Cognitive-motor interference during gait in patients with Multiple Sclerosis: a mixed methods Systematic Review

Postigo-Alonso, B.; Galvao-Carmona, Alejandro; Benítez, Isabel; Conde-Gavilán, Cristina; Jover, Ana; Molina, Silvia; Peña-Toledo, María A.; Agüera, Eduardo

doi:10.1016/j.neubiorev.2018.08.016

Cited by 44 publications

(55 citation statements)

References 96 publications

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“…On the other hand, our results are comparable to the results noted in another recent meta-analysis of studies that assess CMI in pwMSs vs. HCs provided by Postigo-Alonso et al ( 9 ). It was reported that the DTC of gait velocity was significantly different in one study that used the DS as a cognitive distractor, as was done in this study ( 10 ), and that DTC of gait velocity was not different between pwMSs and the HC group in those studies involving walking and counting excluding 3's ( 11 ) or the alternate alphabet task ( 37 , 38 ).…”

Section: Discussionsupporting

confidence: 91%

“…However, in subsequent years, other research has shown no significant differences in DTC on gait performance between persons with and without MS ( 6 – 8 ). For example, the systematic review of Learmonth et al ( 8 ) indicated there is a non-significant minimal difference in CMI between pwMSs and HCs, while the most recent systematic review from Postigo-Alonso et al ( 9 ) concluded there was a significant difference in CMI in pwMSs, although this investigated studies related specifically to motor task–and cognitive task–related factors. Therefore, it seems that the presence of a significant DTC in pwMSs compared with HCs is dependent on the type of spatiotemporal gait parameter analyzed (velocity, cadence, double support, etc.…”

Section: Introductionmentioning

confidence: 99%

“…), as well as the type of the cognitive task added. For example, Postigo-Alonso et al ( 9 ) found that velocity is the most sensitive gait parameter to CMI, but it does not discriminate between pwMSs and HCs, whereas the verbal fluency task with cadence and/or double support and Serial Subtracting 7's with cadence were the proficient in discriminating CMI between pwMSs and HCs. However, it should be noted that they did not include from their analyses the study of Hamilton et al ( 10 ), as Digit Span (DS) was administered only in a forward direction, excluding to report on significant data regarding DTC of walking during a working memory task.…”

Section: Introductionmentioning

confidence: 99%

“…However, it should be noted that they did not include from their analyses the study of Hamilton et al ( 10 ), as Digit Span (DS) was administered only in a forward direction, excluding to report on significant data regarding DTC of walking during a working memory task. Postigo-Alonso et al ( 9 ) investigated the sensitivity and specificity of the following tasks: Alternate Alphabet, Serial Subtracting 7's, Serial Subtracting 3's, and verbal fluency.…”

Section: Introductionmentioning

confidence: 99%

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Comparing 16 Different Dual–Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive–Motor Interference

et al. 2020

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Background: Cognitive–motor interference (CMI) is measured by dual-tasking (DT), which involves motor and cognitive tasks. There is no consensus as to whether CMI is present in multiple sclerosis (MS). Objectives: We investigated the effects of 16 DT conditions by measuring motor complexity, cognitive domain, and task difficulty. Method: In total, 40 persons with MS (pwMSs) with Expanded Disease Status Scale (EDSS) 3.2 ± 1.7 and 31 age- and sex-matched healthy controls (HCs) completed 2 single walking, 8 single cognitive, and 2 complex walking tasks and 16 cognitive–motor DT. The main outcomes were mean values of gait velocity and the percentage change from single to DT (motor DT costs, mDTCs) and mean values of cognitive task accuracy and the percentage changes (cognitive DTC, cDTC). Results: Two-way analyses of variance showed the main effect of cognitive task yielded an F ratio of F (4, 268) = 72.35, p < 0.01, for mean gait velocity, and an F ratio of F (4, 304) = 17.12, p < 0.001, for mDTC, indicating that the mean velocity was significantly lower and the mDTC significantly higher for DS_B (mean = 1.27, SD = 0.03, and mean = 13.52, SD = 1.28, respectively). The main effect of cognitive task yielded an F ratio of F (4, 116) = 84.32, p < 0.001, with the lowest average accuracy for DS_B (mean = 43.95, SD = 3.33); no effect was found for cDTC. In pwMSs, the EDSS accounted for 28% ( F = 13.65, p = 0.001) of variance in a model predicting the highest mDTC. Conclusions: Overall, among different cognitive tasks added, the Digit Span backward was the most interfering cognitive task over gait velocity and accuracy. The effect was similar independently from the motor complexity and the group. PwMSs and HCs behaved in a similar manner at all motor complexity levels and during all cognitive task.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparing 16 Different Dual–Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive–Motor Interference

et al. 2020

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“…Moreover, 2 of 16 in daily life the performance of a motor and a cognitive task simultaneously, such as walking while talking, is a common act. In people with MS (pwMS), the combination of walking and a cognitive task often leads to reduced performance in one or both tasks, called cognitive-motor interference (CMI) [6][7][8]. This CMI is often quantified by the dual task cost (DTC), which is the percentage of change in dual task performance relative to single-task performance [6].…”

Section: Introductionmentioning

confidence: 99%

Structured Cognitive-Motor Dual Task Training Compared to Single Mobility Training in Persons with Multiple Sclerosis, a Multicenter RCT

Veldkamp

Baert

Kalron

et al. 2019

JCM

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The aim was to compare the effectiveness of dual-task training (DTT) compared to single mobility training (SMT) on dual-task walking, mobility and cognition, in persons with Multiple Sclerosis (pwMS). Forty pwMS were randomly assigned to the DTT or SMT groups. The DTT-group performed dual-task exercises using an interactive tablet-based application, while the SMT-group received conventional walking and balance exercises. Both interventions were supervised and identical in weeks (8) and sessions (20). Nine cognitive-motor dual-task conditions were assessed at baseline, after intervention and at 4-weeks follow-up (FU). The dual-task cost (DTC), percentage change of dual-task performance compared to single-task performance, was the primary outcome. Mobility and cognition were secondarily assessed. Mixed model analyses were done with group, time and the interaction between group and time as fixed factors and participants as random factors. Significant time by group interactions were found for the digit-span walk and subtraction walk dual-task conditions, with a reduction in DTC (gait speed) for the DTT maintained at FU. Further, absolute dual-task gait speed during walking over obstacles only improved after the DTT. Significant improvements were found for both groups in various motor and cognitive measures. However, the DTT led to better dual-task walking compared to the SMT.

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Dual‐task difficulties as a risk factor for unemployment in people with multiple sclerosis

Kahraman,

Temiz,

Abasiyanik

et al. 2023

Brain and Behavior

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BackgroundNo study has investigated the impact of dual‐tasking difficulties as a risk factor for unemployment in people with multiple sclerosis (pwMS). The aim was to examine the influence of dual‐task performance on employment status and work difficulties and to identify the predictors of employment status in pwMS.MethodsEighty‐four pwMS, including 42 employed and 42 unemployed, participated in the study. Dual‐task difficulties were assessed using the Dual‐task Impact on Daily‐living Activities‐Questionnaire (DIDA‐Q), while dual‐task performance was evaluated through the 30‐second Walk Test and Nine‐Hole Peg Test, incorporating a cognitive task. Walking and cognitive function were also measured.ResultsEmployed pwMS had better scores in walking, cognitive function, single and dual‐task performance than unemployed pwMS (p < .05). Lower scores in walking (odds ratio [OR] = 1.81, p < .001) and upper extremity‐related (OR = 1.44, p = .019) dual‐task performance and higher scores in the cognitive subscale of the DIDA‐Q questionnaire (OR = 1.20, p = .037) were significantly associated with higher odds of being unemployed. Among employed pwMS, DIDA‐Q subscales showed moderate‐to‐strong correlations with MSWSDQ‐23 scores. The other variables showed weak‐to‐moderate correlations with subscale and total scores of MSWSDQ‐23.ConclusionCognitive function, as opposed to motor function, has been found to be a significant predictor of unemployment in pwMS.

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Cognitive-motor interference during gait in patients with Multiple Sclerosis: a mixed methods Systematic Review

Cited by 44 publications

References 96 publications

Comparing 16 Different Dual–Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive–Motor Interference

Comparing 16 Different Dual–Tasking Paradigms in Individuals With Multiple Sclerosis and Healthy Controls: Working Memory Tasks Indicate Cognitive–Motor Interference

Structured Cognitive-Motor Dual Task Training Compared to Single Mobility Training in Persons with Multiple Sclerosis, a Multicenter RCT

Dual‐task difficulties as a risk factor for unemployment in people with multiple sclerosis

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