Effects of an attention demanding task on dynamic stability during treadmill walking

BackgroundPeople exhibit increased difficulty balancing when they perform secondary attention-distracting tasks while walking. However, a previous study by Grabiner and Troy (J. Neuroengineering Rehabil., 2005) found that young healthy subjects performing a concurrent Stroop task while walking on a motorized treadmill exhibited decreased step width variability. However, measures of variability do not directly quantify how a system responds to perturbations. This study re-analyzed data from Grabiner and Troy 2005 to determine if performing the concurrent Stroop task directly affected the dynamic stability of walking in these same subjects.MethodsThirteen healthy volunteers walked on a motorized treadmill at their self-selected constant speed for 10 minutes both while performing the Stroop test and during undisturbed walking. This Stroop test consisted of projecting images of the name of one color, printed in text of a different color, onto a wall and asking subjects to verbally identify the color of the text. Three-dimensional motions of a marker attached to the base of the neck (C5/T1) were recorded. Marker velocities were calculated over 3 equal intervals of 200 sec each in each direction. Mean variability was calculated for each time series as the average standard deviation across all strides. Both "local" and "orbital" dynamic stability were quantified for each time series using previously established methods. These measures directly quantify how quickly small perturbations grow or decay, either continuously in real time (local) or discretely from one cycle to the next (orbital). Differences between Stroop and Control trials were evaluated using a 2-factor repeated measures ANOVA.ResultsMean variability of trunk movements was significantly reduced during the Stroop tests compared to normal walking. Conversely, local and orbital stability results were mixed: some measures showed slight increases, while others showed slight decreases. In many cases, different subjects responded differently to the Stroop test. While some of our comparisons reached statistical significance, many did not. In general, measures of variability and dynamic stability reflected different properties of walking dynamics, consistent with previous findings.ConclusionThese findings demonstrate that the decreased movement variability associated with the Stroop task did not translate to greater dynamic stability.

[1]  William H. Warren,et al.  Optic flow is used to control human walking , 2001, Nature Neuroscience.

[2]  A. Nayfeh,et al.  Applied nonlinear dynamics : analytical, computational, and experimental methods , 1995 .

[3]  D. Winter,et al.  Anticipatory control of upper body balance during human locomotion , 1994 .

[4]  Zhe Chen,et al.  Attentional focus, processing load, and Stroop interference , 2003, Perception & psychophysics.

[5]  Jeffrey M. Hausdorff,et al.  Effects of Cognitive Challenge on Gait Variability in Patients with Parkinson’s Disease , 2003, Journal of geriatric psychiatry and neurology.

[6]  Yu. A. Kuznetsov,et al.  Applied nonlinear dynamics: Analytical, computational, and experimental methods , 1996 .

[7]  M. Grabiner,et al.  Attention demanding tasks during treadmill walking reduce step width variability in young adults , 2005, Journal of NeuroEngineering and Rehabilitation.

[8]  E. Hurvitz,et al.  Peripheral neuropathy: a true risk factor for falls. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  J T Doucette,et al.  The Contribution of Predisposing and Situational Risk Factors to Serious Fall Injuries , 1995, Journal of the American Geriatrics Society.

[10]  T. M. Owings,et al.  Step width variability, but not step length variability or step time variability, discriminates gait of healthy young and older adults during treadmill locomotion. , 2004, Journal of biomechanics.

[11]  Jonathan B. Dingwell,et al.  A direct comparison of local dynamic stability during unperturbed standing and walking , 2006, Experimental Brain Research.

[12]  W Poewe,et al.  Influence of Concurrent Tasks on Gait: A Dual-Task Approach , 1995, Perceptual and motor skills.

[13]  T. M. Owings,et al.  Variability of step kinematics in young and older adults. , 2004, Gait & posture.

[14]  F Englander,et al.  Economic dimensions of slip and fall injuries. , 1996, Journal of forensic sciences.

[15]  F. Englander,et al.  Commentary on Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. J Forensic Sci 1996: 41(5):733-746 [1] (multiple letters) , 1997 .

[16]  P. Shekelle,et al.  Will my patient fall? , 2007, JAMA.

[17]  Jeffrey M. Hausdorff,et al.  Etiology and modification of gait instability in older adults: a randomized controlled trial of exercise. , 2001, Journal of applied physiology.

[18]  J. Donelan,et al.  Mechanical and metabolic requirements for active lateral stabilization in human walking. , 2004, Journal of biomechanics.

[19]  T. M. Owings,et al.  Mechanisms leading to a fall from an induced trip in healthy older adults. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  S. Haugland,et al.  Falls in the elderly , 1992, The Lancet.

[21]  Jorunn L Helbostad,et al.  Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults. , 2005, Gait & posture.

[22]  A B Schultz,et al.  Stepping over obstacles: dividing attention impairs performance of old more than young adults. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[23]  O. Beauchet,et al.  Dual-task-related gait changes in transitionally frail older adults : The type of the walking-associated cognitive task matter , 2005 .

[24]  F. Ando,et al.  Frequencies and circumstances of falls in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). , 2000, Journal of epidemiology.

[25]  M. Woollacott,et al.  Attention and the control of posture and gait: a review of an emerging area of research. , 2002, Gait & posture.

[26]  W. Sparrow,et al.  Ageing effects on the attention demands of walking. , 2002, Human movement science.

[27]  M. Rosenstein,et al.  A practical method for calculating largest Lyapunov exponents from small data sets , 1993 .

[28]  J. Dingwell,et al.  Nonlinear time series analysis of normal and pathological human walking. , 2000, Chaos.

[29]  C. Bard,et al.  Attentional demands for static and dynamic equilibrium , 2004, Experimental Brain Research.

[30]  Nir Giladi,et al.  Impaired regulation of stride variability in Parkinson's disease subjects with freezing of gait , 2003, Experimental Brain Research.

[31]  D Schmidtbleicher,et al.  Kinematics and Electromyography of Lower Limb Muscles in Overground and Treadmill Running , 1998, International journal of sports medicine.

[32]  H. Kantz,et al.  Nonlinear time series analysis , 1997 .

[33]  J. Ridley Studies of Interference in Serial Verbal Reactions , 2001 .

[34]  Joseph Hamill,et al.  Stability and variability may respond differently to changes in walking speed. , 2005, Human movement science.

[35]  C Basdogan,et al.  Kinematics and dynamic stability of the locomotion of post-polio patients. , 1996, Journal of biomechanical engineering.

[36]  Gérome C Gauchard,et al.  Higher visual dependency increases balance control perturbation during cognitive task fulfilment in elderly people , 2004, Neuroscience Letters.

[37]  J. Duysens,et al.  Distraction Affects the Performance of Obstacle Avoidance During Walking , 2003, Journal of motor behavior.

[38]  Jeffrey M. Hausdorff,et al.  Gait variability and fall risk in community-living older adults: a 1-year prospective study. , 2001, Archives of physical medicine and rehabilitation.

[39]  J. Doyon,et al.  Effects of environmental demands on locomotion after traumatic brain injury. , 2006, Archives of physical medicine and rehabilitation.

[40]  L. Lipsitz Dynamics of stability: the physiologic basis of functional health and frailty. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[41]  D. Sternad,et al.  Local dynamic stability versus kinematic variability of continuous overground and treadmill walking. , 2001, Journal of biomechanical engineering.

[42]  W C Hayes,et al.  Disturbance type and gait speed affect fall direction and impact location. , 2001, Journal of biomechanics.

[43]  M. Lauk,et al.  Pathological tremors: Deterministic chaos or nonlinear stochastic oscillators? , 2000, Chaos.

[44]  Jonathan B Dingwell,et al.  The effects of sensory loss and walking speed on the orbital dynamic stability of human walking. , 2007, Journal of biomechanics.

[45]  S. Studenski,et al.  Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed , 2005, Journal of NeuroEngineering and Rehabilitation.

[46]  Scott A. England,et al.  The influence of gait speed on local dynamic stability of walking. , 2007, Gait & posture.

[47]  J. Dingwell,et al.  Separating the effects of age and walking speed on gait variability. , 2008, Gait & posture.

[48]  Jeffrey M. Hausdorff,et al.  Influence of Executive Function on Locomotor Function: Divided Attention Increases Gait Variability in Alzheimer's Disease , 2003, Journal of the American Geriatrics Society.

[49]  J. Dingwell,et al.  Kinematic variability and local dynamic stability of upper body motions when walking at different speeds. , 2006, Journal of biomechanics.

[50]  B. E. Maki,et al.  Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear? , 1997, Journal of the American Geriatrics Society.

[51]  Jesse C. Dean,et al.  The Effect of Lateral Stabilization on Walking in Young and Old Adults , 2007, IEEE Transactions on Biomedical Engineering.

[52]  A. Forster,et al.  Incidence and consequences offalls due to stroke: a systematic inquiry , 1995, BMJ.

[53]  David A. Winter,et al.  Biomechanics and Motor Control of Human Movement , 1990 .