背景:执行认知-运动双重任务(DT)可能会导致步行速度和认知表现降低。在患有进行性多发性硬化症(pwPMS)的认知功能障碍患者中的作用尚不清楚。
目的:描述认知受损pwPMS患者行走过程中的DT表现,并通过残疾水平检查DT表现。
方法:对CogEx研究的基线数据进行二次分析。参与者,注册符号数字模式测试1.282标准偏差低于标准值,执行认知单一任务([ST],交替字母),电机ST(步行)和DT(两者)。结果是交替字母任务中正确答案的数量,步行速度,和DT成本(DTC:相对于ST的性能下降)。比较EDSS亚组(≤4,4.5-5.5,≥6)之间的结果。在DTC电机与临床测量之间进行Spearman相关性。调整后的显著性水平为0.01。
结果:总体而言,参与者(n=307)步行速度较慢,DT与ST的正确答案较少(均p<0.001),DTC电机为15.8%,DTC认知为2.7%。在DT和ST期间,所有三个亚组的步行速度都较慢,DTCmotor不为零(p<0.001)。只有EDSS≥6组的DT与ST的正确答案较少(p<0.001),但任何组的DTCcognization均无零差异(p≥0.039).
结论:双重任务显著影响认知受损pwPMS的步行表现,EDSS子组的程度相似。
BACKGROUND: Performing cognitive-motor dual tasks (DTs) may result in reduced walking speed and cognitive performance. The effect in persons with progressive multiple sclerosis (pwPMS) having cognitive dysfunction is unknown.
OBJECTIVE: To profile DT-performance during walking in cognitively impaired pwPMS and examine DT-performance by disability level.
METHODS: Secondary analyses were conducted on baseline data from the CogEx-study. Participants, enrolled with Symbol Digit Modalities Test 1.282 standard deviations below normative value, performed a cognitive single task ([ST], alternating alphabet), motor ST (walking) and DT (both). Outcomes were number of correct answers on the alternating alphabet task, walking speed, and DT-cost (DTC: decline in performance relative to the ST). Outcomes were compared between EDSS subgroups (≤ 4, 4.5-5.5, ≥ 6). Spearman correlations were conducted between the DTCmotor with clinical measures. Adjusted significance level was 0.01.
RESULTS: Overall, participants (n = 307) walked slower and had fewer correct answers on the DT versus ST (both p < 0.001), with a DTCmotor of 15.8% and DTCcognitive of 2.7%. All three subgroups walked slower during the DT versus ST, with DTCmotor different from zero (p\'s < 0.001). Only the EDSS ≥ 6 group had fewer correct answers on the DT versus ST (p < 0.001), but the DTCcognitive did not differ from zero for any of the groups (p ≥ 0.039).
CONCLUSIONS: Dual tasking substantially affects walking performance in cognitively impaired pwPMS, to a similar degree for EDSS subgroups.