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Gait speed is more challenging than cognitive load on the stride-to-stride variability in individuals with anterior cruciate ligament deficiency
Authors:Salman Nazary-Moghadam  Mahyar Salavati  Ali Esteki  Behnam Akhbari  Sohrab Keyhani  Afsaneh Zeinalzadeh
Affiliation:1. Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran;2. Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran;3. Department of Biomedical Engineering and Physics, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran;4. Akhtar Orthopedic Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Abstract:

Background

Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.

Methods

The knee flexion–extension Lyapunov exponent (LyE) was measured in 22 ACL-deficient (Mean±SD) (25.95?±?4.69?years) and 22 healthy subjects (24.18?±?3.32?years). They walked at three levels of gait speed in isolation or concurrently with a cognitive task.

Results

Repeated-measure analyses of variance (ANOVAs) demonstrated that the interaction of group by gait speed was statistically significant. As the gait speed increased from low to high, the knee flexion–extension LyE significantly decreased for the subjects with ACL deficiency (effect size: 0.57, P?=?0.01). The interaction of group by cognitive load was not statistically significant (P?=?0.07). In addition, the ACL-deficient subjects had statistically slower reaction times than healthy subjects during the dual-task compared with the single-task condition.

Conclusions

The ACL-deficient and healthy individuals had a tendency to maintain safe gait. It seems that the ACL-deficient subjects sacrificed the cognitive task more than the healthy individuals to pay more attention toward gait. Additionally, it seems that the gait speed was more challenging than cognitive load on the stride-to-stride variability in the individuals with ACL deficiency.
Keywords:Anterior cruciate ligament  Dual task  Gait analysis  Lyapunov exponent  Stride-to-stride variability
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