Abstract

Given the interplay between cognitive and motor functions during walking, cognitive demands required during gait have been investigated with regard to dual task performance. Along with the needs to understand how the type of concurrent task while walking affects gait performance, there are calls for diversified dual tasks that can be applied to older adults with varying levels of cognitive decline. Therefore, this study aimed to examine how rhythm-motor tasks affect dual task performance and gait control, compared to a traditional cognitive-motor task. Also, it examined whether rhythm-motor tasks are correlated with traditional cognitive-motor task performance and cognitive measures. Eighteen older adults without cognitive impairment participated in this study. Each participant was instructed to walk at self-paced tempo without performing a concurrent task (single walking task) and walk while separately performing two types of concurrent tasks: rhythm-motor and cognitive-motor tasks. Rhythm-motor tasks included instrument playing (WalkIP), matching to rhythmic cueing (WalkRC), and instrument playing while matching to rhythmic cueing (WalkIP+RC). The cognitive-motor task involved counting forward by 3s (WalkCount.f3). In each condition, dual task costs (DTC), a measure for how dual tasks affect gait parameters, were measured in terms of walking speed and stride length. The ratio of stride length to walking speed, a measure for dynamic control of gait, was also examined. The results of this study demonstrated that the task type was found to significantly influence these measures. Rhythm-motor tasks were found to interfere with gait parameters to a lesser extent than the cognitive-motor task (WalkCount.f3). In terms of ratio measures, stride length remained at a similar level, walking speed greatly decreased in the WalkCount.f3 condition. Significant correlations between dual task-related measures during rhythm-motor and cognitive-motor tasks support the potential of applying rhythm-motor tasks to dual task methodology. This study presents how rhythm-motor tasks demand cognitive control at different levels than those engaged by cognitive-motor tasks. It also indicates how these new dual tasks can effectively mediate dual task performance indicative of fall risks, while requiring increased cognitive resources but facilitating gait control as a compensatory strategy to maintain gait stability.

Highlights

  • Increased fall risks and fall-related serious injuries associated with aging are a public health concern [1, 2]

  • This study demonstrated that rhythm-motor tasks involve cognitive control of attentional resources supporting their application to traditional cognitive-motor tasks for dual task intervention

  • Given that the inclusion of dual tasks, not intervention in single cognitive or motor functioning, leads to improvement in dual task performance and fall prevention, the results with rhythm-motor tasks support their applicability to intervening in such needs of older populations

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Summary

Introduction

Increased fall risks and fall-related serious injuries associated with aging are a public health concern [1, 2]. Since many daily tasks are performed while people are standing or walking, increased risk of falling among the elderly leads to changes in their life style, including a tendency to become sedentary and avoid physical activity. Such changes often result in decreased quality of life [3]. Given that falls have been documented to be associated with a high prevalence of comorbidities or increased mortality, understanding risk factors for falls and strategies to intervene in age-related changes in gait is of great interest. Older adults with a history of falling tend to show decreases in walking speed as well as in step frequency and stride length

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