectory length (p < 0.001), whereas participants with iSCI reduced CoM trajectory length only in the vertical direction (p = 0.002). Mean CoM Euclidean distance TW-NW correlated with participants' neurological level of injury (R = 0.76, p = 0.002) and CoM trajectory length (during TW) correlated with outdoor mobility score (R = - 0.64, p = 0.026).ConclusionsThis study demonstrated that reduction of CoM movement is a common strategy to cope with TW challenge in controls, but it is impaired in individuals with iSCI. In the iSCI group, the ability to cope with gait challenges worsened the more rostral the level of injury. Thus, the TW task could be used as a gait challenge paradigm in ambulatory iSCI individuals. Trial registration Registry number/ ClinicalTrials.gov Identifier: NCT03343132, date of registration 2017/11/17.

Dataset Information

Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS.

Publications

Backward Walking and Dual-Task Assessment Improve Identification of Gait Impairments and Fall Risk in Individuals with MS.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets