Abstract
BackgroundPrevious research has shown that visuospatial processing requiring working memory is particularly important for balance control during standing and stepping, and that limited spatial encoding contributes to increased interference in postural control dual tasks. However, visuospatial involvement during locomotion has not been directly determined. This study examined the effects of a visuospatial cognitive task versus a nonspatial cognitive task on gait speed, smoothness and variability in older people, while controlling for task difficulty.MethodsThirty-six people aged ≥75 years performed three walking trials along a 20 m walkway under the following conditions: (i) an easy nonspatial task; (ii) a difficult nonspatial task; (iii) an easy visuospatial task; and (iv) a difficult visuospatial task. Gait parameters were computed from a tri-axial accelerometer attached to the sacrum. The cognitive task response times and percentage of correct answers during walking and seated trials were also computed.ResultsNo significant differences in either cognitive task type error rates or response times were evident in the seated conditions, indicating equivalent task difficulty. In the walking trials, participants responded faster to the visuospatial tasks than the nonspatial tasks but at the cost of making significantly more cognitive task errors. Participants also walked slower, took shorter steps, had greater step time variability and less smooth pelvis accelerations when concurrently performing the visuospatial tasks compared with the nonspatial tasks and when performing the difficult compared with the easy cognitive tasks.ConclusionsCompared with nonspatial cognitive tasks, visuospatial cognitive tasks led to a slower, more variable and less smooth gait pattern. These findings suggest that visuospatial processing might share common networks with locomotor control, further supporting the hypothesis that gait changes during dual task paradigms are not simply due to limited attentional resources but to competition for common networks for spatial information encoding.
Highlights
Dual task studies requiring individuals to simultaneously perform cognitive and balance tasks have shown that performance in either or both tasks is compromised [1,2], and that this interference is more marked in those with reduced sensorimotor and/or cognitive functioning due to age and disease [1,2]
The three-way repeated measures ANOVA revealed a significant ambulation by task type by difficulty interaction effect (F1, 29 = 7.073, p = .013) on cognitive task response time
There was a significant task type by difficulty interaction effect (F1, 31 = 15.24, p,.001) on response time resulting from a greater differential effect of increased difficulty for the NS compared with the VS cognitive tasks
Summary
Dual task studies requiring individuals to simultaneously perform cognitive and balance tasks have shown that performance in either or both tasks is compromised [1,2], and that this interference is more marked in those with reduced sensorimotor and/or cognitive functioning due to age and disease [1,2] These findings suggest that balance control requires higher-level cognitive functioning to selectively process information (attention) and actively maintain and manipulate it (working memory) [3]. Previous research has shown that visuospatial processing requiring working memory is important for balance control during standing and stepping, and that limited spatial encoding contributes to increased interference in postural control dual tasks. This study examined the effects of a visuospatial cognitive task versus a nonspatial cognitive task on gait speed, smoothness and variability in older people, while controlling for task difficulty
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