Abstract
Automaticity is a hallmark feature of walking in adults who are healthy and well-functioning. In the context of walking, “automaticity” refers to the ability of the nervous system to successfully control typical steady state walking with minimal use of attention-demanding executive control resources. Converging lines of evidence indicate that walking deficits and disorders are characterized in part by a shift in the locomotor control strategy from healthy automaticity to compensatory executive control. This is potentially detrimental to walking performance, as an executive control strategy is not optimized for locomotor control. Furthermore, it places excessive demands on a limited pool of executive reserves. The result is compromised ability to perform basic and complex walking tasks and heightened risk for adverse mobility outcomes including falls. Strategies for rehabilitation of automaticity are not well defined, which is due to both a lack of systematic research into the causes of impaired automaticity and to a lack of robust neurophysiological assessments by which to gauge automaticity. These gaps in knowledge are concerning given the serious functional implications of compromised automaticity. Therefore, the objective of this article is to advance the science of automaticity of walking by consolidating evidence and identifying gaps in knowledge regarding: (a) functional significance of automaticity; (b) neurophysiology of automaticity; (c) measurement of automaticity; (d) mechanistic factors that compromise automaticity; and (e) strategies for rehabilitation of automaticity.
Highlights
Safe and independent mobility function at home and in the community requires well-coordinated control of walking
A second phenomenon is that automatic processing requires little effort and can operate in high workload situations, whereas controlled/executive processing requires substantial effort and interferes with other controlled processing tasks (Schneider and Chein, 2003). This is concerning for walking because loss of automaticity and a compensatory reliance on executive control could overly encumber the available supply of executive resources
The cumulative evidence indicates that compromised automaticity of walking has important functional implications, which highlights the crucial need for improved mechanistic understanding and enhanced rehabilitative strategies
Summary
Safe and independent mobility function at home and in the community requires well-coordinated control of walking. Research by Shiffrin, Schneider and colleagues provides a framework for understanding the important functional implications of automaticity (Schneider and Shiffrin, 1977; Shiffrin and Schneider, 1977) This framework was developed to explain two complementary forms of cognitive processing, automatic and controlled, but the concepts can be applied to locomotor control. A second phenomenon is that automatic processing requires little effort and can operate in high workload situations, whereas controlled/executive processing requires substantial effort and interferes with other controlled processing tasks (Schneider and Chein, 2003) This is concerning for walking because loss of automaticity and a compensatory reliance on executive control could overly encumber the available supply of executive resources. The cumulative evidence indicates that compromised automaticity of walking has important functional implications, which highlights the crucial need for improved mechanistic understanding and enhanced rehabilitative strategies
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