Abstract
BackgroundGait impairments present while dual-tasking in older adults with multiple sclerosis (MS) have been associated with an increased risk of falls. Prior studies have examined prefrontal cortex (PFC) activity using functional near infrared spectroscopy (fNIRS) while dual-tasking in older adults with and without cognitive impairment. While the benefits of partial body weight support (PBWS) on gait have been clearly outlined in the literature, the potential use of PBWS to improve the ability to dual task in older adults with and without MS has not been examined. The aim of this study was to examine the effects of PBWS on the PFC activation while dual-tasking in older adults with and without MS.MethodsTen individuals with MS (mean 56.2 ± 5.1 yrs., 8 females) and 12 healthy older adults (HOA) (mean 63.1 ± 4.4 yrs., 9 females) participated in this study. PFC activation (i.e., oxygenated hemoglobin-HbO2) was measured using fNIRS. Assessments were done under two treadmill walking conditions: no body weight support (NBWS) and PBWS. Under each condition, participants were asked to walk at a comfortable speed (W) or walk and talk (WT). Linear mixed models were used to test for differences between cohorts, conditions, and tasks.ResultsHbO2 levels differed significantly between task (p < .001), cohort (p < .001), and BWS (p = .02). HbO2 levels increased under higher cognitive demands (i.e., W vs WT), in individuals with MS, and under different conditions (i.e., NBWS vs PBWS). Post-hoc analysis demonstrated a significant difference between cohorts during the WT and NBWS condition (p = .05). When examining the relative change in HbO2 levels during each task, a significant interaction between task, BWS, and cohort across time was observed (p < 0.01). While HOA increased PFC activation across time, MS exhibited a maintenance of PFC activation patterns during the WT under PBWS condition.ConclusionsThis study establishes the potential impact of PBWS on PFC activation patterns under dual-tasking conditions and sheds light on the ability for PBWS to be used as a therapeutic tool in individuals with neurological conditions to decrease cognitive demands while dual-tasking and thus decrease the risk of falls.
Highlights
Gait impairments present while dual-tasking in older adults with multiple sclerosis (MS) have been associated with an increased risk of falls
The present study aims to 1) better understand how prefrontal cortex (PFC) activation patterns differ between MS and healthy older adults (HOA) in a single session of partial body weight support (PBWS) and 2) to validate prior findings of PFC activation changes in MS and HOA on selfpaced treadmill walking using functional near infrared spectroscopy (fNIRS)
As benefits that are observed over a one-time session of dualtasking under PBWS would be expected to be further enhanced after an intervention program, this study provides potential measures for future intervention programs using dual-task training under PBWS conditions
Summary
Gait impairments present while dual-tasking in older adults with multiple sclerosis (MS) have been associated with an increased risk of falls. When walking and talking, gait rhythmicity and automaticity decrease based on decrements in gait parameters such as reduced gait speed and stride length when compared with walking alone [1,2,3,4] These dualtask-related impairments on gait parameters have been correlated with an increased risk of falls [1, 5,6,7] and have been well established in healthy older adults (HOA) [4, 8, 9] and in adults with neurological conditions such as multiple sclerosis (MS) [10, 11].
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