Computerized Dual-Task Testing of Gait and Visuospatial Cognitive Functions; Test-Retest Reliability and Validity

Abstract

The common occurrence of age decline in mobility and cognition does cause a decrease in the level of physical activity and an increased falls risk. Consequently, dual -task (DT) assessment that simultaneously addresses both mobility skills and cognitive functions are important because, continued difficulties and fall injuries will have a sizable impact in this population. The first objective of the present study was to assess test-retest reliability of a computerized DT treadmill walking protocol and concurrent outcome measures of gait and visuospatial executive function in a group of healthy older adults. Secondly, discriminative validity was evaluated by examining the effect of DT conditions (single task vs. dual-task) on; (a) spatiotemporal gait measures (average and coefficient of variation) and (b) visuomotor and visuospatial executive performance measures. Twenty-five community-dwelling individuals median age 65 (range 61–67) were recruited from a Fitness Facility. Participants performed a computerized visuomotor tracking task and a visuospatial executive game task in standing and while treadmill walking. Testing was conducted on two occasions, 1 week apart. Moderate to high test-retest reliability (ICC values of 0.65–0.88) were observed for spatiotemporal gait variables. No significant differences between the group means were observed between test periods in any gait variable. Moderate test-retest reliability (ICC values of 0.6–0.65) was observed for measures of visuomotor and visuospatial executive performance during treadmill walking. Significant DT effects were observed for both spatiotemporal gait variables and visuospatial executive performance measures. This study demonstrates the reliability and reproducibility of the computer-based assessment tool for dual task treadmill walking. The high to moderate ICC values and the lack of systematic errors in the measures indicate that this tool has the ability to repeatedly record reliable data from community-dwelling older adults. The present computerized dual-task protocols broaden the types of standardized visuomotor and visuospatial executive activities for use with DT treadmill walking that has previously been reported.

Imaging Cerebral Glucose Metabolism during Dual‐Task Walking in Patients with Parkinson's disease

“…A custom computer application with the following two assessment modules was used for the DT test conditions: (1) a visuomotor (VM) task and (2) a visuospatial cognitive game (VCG) task. As described in previous publications, 11,23 an inertial-based mouse (Scoop Pointer Remote Model: RXR1000-0302E; Hillcrest Labs, Rockville, MD) was used to control and interact with the cognitive assessment games. As per our published method, 11 assessment of gait function under single-task (walk only) and DT conditions (VM and VCG tasks) was conducted on a treadmill instrumented with a pressure mapping system (Vista Medical Ltd. Medical, Winnipeg, Canada).…”

“…As described in previous publications, 11,23 an inertial-based mouse (Scoop Pointer Remote Model: RXR1000-0302E; Hillcrest Labs, Rockville, MD) was used to control and interact with the cognitive assessment games. As per our published method, 11 assessment of gait function under single-task (walk only) and DT conditions (VM and VCG tasks) was conducted on a treadmill instrumented with a pressure mapping system (Vista Medical Ltd. Medical, Winnipeg, Canada). Treadmill walking was used to obtain 30 consecutive steps at a constant speed for both the walk only and DT walk trials.…”

“…To investigate the different DT interference effects on the prefrontal regions across individuals, a single subject t-test was performed with inclusive masking of Brodmann's area 8,9,10,11,12,24,32,44,45,46, and 47. A single subject t-test is essentially a two-sample t-test with n = 1 (DT) versus n = 10 (REST).…”

“…A detailed description of the GTP and applications is available in a prior publication. 11 At present, understanding the neural underpinnings of DT walking and training effects in PD is limited due to methodological limitations in neuroimaging. 12 The majority of neuroimaging investigations of DT walking have utilized functional near infrared spectroscopy and have revealed that the prefrontal cortex is bilaterally active and remains active during DT walking as compared to single task walking.…”

Extrahippocampal Contributions to Age-Related Changes in Spatial Navigation Ability

“…This is because older adults’ slower movements effectively increase the delay or retention intervals across learning trials, and sets up dual tasking scenarios (e.g., attending to stimuli on screen and manipulating the control device simultaneously) for older adults that may not necessarily apply to younger adults. More specifically, prefrontal executive resources have been shown to be vital for older adults in mediating the dual task demands of visual and motor processing (Taillade et al, 2013a ), as well as in supporting gait (Szturm et al, 2017 ). Declines in these functions may thus predispose older adults to slower movements and poorer cognitive performance in both virtual (Taillade et al, 2013a , b , 2016 ; Szturm et al, 2017 ) and real-world (Taillade et al, 2016 ) environments.…”