How cognitive loads modulate the postural control of older women with low back pain?

Le Ge,Siyun Zhang,Xin Li,Chuhuai Wang,Qiuhua Yu,Shanshan Zhang,Huanjie Huang

doi:10.1186/s12877-021-02025-z

Abstract

BackgroundThe capacity of postural control is a key factor related to falling in older people, particularly in older women with low back pain (LBP). Cognitive involvement in postural control increases with age. However, most scholars have not considered different difficulty levels of cognitive loads when exploring the effects of cognition on postural control in older patients with LBP. The present study is to investigate how different levels of cognitive loads modulate postural control in older women with LBP.MethodsThis was a cross-sectional study. Twenty older women with LBP were recruited into the LBP group, and 20 healthy older women without the history of LBP were recruited into the healthy control group. Balance parameters were computed to quantify postural control. All participants underwent the balance test, which required the participant to maintain stability during standing on a force platform with or without a concurrent cognitive task. The balance test included three levels of difficulties of posture tasks (eyes-open vs. eyes-closed vs. one-leg stance) and three cognitive tasks (without cognitive task vs. auditory arithmetic task vs. serial-7 s arithmetic task).ResultsA repeated-measure analysis of variance (3 postural tasks × 3 congnitive tasks× 2 groups) testing the effects of the different congnitive task levels on the performance in different postural conditions. Older women with LBP had worse postural control (as reflected by larger center of pressure (COP) parameters) than control group regardless of postural or cognitive difficulties. Compared with the single task, the COP parameters of participants with LBP were larger during dual tasks, even though the difficulty level of the cognitive task was low. Larger COP parameters were shown only if the difficulty level of the cognitive task was high in control group. Correlations between sway area/sway length and the number of falls were significant in dual tasks.ConclusionOur findings shed light on how cognitive loads modulate postural control for older women with LBP. Compared with control group, cognitive loads showed more disturbing effects on postural control in older women with LBP, which was associated with falling.

Highlights

The capacity of postural control is a key factor related to falling in older people, in older women with low back pain (LBP)
If one of the dual tasks needs a high level of arousal or increased attentional demand, not sufficient cognitive resources may be able to be allocated to carry out daily activities, thereby leading to higher risk of falling
Instruments and experimental design postural control (PC) was measured by the center of pressure (COP) in two conditions, which were single task and dual task (Fig. 1)

Summary

Introduction

The capacity of postural control is a key factor related to falling in older people, in older women with low back pain (LBP). Studies have shown that cognition can modulate PC [3] and that the modulation effect increases with aging [4] In daily life, it is very common for postural tasks to be accompanied with cognitive tasks (e.g., making a telephone call while walking). Studies have shown that decreased/divided attention is a high risk factor for falling in daily life for older people [6, 7] This finding was supported by a large number of studies, which explored the effect of dual-tasking on postural control in older people [8,9,10]. If one of the dual tasks needs a high level of arousal or increased attentional demand, not sufficient cognitive resources may be able to be allocated to carry out daily activities (e.g., undertaking functional activities and maintaining postural balance simultaneously), thereby leading to higher risk of falling. All the findings in the previous studies suggested that high cognitive demands seem to have inhibited effect upon PC in dual-task conditions, whereas the low cognitive demands have facilitative effect upon PC in dual-task conditions [5]

Methods

Results

Discussion

Conclusion