Abstract
Dual-task paradigms have been increasingly used to assess the interaction between cognitive demands and the control of balance and gait. The interaction between functional and cognitive demands can alter movement patterns and increase knee instability in individuals with knee conditions, such as knee anterior cruciate ligament (ACL) injury or osteoarthritis (OA). However, there is no consensus on the effects of dual-task on gait mechanics and balance in those individuals. This systematic scoping review aims to examine the impact of dual-task gait and standing balance on motor and cognitive performance in individuals with knee OA or ACL injury. A comprehensive search of MEDLINE, PubMed, Web of Science, and EMBASE electronic databases up until December 2019 was carried out. Inclusion criteria was limited to include dual-task studies that combined cognitive tasks performed simultaneously with gait or standing balance in individuals with knee OA or ACL injuries. In total, fifteen studies met the inclusion criteria, nine articles examined dual-task effects on balance, and six articles reported the effects of dual-task on gait. The total number of individuals included was 230 individuals with ACL injuries, and 168 individuals with knee OA. A decline in gait and balance performance during dual-task testing is present among individuals with ACL injury and/or ACL reconstruction and knee OA. Further research is required, but dual taking assessment could potentially be used to identify individuals at risk of falling or further injury and could be used to develop targeted rehabilitation protocols. A variety of outcome measures have been used across the studies included, making comparisons difficult. The authors, therefore, recommend developing a standardized set of biomechanical balance variables.
Highlights
Motor activities such as gait were thought to be a series of automated movements, requiring minimum cognitive demands [1]
It is worth saying that a mixed response of dual-task interference was observed, and gait seemed to be more affected than balance, which might be related to the fact that gait, unlike balance, requires more cognitive resources
This review aims to look into the nature and scope of literature studying the effects of dual-tasks on subjects suffering with knee pain
Summary
Motor activities such as gait were thought to be a series of automated movements, requiring minimum cognitive demands [1]. Many studies [2,3,4] have challenged this notion and established that there is a relationship between motor performance and cognition. A purposeful locomotion requires the ability to adjust to overcome environmental burdens, meet goals, and involves performing a concurrent cognitive task while performing a motor task. Such interaction can be explored using dual-task methodology. Dual-task is used to assess the simultaneous performance of a postural task and a cognitive task or motor task to study the interaction or the effect of the secondary task on the performance of the primary task [5]. Dual-task interference occurs due to the conflict arising in the allocation of attention between the two tasks [6]
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