Automaticity of walking – implications for physiotherapy practice

Abstract

Automaticity is the term used to indicate that a skill is performed with little demand on attentional resources. One of the features of everyday tasks performed by healthy people is their automaticity. For example, walking is normally automated so that it is possible to perform additional tasks, such as talking and/or buttoning a jacket, concurrently. This review examines models of attention underlying automaticity, methods to improve automaticity, measurement of automaticity and implications of this information for physiotherapy practice. A measure of automaticity, an automaticity index, is proposed which enables studies to be compared, patients to be assessed and interventions to be evaluated. Strategies for assessment and training of automaticity in clinical practice are outlined using the everyday task of walking as an example.

Is automaticity of walking regained after stroke?

“…To quantify automaticity of walking, an automaticity index [2] was calculated by expressing the velocity of walking under each additional task condition as a percentage of the velocity under the single-task condition, as seen in Table II. The automaticity indices shown in Figure 2b clearly demonstrate that walking was better automated in the young subjects than in the elderly or stroke subjects.…”

“…The methods and tasks used in this study provide a clinically feasible way of measuring automaticity of walking after stroke. An automaticity index [2] (i.e., walking velocity under dual-task conditions expressed as a percentage of walking velocity under single-task condition) can be calculated to give an indication of the current level of automaticity of walking, with an automaticity index 590%, indicating that walking has not been re-automated to an adequate level. It has been suggested that measures of automaticity of walking could provide useful information when considering the likelihood of safe community ambulation [8,9].…”

“…The extent of the decrement in the task of interest when performed with an additional task compared to when performed alone provides an indication of the automaticity of the task of interest. In the case of walking, the performance of additional tasks by healthy young adults only produces decrements of 5 -10% in walking performance, even when the additional tasks are complicated (for review, see [2]). …”

Relationship between walking performance and types of community-based activities in people with stroke: an observational study

“…This group of community-dwelling people with stroke could all walk and use stairs although with varying levels of performance. On average, walking speed 18 , automaticity 19 , capacity 20 , and ability to use stairs 21 was about three-quarters of normal elderly performance. Third, there are other factors that may correlate with community activity of this population.…”

Cognitive engineering

“…Automaticity is itself gradated so that tasks require more or less attention resources. Some researchers argue that all tasks have some attention costs, although they can be small, to the point that it is difficult to determine the attention cost with current methods90 (see Ref 91 for an alternative perspective). Nevertheless, there is significant evidence to suggest that skills become more automated and less attention demanding with practice 92.…”