The influence of divided attention on walking turns: Effects on gait control in young adults with and without a history of low back pain |
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| Institution: | 1. Department of Physical Therapy, Harry and Diane Rinker Health Science Campus, Chapman University, 9401 Jeronimo Rd, Irvine, CA 92618, USA;2. Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar Street, CHP-155, Los Angeles, CA 90089, USA;1. Institute of Environmental Engineering, ETH Zurich, Zurich, Switzerland;2. Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland;1. School of Engineering and Applied Science, University of Virginia, Charlottesville, VA 22904, USA;2. Department of Mechanical Engineering, Dublin City University, Glasnevin, Dublin 9, Ireland;1. Department of Mechanical & Industrial Engineering, Montana State University, United States;2. Department of Cell Biology & Neurosciences, Montana State University, United States;3. Department of Orthopaedics & Sports Medicine, University of Washington, United States;1. Graduate School of Engineering Science, Osaka University, 1-3 Machikaneyama, Toyonaka, Osaka 560-8531, Japan;2. Division of Dental Informatics, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan;1. Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands;2. Department of Orthopedic Surgery, State University of New York, Upstate Medical University, Syracuse, NY, USA;3. University of Twente, Laboratory for Biomechanical Engineering, Faculty of Engineering Technology, Enschede, The Netherlands;1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy;2. Department of Geriatrics, Azienda Sanitaria dell''Alto Adige, Bolzano, Italy;3. Emergency Department, Azienda Sanitaria dell''Alto Adige, Bolzano, Italy;4. National Research Council, Institute of Neuroscience, Aging Branch, Padova, Italy |
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| Abstract: | The cognitive control of gait is altered in individuals with low back pain, but it is unclear if this alteration persists between painful episodes. Locomotor perturbations such as walking turns may provide a sensitive measure of gait adaptation during divided attention in young adults. The purpose of this study was to investigate changes in gait during turns performed with divided attention, and to compare healthy young adults with asymptomatic individuals who have a history of recurrent low back pain (rLBP). Twenty-eight participants performed 90° ipsilateral walking turns at a controlled speed of 1.5 m/s. During the divided attention condition they concurrently performed a verbal 2-back task. Step length and width, trunk-pelvis and hip excursion, inter-segmental coordination and stride-to-stride variability were quantified using motion capture. Mixed-model ANOVA were used to examine the effect of divided attention and group, and interaction effects on the selected variables. Step length variability decreased significantly with divided attention in the healthy group but not in the rLBP group (post-hoc p = 0.024). Inter-segmental coordination variability was significantly decreased during divided attention (main effect of condition p < 0.000). There were small but significant reductions in hip axial and sagittal motion across groups (main effect of condition p = 0.044 and p = 0.040 respectively), and a trend toward increased frontal motion in the rLBP group only (post-hoc p = 0.048). These findings suggest that the ability to switch attentional resources during gait is altered in young adults with a history of rLBP, even between symptomatic episodes. |
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| Keywords: | Walking turn Divided attention Low back pain Variability |
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