Cognitive motor interference during dual-task gait in essential tremor |
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| Authors: | Ashwini K Rao Jasim Uddin Arthur Gillman Elan D Louis |
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| Institution: | 1. Program in Physical Therapy and G.H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, USA;2. Program in Physical Therapy, Columbia University College of Physicians and Surgeons, New York, USA;3. G.H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, USA;4. G.H. Sergievsky Center, Taub Institute for Alzheimer''s Disease and the Aging Brain and Department of Neurology, Columbia University College of Physicians and Surgeons, New York, USA;5. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA;1. School of Physical Education and Sport at Ribeirão Preto, University of São Paulo, Brazil;2. Department of Physical Education, Biosciences Institute, São Paulo State University, Brazil;1. Walter Reed National Military Medical Center, Department of Orthopaedics and Rehabilitation, Bethesda, MD, United States;2. Seattle Veterans Administration Medical Center, Seattle, WA, United States;3. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States;1. Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany;2. Novotec Medical GmbH, 75172 Pforzheim, Germany;1. Université Versailles Saint Quentin en Yvelines, EA 4497, CIC-IT 805, APHP Service de physiologie et d’exploration fonctionnelle, Hôpital Raymond Poincaré, 92380 Garches, France;2. Laboratoire AGIM, FRE 3405 CNRS/UJF Grenoble/UPMF/EPHE, La Tronche, France;3. Institut Universitaire de France, 103, boulevard Saint-Michel, 75005 Paris, France;1. Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE, USA;2. Movement to Health Laboratory (EA 2991), Montpellier-1 University, Montpellier, France;3. Laboratoire de Neurosciences Cognitives (UMR 7291), CNRS & Aix-Marseille Université, Marseille, France;4. Environmental, Agricultural and Occupational Health Sciences, College of Public Health Department, University of Nebraska Medical Center, Omaha, NE, USA |
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| Abstract: | BackgroundFunctional ambulation requires concurrent performance of motor and cognitive tasks, which may create interference (degraded performance) in either or both tasks. People with essential tremor (ET) demonstrate impairments in gait and cognitive function. In this study we examined the extent of interference between gait and cognition in people with ET and controls during dual-task gait.MethodsWe tested 62 controls and 151 ET participants (age range: 72–102). ET participants were divided into two groups based on median score on the modified Mini Mental State Examination. Participants walked at their preferred speed, and performed a verbal fluency task while walking. We analyzed gait velocity, cadence, stride length, double support time, stride time, step width, step time difference, coefficient of variation (CV) of stride time and stride length.ResultsVerbal fluency performance during gait was similar across groups (p = 0.68). Velocity, cadence and stride length were lowest whereas step time difference (p = 0.003), double support time (p = 0.009), stride time (p = 0.002) and stride time CV (p = 0.007) were highest for ET participants with lower cognitive scores (ETp-LCS), compared with ET participants with higher cognitive scores (ETp-HCS) and controls. ETp-LCS demonstrated greatest interference for double support time (p = 0.005), step time difference (p = 0.013) and stride time coefficient of variation (p = 0.03).ConclusionsETp-LCS demonstrated high levels of cognitive motor interference. Gait impairments during complex tasks may increase risk for falls for this subgroup and underscore the importance of clinical assessment of gait under simple and dual-task conditions. |
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