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Frengopoulos C.1, Janes I.1, Modarresi S.1, Thompson S.1, Hunter S.2
1Western University, Health & Rehabilitation Sciences, London, Canada, 2Western University, Physical Therapy, London, Canada
Background: Walking is a complex task and cognition, specifically executive function, plays a key role in the normal regulation of walking. Complex tasks need high levels of motor control and require cognition to generate motor patterns that are responsive to sensory inputs and environmental conditions. Dual-task testing assesses the interaction between cognition and walking, but the impact of different test protocols is limited.
Purpose: The objective is to evaluate the influence of the test protocol feature of walking path configuration on the performance of dual-task gait testing in healthy young and older adults.
Methods: Cross-sectional study with 20 young adults (age=24.2±1.7 years, 50% female) and 20 older adults (age=68.6±5.3 years, 65% female) without history of concussion, subjective memory complaints or history of falls in last 12 months. Cognition was measured with the Trail Making Test A and B (executive function) and the Montreal Cognitive Assessment. Three walking configurations straight-path and two complex-paths over a 6-meter distance at a self-selected comfortable speed were evaluated. The straight-path configuration had participants walk in a straight line. The complex-path walking patterns were the Figure-of-8 Walk (FOE) Test and the Timed Up & Go (TUG) Test. Dual-task testing protocols in each path configuration involved four tests with a cognitive task (counting forwards by ones, counting backwards by threes, having a conversation, and a verbal fluency task, four tests using a secondary motor task (turning the head to the left and right, carrying a wine glass filled with water on a tray, stepping over 6-inch blocks on the floor and needing to step on/off a step) and one combined multi-task (carrying a glass of water and counting backwards by 3s) in each path configuration. Velocity and dual-task cost (DTC) were calculated for each task. Mann-Whitney tests were used to compare velocity and dual-task cost between young and older adults for each task in each path configuration.
Results: In the straight-path, young and older adults walked over 1m/s for all tasks. Velocity was different in single task for young adults (1.30±0.13 versus 1.21±0.15, p=0.035), but there was no difference in DTC. In the FOE, gait was under 1m/s for all tasks in both groups and older adults walked at a slower velocity on all tasks (p 0.05), except carrying a glass of water. DTC differed in the FOE for counting forward by 1s only, older adults had an improvement in gait (p=0.38). In the TUG, both groups walked slower than 1m/s and young adults walked faster on all tasks (p 0.05). DTC differed only on counting backwards by 3s (p=0.01), with older adults experiencing a greater decrement is performance.
Conclusion(s): The path configuration has an impact on velocity and DTC, with slower walking in the complex-path configurations. The complex-paths demonstrated greater differences between young and older adults than the straight-path. The DTC showed minimal difference between healthy young and older adults.
Implications: Path configurations in dual-task gait testing are not interchangeable, the testing protocol should be consistent within a person and comparison using different protocols should not be used.
Funding acknowledgements: Not applicable
Topic: Older people
Ethics approval: This study was approved by Western University Health Science Research Ethics board (HSREB#107242).
All authors, affiliations and abstracts have been published as submitted.
