Balancing the Demands of Two Tasks: An Investigation of Cognitive-Motor Dual-Tasking in Relapsing Remitting Multiple Sclerosis

被引:17
作者
Butchard-MacDonald, Emma [1 ]
Paul, Lorna [2 ]
Evans, Jonathan J. [1 ]
机构
[1] Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland
[2] Glasgow Caledonian Univ, Inst Appl Hlth Res, Glasgow, Lanark, Scotland
关键词
Attention; Anxiety; Balance; Postural; Cognition; Falls; POSTURAL CONTROL; HOSPITAL ANXIETY; IMPACT SCALE; WALKING; ATTENTION; TALKING; DEPRESSION; INTERFERENCE; IMPAIRMENT; FATIGUE;
D O I
10.1017/S1355617717000947
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: People with relapsing remitting multiple sclerosis (PwRRMS) suffer disproportionate decrements in gait under dual-task conditions, when walking and a cognitive task are combined. There has been much less investigation of the impact of cognitive demands on balance. Objectives: This study investigated whether: (1) PwRRMS show disproportionate decrements in postural stability under dual-task conditions compared to healthy controls, and (2) dual-task decrements are associated with everyday dual-tasking difficulties. The impact of mood, fatigue, and disease severity on dual-tasking was also examined. Methods: A total of 34 PwRRMS and 34 matched controls completed cognitive (digit span) and balance (movement of center of pressure on Biosway on stable and unstable surfaces) tasks under single- and dual-task conditions. Everyday dual-tasking was measured using the Dual-Tasking Questionnaire. Mood was measured by the Hospital Anxiety & Depression Scale. Fatigue was measured via the Modified Fatigue Index Scale. Results: No differences in age, gender, years of education, estimated pre-morbid IQ, or baseline digit span between groups. Compared with controls, PwRRMS showed significantly greater decrement in postural stability under dual-task conditions on an unstable surface (p = .007), but not a stable surface (p = .679). Balance decrement scores were not correlated with everyday dual-tasking difficulties or fatigue. Stable surface balance decrement scores were significantly associated with levels of anxiety (rho = 0.527; p = .001) and depression (rho = 0.451; p = .007). Conclusions: RRMS causes dual-tasking difficulties, impacting balance under challenging conditions, which may contribute to increased risk of gait difficulties and falls. The relationship between anxiety/depression and dual-task decrement suggests that emotional factors may be contributing to dual-task difficulties.
引用
收藏
页码:247 / 258
页数:12
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