Balance Recovery Stepping Responses During Walking Were Not Affected by a Concurrent Cognitive Task Among Older Adults

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2022 Apr 7

PMID 35387589

Authors

Inbal Paran

Hadas Nachmani

Moti Salti

Ilan Shelef

Itshak Melzer

Affiliations

Soon will be listed here.

Abstract

Background: Most of older adults' falls are related to inefficient balance recovery after an unexpected loss of balance, i.e., postural perturbation. Effective balance recovery responses are crucial to prevent falls. Due to the considerable consequences of lateral falls and the high incidence of falls when walking, this study aimed to examine the effect of a concurrent cognitive task on older adults' balance recovery stepping abilities from unannounced lateral perturbations while walking. We also aimed to explore whether cognitive performance accuracy is affected by perturbed walking and between task trade-offs.

Methods: In a laboratory-based study, 20 older adults (> 70 years old) performed the following test conditions: (1) cognitive task while sitting; (2) perturbed walking; and (3) perturbed walking with a concurrent cognitive task. The cognitive task was serial numbers subtraction by seven. Single-step and multiple-step thresholds, highest perturbation achieved, 3D kinematic analysis of the first recovery step, and cognitive task performance accuracy were compared between single-task and dual-task conditions. Between task trade-offs were examined using dual-task cost (DTC).

Results: Single-step and multiple-step thresholds, number of recovery step trials, number of foot collision, multiple-step events and kinematic recovery step parameters were all similar in single-task and dual-task conditions. Cognitive performance was not significantly affected by dual-task conditions, however, different possible trade-offs between cognitive and postural performances were identified using DTC.

Conclusions: In situations where postural threat is substantial, such as unexpected balance loss during walking, balance recovery reactions were unaffected by concurrent cognitive load in older adults (i.e., posture first strategy). The study was approved by the Helsinki Ethics Committee of Soroka University Medical Center in Beer-Sheva, Israel (ClinicalTrials.gov Registration number NCT04455607 , ID Numbers: Sor 396-16 CTIL; 02/07/2020).

Citing Articles

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References

Kelly V, Janke A, Shumway-Cook A . Effects of instructed focus and task difficulty on concurrent walking and cognitive task performance in healthy young adults. Exp Brain Res. 2010; 207(1-2):65-73. PMC: 3058115. DOI: 10.1007/s00221-010-2429-6. View

Batcir S, Sharon H, Shani G, Levitsky N, Gimmon Y, Kurz I . The inter-observer reliability and agreement of lateral balance recovery responses in older and younger adults. J Electromyogr Kinesiol. 2018; 40:39-47. DOI: 10.1016/j.jelekin.2018.03.002. View

Brown L, Sleik R, Polych M, Gage W . Is the prioritization of postural control altered in conditions of postural threat in younger and older adults?. J Gerontol A Biol Sci Med Sci. 2002; 57(12):M785-92. DOI: 10.1093/gerona/57.12.m785. View

Richer N, Polskaia N, Lajoie Y . Continuous Cognitive Task Promotes Greater Postural Stability than an Internal or External Focus of Attention in Older Adults. Exp Aging Res. 2017; 43(1):21-33. DOI: 10.1080/0361073X.2017.1258214. View

Richer N, Saunders D, Polskaia N, Lajoie Y . The effects of attentional focus and cognitive tasks on postural sway may be the result of automaticity. Gait Posture. 2017; 54:45-49. DOI: 10.1016/j.gaitpost.2017.02.022. View

Mcilroy W, Maki B . Age-related changes in compensatory stepping in response to unpredictable perturbations. J Gerontol A Biol Sci Med Sci. 1996; 51(6):M289-96. DOI: 10.1093/gerona/51a.6.m289. View

Maki B, McIlroy W . Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing. 2006; 35 Suppl 2:ii12-ii18. DOI: 10.1093/ageing/afl078. View

Shapiro A, Melzer I . Balance perturbation system to improve balance compensatory responses during walking in old persons. J Neuroeng Rehabil. 2010; 7:32. PMC: 2911463. DOI: 10.1186/1743-0003-7-32. View

Horak F . Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls?. Age Ageing. 2006; 35 Suppl 2:ii7-ii11. DOI: 10.1093/ageing/afl077. View

10.

Berg W, Alessio H, Mills E, Tong C . Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing. 1997; 26(4):261-8. DOI: 10.1093/ageing/26.4.261. View

11.

Nnodim J, Kim H, Ashton-Miller J . Effect of a vocal choice reaction time task on the kinematics of the first recovery step after a sudden underfoot perturbation during gait. Gait Posture. 2012; 37(1):61-6. PMC: 4050174. DOI: 10.1016/j.gaitpost.2012.06.002. View

12.

van Doorn J, den Bergh D, Bohm U, Dablander F, Derks K, Draws T . The JASP guidelines for conducting and reporting a Bayesian analysis. Psychon Bull Rev. 2020; 28(3):813-826. PMC: 8219590. DOI: 10.3758/s13423-020-01798-5. View

13.

Paran I, Nachmani H, Melzer I . A concurrent attention-demanding task did not interfere with balance recovery function in standing and walking among young adults - An explorative laboratory study. Hum Mov Sci. 2020; 73:102675. DOI: 10.1016/j.humov.2020.102675. View

14.

Yogev-Seligmann G, Hausdorff J, Giladi N . The role of executive function and attention in gait. Mov Disord. 2007; 23(3):329-42. PMC: 2535903. DOI: 10.1002/mds.21720. View

15.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

16.

Jacobs J, Horak F . Cortical control of postural responses. J Neural Transm (Vienna). 2007; 114(10):1339-48. PMC: 4382099. DOI: 10.1007/s00702-007-0657-0. View

17.

Pashler H . Dual-task interference in simple tasks: data and theory. Psychol Bull. 1994; 116(2):220-44. DOI: 10.1037/0033-2909.116.2.220. View

18.

Wittenberg E, Thompson J, Nam C, Franz J . Neuroimaging of Human Balance Control: A Systematic Review. Front Hum Neurosci. 2017; 11:170. PMC: 5385364. DOI: 10.3389/fnhum.2017.00170. View

19.

Maki B, Edmondstone M, Mcilroy W . Age-related differences in laterally directed compensatory stepping behavior. J Gerontol A Biol Sci Med Sci. 2000; 55(5):M270-7. DOI: 10.1093/gerona/55.5.m270. View

20.

Al-Yahya E, Dawes H, Smith L, Dennis A, Howells K, Cockburn J . Cognitive motor interference while walking: a systematic review and meta-analysis. Neurosci Biobehav Rev. 2010; 35(3):715-28. DOI: 10.1016/j.neubiorev.2010.08.008. View