Multi-tasking deteriorates trunk movement control during and after obstacle avoidance

Abstract

Dynamic and cognitive multi-tasking might affect balance and walking negatively and increase risk of falling. Trunk movement control is critical for balance maintenance and fall-prevention. The impact of multi-tasking on trunk movement control has not been thoroughly studied. In a challenging dynamic multi-tasking condition such as walking and obstacle avoidance, presence of a cognitive task not only increases risk of tripping but also may increase risk of falling by deteriorating trunk control. Our objective was to investigate the impacts of a challenging dynamic and cognitive multi-tasking condition (walking + obstacle avoidance + cognitive task) on trunk kinematics and kinetics and compare those with other joints/segments. Trunk, pelvis, hip, knee, and ankle kinematics and kinetics of 12 young adults were compared between joints/segments and conditions. During walking and obstacle avoidance (dynamic multi-tasking), the trunk had the largest normalized increase in peak flexion angle and extension torque compared to walking, among the other joints/segments. The presence of a cognitive task during walking and obstacle avoidance (dynamic and cognitive multi-tasking) did not impact any of the joints/segments biomechanics except the trunk peak extension torque that was increased. Furthermore, trunk kinematics showed the largest residual differences (post-effects) in 3 cycles after obstacle avoidance compared to walking. The presence of a cognitive task (dynamic and cognitive multi-tasking) did not impact the post-effects of obstacle avoidance on any joints/segments except the trunk with its residual difference from normal walking further increased. These results suggest that a cognitive task deteriorates trunk control and interferes with the ability to regain normal trunk biomechanics after obstacle avoidance. In summary, the trunk requires the largest biomechanical adjustments in a challenging dynamic and cognitive multi-tasking condition where there is a risk of falling. Our study provides baseline results suggesting that trunk control demands more attention and is more negatively affected by dynamic and cognitive multi-tasking. Our results raise a concern for elderly population as their trunk control is already impaired and common daily multi-tasking could further deteriorate their trunk control and increase fall risk.