Cognitive-motor Interference Research Articles

Gender differences in the use of an upper-extremity exoskeleton during physically and cognitively demanding tasks- a study protocol for a randomized experimental trial.

Upper limb exoskeletons are recommended to alleviate muscle fatigue, particularly in working conditions inducing musculoskeletal discomfort like overhead work. However, wearing an exoskeleton might introduce cognitive-motor interference, affecting performance. Understanding its neural impact and potential gender differences in design effects is crucial. Therefore, the aim of this study is to examine exoskeleton effects addressing cross-gender comparisons, and exploring the impact on cognitive and physical workload in real-world scenarios. The research questions address the impact of exoskeleton use on muscle synergies, upper body posture, cognitive resources, comfort/discomfort, acceptance and usability. The cross-sectional study integrates a multifactorial mixed-measure design. Participants are grouped by gender (female vs. male) and working condition (with vs. without exoskeleton). Motor performance and underlying neuronal correlates (fNIRS) will be analyzed. Based on an a priori sample size calculation, 80 participants (40 female/40 male) will be recruited. Working performance will be assessed by 1. Physical Performance Task (PILE task) and 2. Precision Task (following the Fitts paradigm), while body postures will be monitored with an Xsens motion capture system. Brain activation will be captured with an fNIRS system comprising 32 active optodes. Postural comfort/discomfort, acceptance, and usability will be reported via standardized questionnaires. The study will gain insights into potential gender differences in exoskeleton use and will contribute to designing and optimizing the implementation of exoskeletons by considering muscle synergies, movement variability and cognitive resource allocation. Additionally, the study also highlights user discomfort, a crucial factor that could impede widespread adoption, particularly among females, in real-world scenarios.

Cognitive-motor interference in people with essential tremor

Adapting to different environments throughout daily activities requires flexibility in allocating attention. Compromised dual-tasking can hinder mobility, increase fall risk, and decrease functional independence in patients with essential tremor, who exhibit both mobility and cognitive impairments. We evaluated motor and cognitive dual-task effects and task prioritization in 15 people with Essential Tremor (ET) and 15 age-matched people without ET during a standard and more challenging water-carry TUG. Task-specific interference was evaluated by calculating motor and cognitive dual-task effects, whereas task prioritization was assessed by contrasting the cognitive dual-task effect with the motor dual-task effect. The simultaneous performance of two tasks did not differentially impact motor or cognitive performance in either group, and both groups prioritized cognitive task performance in standard and water-carry TUG assessments. This study enhances our understanding of motor-cognitive interactions in individuals with essential tremor. These insights could lead to patient-centered approaches to therapy to improve functional performance in dynamic daily environments.

The effects of cognitive-motor interference on walking performance in adolescents with low balance

BackgroundChildren with reduced motor competence (MC) have reported differences in their walking performance when compared to their typically developed peers, albeit, with inconsistent results.Research questions:What is the effect of reduced balance on walking performance in adolescent boys and girls under cognitive-motor interference conditions? MethodsThis cross-sectional study assessed motor competence, in adolescents aged 13–14 years, using the Movement Assessment Battery for Children 2nd edition and walking performance from gait parameters derived from an inertial measurement unit placed over the estimated centre of mass. Each participant performed two 10 m straight-line walks at their self-selected speed. These consisted of a walk with no distractions and a cognitive-motor interference walk (reciting the alternate letters of the alphabet out loud). A two-way mixed ANOVA was used to assess for significant interactions. Results365 adolescents, (low balance = 58, typical balance = 307) participated in this study (boys = 204, girls = 161). Significant interactions were reported between MC groups and walking condition for walking speed in boys (F(1,195) = 5.23, p= 0.02, ηp2 = 0.03) and girls (F(1,154) = 4.05, p= 0.046, ηp2 = 0.03). Both sexes with low balance reduced their walking speed to a greater extent than their typically developed peers under cognitive-motor interference conditions compared to the single-task walk. In addition, boys with low balance reported increased stride length variability (F(1,198)= 4.40, p= 0.037, ηp2= 0.02) compared to typically developed peers. SignificanceAdolescents with low balance report altered walking. Our data could support a better understanding of the relationship between balance and gait and may help the development of interventions to support those with difficulties.

Cognitive-motor interference in multiple sclerosis and healthy controls: results from single, dual, and triple task posturography

Cognitive-motor interference in multiple sclerosis and healthy controls: results from single, dual, and triple task posturography

Investigating cognitive-motor effects during slacklining using mobile EEG.

Balancing is a very important skill, supporting many daily life activities. Cognitive-motor interference (CMI) dual-tasking paradigms have been established to identify the cognitive load of complex natural motor tasks, such as running and cycling. Here we used wireless, smartphone-recorded electroencephalography (EEG) and motion sensors while participants were either standing on firm ground or on a slackline, either performing an auditory oddball task (dual-task condition) or no task simultaneously (single-task condition). We expected a reduced amplitude and increased latency of the P3 event-related potential (ERP) component to target sounds for the complex balancing compared to the standing on ground condition, and a further decrease in the dual-task compared to the single-task balancing condition. Further, we expected greater postural sway during slacklining while performing the concurrent auditory attention task. Twenty young, experienced slackliners performed an auditory oddball task, silently counting rare target tones presented in a series of frequently occurring standard tones. Results revealed similar P3 topographies and morphologies during both movement conditions. Contrary to our predictions we observed neither significantly reduced P3 amplitudes, nor significantly increased latencies during slacklining. Unexpectedly, we found greater postural sway during slacklining with no additional task compared to dual-tasking. Further, we found a significant correlation between the participant's skill level and P3 latency, but not between skill level and P3 amplitude or postural sway. This pattern of results indicates an interference effect for less skilled individuals, whereas individuals with a high skill level may have shown a facilitation effect. Our study adds to the growing field of research demonstrating that ERPs obtained in uncontrolled, daily-life situations can provide meaningful results. We argue that the individual CMI effects on the P3 ERP reflects how demanding the balancing task is for untrained individuals, which draws on limited resources that are otherwise available for auditory attention processing. In future work, the analysis of concurrently recorded motion-sensor signals will help to identify the cognitive demands of motor tasks executed in natural, uncontrolled environments.

Dual Tasking Affects the Outcomes of Instrumented Timed up and Go, Sit-to-Stand, Balance, and 10-Meter Walk Tests in Stroke Survivors.

Stroke can impair mobility, with deficits more pronounced while simultaneously performing multiple activities. In this study, common clinical tests were instrumented with wearable motion sensors to study motor-cognitive interference effects in stroke survivors (SS). A total of 21 SS and 20 healthy controls performed the Timed Up and Go (TUG), Sit-to-Stand (STS), balance, and 10-Meter Walk (10MWT) tests under single and dual-task (counting backward) conditions. Calculated measures included total time and gait measures for TUG, STS, and 10MWT. Balance tests for both open and closed eyes conditions were assessed using sway, measured using the linear acceleration of the thorax, pelvis, and thighs. SS exhibited poorer performance with slower TUG (16.15 s vs. 13.34 s, single-task p < 0.001), greater sway in the eyes open balance test (0.1 m/s2 vs. 0.08 m/s2, p = 0.035), and slower 10MWT (12.94 s vs. 10.98 s p = 0.01) compared to the controls. Dual tasking increased the TUG time (~14%, p < 0.001), balance thorax sway (~64%, p < 0.001), and 10MWT time (~17%, p < 0.001) in the SS group. Interaction effects were minimal, suggesting similar dual-task costs. The findings demonstrate exaggerated mobility deficits in SS during dual-task clinical testing. Dual-task assessments may be more effective in revealing impairments. Integrating cognitive challenges into evaluation can optimize the identification of fall risks and personalize interventions targeting identified cognitive-motor limitations post stroke.

Risk of using smartphones while walking for digital natives in realistic environments: Effects of cognitive–motor interference

The effect of using smartphones while walking on the cognitive and physical abilities of the “digital native” generation, i.e., individuals who have grown up in a digital media–centric environment, remains poorly understood. This study evaluated the effects of cognitive–motor interference on the use of smartphones while walking in children and young adults. The study involved 50 individuals from the digital age generation, including 24 children and 26 young adults. The study encompassed three experimental conditions, in which participants were instructed to traverse a distance of 60 m. The initial condition functioned as a control, wherein the participants walked without supplementary stimuli. In the second condition, the participants were provided with explicit instructions to grasp the smartphone device and position it in front of their chest by using both hands. This manipulation introduced a postural component into the experimental setup. The third condition required participants to be ambulatory while concurrently engaging in a cognitive task, namely, participating in a game that necessitated focused attention. Gait parameters were obtained by using inertial measurement unit sensors. Subsequently, the acquired gait characteristics were converted into dual-task costs (DTC). In the cognitive condition, children exhibited significantly greater DTC values for gait speed (76%), stride length (79%), stride time (102%), and stride length coefficient of variation (CV) than the young adults (p < 0.025). Moreover, as shown by the increased CV, a significant association exists between poor performance in smartphone games among children and increased variability in stride length. In children, the DTC of stride time CV decreased as smartphone game scores increased (R2 = 16.5%), and the DTC of stride length CV decreased more markedly as smartphone game scores increased (R2 = 28.2%). In conclusion, children are at a higher risk of pedestrian accidents when using smartphones while walking compared to young adults.

Evaluating Cognitive-Motor Interference in Multiple Sclerosis: A Technology-Based Approach.

People with multiple sclerosis (PwMS) frequently present both cognitive and motor impairments, so it is reasonable to assume they may have difficulties in executing dual-tasks (DT). The aim of the present study is to identify novel technology-based parameters to assess cognitive-motor interference (CMI) in PwMS. In particular, we focused on the definition of dual-task cost (DTC) measures using wearable and portable tools such as insoles and mobile apps. All participants underwent a verbal fluency task (cognitive single-task, ST), a motor ST of walking, and a combination of these tasks (DT). Number of words uttered in the cognitive ST and steps recorded by insoles were used to calculate the motor and cognitive DTC. The number of steps strongly correlated with the walked meters for both single- (r = 0.88, p < 0.05) and dual- (r = 0.91, p < 0.05) tasks. Motor but not cognitive performances significantly worsened during DT. Over the cognitive ST and DT, the number of pronounced words progressively decreased, probably due to the activation of different cognitive processes. Cognitive efforts could be the cause of cognitive task prioritization. Our findings promote the use of low-cost devices to assess CMI easily in the clinical context and to detect ecologically valid DT impairments.

Cognitive-Motor Dual-Task Performance of the Landing Error Scoring System.

The Landing Error Scoring System (LESS) is a common assessment used to determine biomechanical landing errors. However, this assessment is completed as a single motor task, which does not require additional attentional resources. It is unclear if the LESS can be used to detect cognitive-motor interference (i.e., dual-task cost) in biomechanical errors associated with lower extremity injury. To determine if the LESS is a suitable clinical assessment of dual-task performance in uninjured females and to evaluate whether specific landing criteria are more affected by an additional cognitive load than others. Observational Cross-Sectional Design. Setting: University research laboratory. Twenty uninjured, physically active females participated. Intervention(s): Participants performed the LESS under three different conditions: baseline landing with no cognitive distraction (Single), a visual-based dual-task (Visual), and a number-based dual-task (Number). Mean sagittal, frontal, and total LESS scores were compared between conditions using a one-way repeated measures analysis of variance with Tukey post hoc corrections. Cohen's d effect sizes with 95% confidence intervals were used to determine the magnitude of differences. The frequency of errors for each individual LESS item under the three conditions were compared using Chi-Squared analyses. Participants exhibited greater sagittal plane (P=.013, d=0.91 [0.26, 1.56]) and total (P=.008, d=1.03 [0.37, 1.69]) errors during the Visual condition compared to the Single condition. Frontal plane errors were significantly greater during the Number condition compared to the Single condition (P=.008, d=1.03 [0.37, 1.69]). The frequency of errors observed for each LESS item did not statistically differ between conditions (all P>.05). The LESS was able to detect a dual-task cost in landing errors during both the Visual and Number conditions. We recommend developing clinically-oriented solutions to incorporate similar dual- task paradigms in traditional injury risk reduction programs.

Cognitive function influences cognitive-motor interference during dual task walking in multiple sclerosis

BackgroundBoth physical and cognitive impairments are common in people with multiple sclerosis (PwMS). Performing a cognitive task while walking (i.e., dual-task walking) can introduce cognitive-motor interference (CMI), resulting in changes in walking performance. The association between the levels of cognitive impairment and of CMI in MS remains unclear. ObjectivesTo examine the association between cognitive functioning and differences in walking performance arise between single- and dual-task walking. MethodsNinety-five PwMS performed self-preferred pace walking and dual-task walking. The gait parameters recorded were used to compute dual task costs (DTC) as a metric of CMI. Cognitive functioning was assessed using Match, an unsupervised test developed based on the Symbol Digit Modalities Test. Participants were categorized as higher (HCF) and lower cognitive functioning (LCF) based on a Match z-score < −1.5. ResultsLCF group had elevated DTC for stride velocity, relative to the HCF group. Higher DTC for stride velocity was associated with lower cognition, as assessed by Match test. ConclusionThe findings support the hypothesis that CMI is associated with cognitive functioning in PwMS.

Cognitive-motor interference during walking with modified leg mechanics: a dual-task walking study.

The use of mobile exoskeletons as assistive walking devices has the potential to affect the biomechanics of the musculoskeletal system due to their weight and restricted range of motion. This may result in physical and cognitive load for the user. Understanding how lower extremity loading affects cognitive-motor interference is crucial for the design of wearable devices, including powered exoskeletons, and the development of effective training interventions. This study aims to examine the effects of modified leg mechanics on cognitive-motor interference in dual-task walking. Gait variability, as an indicator of motor control, was analyzed to investigate its relation to cognitive task difficulty and to determine whether lower extremity loading modifies this relationship. Additionally, the impact on the gait pattern, as represented by the mean values of spatio-temporal gait parameters were investigated. Fifteen healthy young adults walked on a treadmill with and without weight cuffs bilaterally attached to their thighs and shanks while performing a visual-verbal Stroop test (simple task) and a serial subtraction task (difficult task). Dependent variables include mean values and variability (coefficients of variation) of step length, step width, stride time and double support time. Additionally, secondary task performance as correct response rates and perceived workload were assessed. Double support time variability decreased during dual-task walking, but not during walking with modified leg mechanics while performing the difficult secondary task. Walking with modified leg mechanics resulted in increased gait variability compared to normal walking, regardless of cognitive load. During walking with modified leg mechanics, step length, step width, and stride time increased, while double support time decreased. The secondary tasks did not affect the gait pattern. The interplay between an external focus of attention and competition for attentional resources may influence the variability of double support time. The findings suggest that walking with modified leg mechanics could increase cognitive-motor interference for healthy young adults in demanding dual-task situations. Therefore, it is important to analyze the underlying mechanisms of cognitive-motor interference in the context of human-exoskeleton interaction.

Mobile EEG for the study of cognitive-motor interference during swimming?

Research on brain function in natural environments has become a new interest in cognitive science. In this study, we aim to advance mobile electroencephalography (EEG) participant and device mobility. We investigated the feasibility of measuring human brain activity using mobile EEG during a full-body motion task as swimming, by the example of cognitive-motor interference (CMI). Eleven participants were given an auditory oddball task while sitting and swimming, with mobile EEG recording ongoing brain activity. Measures of interest were event-related potentials (ERPs) elicited by experimental stimuli. While the auditory N100 was measured to verify signal quality, the P300 to task-relevant stimuli served as a marker of CMI effects. Analyzes were first performed within subjects, while binomial tests assessed the proportion of significant effects. Event-related changes in the time-frequency domain around turns during swimming were analyzed in an exploratory fashion. The successful recording of the N100 in all conditions shows that the setup was functional throughout the experiment. Regarding CMI, we did not find reliable changes in P300 amplitude in different motor settings in all subjects. However, we found plausible modulations in the alpha/mu and beta bands before and after turns. This study shows that it is generally feasible to measure mobile EEG in the time and time-frequency domain in an aquatic environment while subjects are freely moving. We see promising potential in the use of mobile EEG in extreme settings, advancing toward the application of mobile EEG in more real-life situations.

Impact of a passive upper-body exoskeleton on muscular activity and precision in overhead single and dual tasks: an explorative randomized crossover study.

Tasks performed at or above head height in industrial workplaces pose a significant challenge due to their association with musculoskeletal disorders. Upper-body exoskeletons have been identified as a potential solution for mitigating musculoskeletal loads and fighting against excessive muscular fatigue. However, the influence of such support on fine motor control, as well as on cognitive-motor interference, has received limited attention thus far. Therefore, this crossover randomized study aimed to investigate the impact of the use of a passive upper-body exoskeleton in the presence of muscular fatigue or not. Additionally, focusing on differences between single (ST) and dual (DT) industrial tasks consisting of overhead speed and accuracy exercises. In both scenarios, N = 10 participants (5 male/5 female) engaged in an overhead precision task using a nail gun to precisely target specific areas on three differently sized regions, based on Fitts' law paradigm (speed-accuracy trade-off task). This was done with and without the passive upper-body exoskeleton, before and immediately after a fatiguing exercise of shoulder and leg muscles. In addition, a second task (dual-task, DT) was carried out in which the occurrence of an auditory signal had to be counted. The main outcomes were muscular activation of the shoulder girdle as well as the time to perform speed-accuracy tasks of different difficulty indexes (calculated by means of Fitts' law). In the absence of fatigue, the exoskeleton did not affect the speed-accuracy trade-off management of participants in the single task, but it did in the dual-task conditions. However, after muscle fatigue, the speed-accuracy trade-off was differently affected when comparing its execution with or without the exoskeleton. In general, the dual task resulted in longer times to perform the different tasks, whether it was with or without the exoskeleton. Furthermore, the use of the exoskeleton decreased muscle activity, which is associated with less physical effort, but only significantly for the M. deltoideus and M. trapezius when compared by tasks. Overall, these study findings highlight the potential supportive effects of using an upper-body exoskeleton for industrial overhead tasks.

Evaluation of mild-to-moderate COVID-19 through dual-task paradigm: a longitudinal case-controlled study.

Coronavirus disease (COVID-19) was associated with cognitive alterations affecting everyday life activities. These need input integration of both motor and cognitive systems. The study aim is to evaluate cognitive-motor interference phenomenon in previously independent patients with mild-to-moderate COVID-19 (PwMCOVID-19) compared with healthy controls (HC), through dual-task (DT) paradigm. PwMCOVID-19 were included if being independent at home, had no previous referred cognitive impairment, mechanical ventilation or oxygen need. They were assessed at admission and after 6 months with a motor-cognitive DT test (counting backward by twos while walking 2 min). HC were enrolled as control group. Differences between single-task (ST) and DT performance, DT effect (DTE) and task prioritization amongst groups and during time points were analyzed. One-hundred PwMCOVID-19 [mean age=67.32(12.08) years; 53 M/47 F] and 39 HC [mean age=63.11(9.90) years; 20 M/19 F] were recruited. Upon T0, PwMCOVID-19 showed lower cognitive and motor DT performances than ST and HC. Mutual interference pattern was predominant in PwMCOVID-19. At T1, 41 PwMCOVID-19 were examined [mean age=64.85(10.75); 22 M/19 F]. They had a worse DT performance compared to ST, although DT improved at T1. A stronger cognitive ST-DT difference was present at T0, compared to ST-DT difference at T1, while motor ST-DT difference was unchanged over time in PwCOVID-19. In PwMCOVID-19, there is an impairment of DT counting while walking at baseline and after 6 months from hospitalization, with a more pronounced DT mutual interference pattern at T0. After 6 months, the motor and cognitive ST and DT performances ameliorated, not reaching the HC level.

Cognitive Task Domain Influences Cognitive-Motor Interference during Large-Magnitude Treadmill Stance Perturbations.

Reactive balance is postulated to be attentionally demanding, although it has been underexamined in dual-tasking (DT) conditions. Further, DT studies have mainly included only one cognitive task, leaving it unknown how different cognitive domains contribute to reactive balance. This study examined how DT affected reactive responses to large-magnitude perturbations and compared cognitive-motor interference (CMI) between cognitive tasks. A total of 20 young adults aged 18-35 (40% female; 25.6 ± 3.8 y) were exposed to treadmill support surface perturbations alone (single-task (ST)) and while completing four cognitive tasks: Target, Track, Auditory Clock Test (ACT), Letter Number Sequencing (LNS). Three perturbations were delivered over 30 s in each trial. Cognitive tasks were also performed while seated and standing (ST). Compared to ST, post-perturbation MOS was lower when performing Track, and cognitive performance was reduced on the Target task during DT (p < 0.05). There was a larger decline in overall (cognitive + motor) performance from ST for both of the visuomotor tasks compared to the ACT and LNS (p < 0.05). The highest CMI was observed for visuomotor tasks; real-life visuomotor tasks could increase fall risk during daily living, especially for individuals with difficulty attending to more than one task.

Clinical Correlates Of Cognitive-motor Interference During Jump Landings Following Anterior Cruciate Ligament Reconstruction

Clinical Correlates Of Cognitive-motor Interference During Jump Landings Following Anterior Cruciate Ligament Reconstruction

The Effect of Cognitive Task, Gait Speed, and Age on Cognitive-Motor Interference during Walking.

Dual-tasking can cause cognitive-motor interference (CMI) and affect task performance. This study investigated the effects of age, gait speed, and type of cognitive task on CMI during gait. Ten younger and 10 older adults walked on a pressure-sensitive GAITRite walkway which recorded gait speed and step length. Participants walked at a slow, preferred, or fast speed while simultaneously completing four cognitive tasks: visuomotor reaction time (VMRT), serial subtraction (SS), word list generation (WLG), and visual Stroop (VS). Each combination of task and speed was repeated for two trials. Tasks were also performed while standing. Motor and cognitive costs were calculated with the formula: ((single-dual)/single × 100). Higher costs indicate a larger reduction in performance from single to dual-task. Motor costs were higher for WLG and SS than VMRT and VS and higher in older adults (p < 0.05). Cognitive costs were higher for SS than WLG (p = 0.001). At faster speeds, dual-task costs increased for WLG and SS, although decreased for VMRT. CMI was highest for working memory, language, and problem-solving tasks, which was reduced by slow walking. Aging increased CMI, although both ages were affected similarly by task and speed. Dual-task assessments could include challenging CMI conditions to improve the prediction of motor and cognitive status.

The impact of vestibular function on cognitive–motor interference: a case–control study on dual-tasking in persons with bilateral vestibulopathy and normal hearing

Bilateral vestibulopathy (BV) is a chronic vestibular disorder, characterized by bilaterally absent or significantly impaired vestibular function. Symptoms typically include, but are not limited to, unsteadiness and movement-induced blurred vision (oscillopsia). This prospective case–control study aimed to elucidate the impact of BV on cognitive and motor performance and on cognitive–motor interference. Cognitive and motor performance, as well as cognitive–motor interference were measured in persons with BV and normal hearing using the 2BALANCE dual-task protocol. The experimental group was matched to a healthy control group based on age, sex, and educational level. The 2BALANCE protocol comprises cognitive tests assessing visuospatial memory, mental rotation, visual and auditory response inhibition, visual and auditory working memory, and processing speed. The cognitive tests were performed in single-task condition (while seated), and in dual-task condition (during a static and a dynamic motor task). The static motor task consisted of balancing on a force platform with foam pad. The dynamic motor task consisted of walking at a self-selected speed. These motor tasks were also performed in single-task condition. A generalized estimating equations model was used to investigate group differences for all cognitive and motor outcome measures. The estimated marginal means, as well as the odds ratios (OR), and their 95% confidence intervals (CI) were calculated. For the backward digit recall test, a baseline measurement was performed and analyzed using a student-t test. A total of 22 patients with BV and normal hearing and 22 healthy control subjects were assessed [mean age (SD), BV = 53.66 (13.35) and HC = 53.21 (13.35), 68% male]. The BV group had poorer mental rotation skills in single-task condition, compared to the control group [odds ratio (OR) = 2.30, confidence interval (CI) = 1.12–4.73, P = 0.024]. Similarly, auditory and visual working memory were also poorer in the BV group in single-task condition (P = 0.028 and P = 0.003, respectively). The BV group also performed poorer on the mental rotation task and the visual response inhibition task in dual-task condition (OR = 2.96, CI = 1.57–5.59, P < 0.001 and OR = 1.08, CI = 1.01–1.16, P = 0.032, respectively). Additionally, an interaction effect, indicating increased cognitive–motor interference in the BV group, was observed for mental rotation, response inhibition, and auditory working memory (P = 0.003 to 0.028). All static motor outcome parameters indicated more postural sway in the BV group compared to the control group for all test conditions (P < 0.001 to 0.026). No group differences were noted for the dynamic motor task. These findings suggest a link between vestibular function and cognitive performance, as well as a greater interference between cognitive and motor performance in BV, compared to healthy controls.

Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome

BackgroundIndividuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AimsThis study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). Methods and proceduresFifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. Outcomes and resultsIn the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. ConclusionAdolescents with DS are more prone to DT effects on postural balance than those with TD.

Association of Bilateral Vestibulopathy With and Without Hearing Loss With Cognitive-Motor Interference

The past years, evidence suggested that the primary symptoms traditionally associated with bilateral vestibulopathy (BV) do not represent the full picture of this patient population. Recent literature also demonstrated cognitive impairment. However, although multitasking and dual-tasking are widely present in everyday activities, most of these studies assessed cognitive function only in single-task conditions. To uncover the association of BV with and without hearing loss with cognitive and motor performance and cognitive-motor interference. This prospective case-control study assessed persons with an isolated BV and persons with BV and a concomitant hearing loss compared with a healthy control group. Data were analyzed in December 2022. The study was conducted at Ghent University (Ghent, Belgium). Data collection took place between March 26, 2021, and November 29, 2022. All participants completed the 2BALANCE dual-task protocol, comprising a static and a dynamic motor task that was combined with 5 visual cognitive tasks. These cognitive tasks assessed mental rotation, visuospatial memory, working memory, response inhibition (executive function), and processing speed. All cognitive tasks were performed in a single-task condition (while seated) and in a dual-task condition (combined with a static and a dynamic motor task). The static task comprised balancing on a force platform with foam pad, and the dynamic task comprised walking at a self-selected speed on the GAITRite Walkway. Both motor tasks were performed in the single-task and dual-task condition. Nineteen persons with BV and hearing loss (mean [SD] age, 56.70 [10.12] years; 10 women [52.6%]), 22 persons with an isolated BV (mean [SD] age, 53.66 [13.35] years; 7 women [31.8%]), and 28 healthy control participants were included (mean [SD] age, 53.73 [12.77] years; 12 women [42.9%]). Both patient groups had mental rotation and working memory impairment in a single-task condition and slower processing speed when walking (ie, during the dynamic dual-task condition). Additionally, the patient group with hearing loss had impaired visuospatial memory and executive function deficits in single-task and dual-task conditions, while this could only be elicited when performing a motor task in persons with isolated BV (ie, when dual-tasking). The findings of this case-control study suggest an association between vestibular function and cognitive and motor performance, even greater in persons with a concomitant hearing loss than in persons with an isolated BV.