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Nowadays, gait assessment in the real life environment is gaining more attention. Therefore, it is desirable to know how some factors, such as surfaces (natural, artificial) or dual-tasking, influence real life gait pattern. The aim of this study was to assess gait variability and gait complexity during single and dual-task walking on different surfaces in an outdoor environment. Twenty-nine healthy young adults aged 23.31 ± 2.26 years (18 females, 11 males) walked at their preferred walking speed on three different surfaces (asphalt, cobbles, grass) in single-task and in two dual-task conditions (manual task—carrying a cup filled with water, cognitive task—subtracting the number 7). A triaxial inertial sensor attached to the lower trunk was used to record trunk acceleration during gait. From 15 strides, sample entropy (SampEn) as an indicator of gait complexity and root mean square (RMS) as an indicator of gait variability were computed. The findings demonstrate that in an outdoor environment, the surfaces significantly impacted only gait variability, not complexity, and that the tasks affected both gait variability and complexity in young healthy adults.

The aim of this study was (1) to evaluate the relative and absolute reliability of gait parameters during walking in single- and dual-task conditions in patients with axial spondyloarthritis (axSpA), (2) to evaluate the absolute and relative reliability of dual task effects (DTE) parameters, and (3) to determine the number of trials required to ensure reliable gait assessment, in patients with axSpA. Twenty patients with axSpa performed a 10-m walk test in single- and dual-task conditions, three times for each condition. Spatiotemporal, symmetry, and DTE gait parameters were calculated from foot-worn inertial sensors. The relative reliability (intraclass correlation coefficients-ICC) and absolute reliability (standard error of measurement-SEM and minimum detectable change-MDC) were calculated for these parameters in each condition. Spatiotemporal gait parameters showed good to excellent reliability in both conditions (0.59 < ICC < 0.90). The reliability of symmetry and DTE parameters was low. ICC, SEM, and MDC were better when using the mean of the second and the third trials. Spatiotemporal gait parameters obtained from foot-worn inertial sensors assessed in patients with axSpA in single- and dual-task conditions are reliable. However, symmetry and DTE parameters seem less reliable and need to be interpreted with caution. Finally, better reliability of gait parameters was found when using the mean of the 2nd and the 3rd trials.

Objectives: This study aimed to examine the effect of dual-tasking on functional mobility and manual dexterity in patients with multiple sclerosis (MS) at different stages of disability Patients and methods: Forty-five patients (18 males, 27 females; mean age: 39.0[+ or -]10.7 years; range: 21 to 62 years) with MS, 15 in the very mild group (EDSS 0-1.5), 15 in the mild group (EDSS 2-3.5), and 15 in the moderate group (EDSS 4-6.5), were included in the cross-sectional study between July 2022 and September 2022. Fifteen healthy controls (6 males, 9 females; mean age: 38.2[+ or -]13.4 years; range: 23 to 65 years) were recruited. The timed up and go (TUG) test and the nine-hole peg test (9HPT) were used to assess functional mobility and manual dexterity. The dual-task condition was carried out using the TUG test and the 9HPT as the single-task condition, combined with a serial sevens subtraction task. Results: Dual-task scores for functional mobility and manual dexterity were significantly worse than single-task scores in all groups. The order of the magnitude of the dual-task effect (DTE) in functional mobility was as follows: healthy controls = patients with very mild MS = patients with mild MS < patients with moderate MS. In addition, the order of the magnitude of the DTE in both dominant and nondominant hand manual dexterity was as follows: healthy controls = patients with very mild MS < patients with mild MS < patients with moderate MS. The very mild group was similar to healthy controls in DTE on both functional mobility and manual dexterity. Conclusion: The results suggest that dual-tasking has a negative effect on functional mobility and manual dexterity performance in patients with MS regardless of disability level. Also, the negative effect of dual-task begins to be evident at an earlier level of the disease in manual dexterity performance than in functional mobility performance. Keywords: Disability level, dual-task, functional mobility, manual dexterity, multiple sclerosis.

Background Daily manual tasks require cognitive-motor interactions. There is limited research on cognitive-motor dual-tasks involving the upper extremity. In this study we used a manual visuomotor dual-task to measure post-stroke cognitive-motor impairments. Given previous evidence of impaired cognitive-motor interaction in stroke we hypothesized that the presence of enhanced dual-task cognitive load will impact motor performance in stroke patients. We also hypothesized that this dual-task effect would be greater in stroke patients compared to healthy controls. We also explored whether cognitive-motor impairments observed in these single- and dual-task conditions would relate to deficits in manual dexterity. Methods 30 chronic stroke participants (29.77 ± 35.39 months post-stroke) with mild-to-moderate hemiparesis without cognitive impairment (global screening test) and 30 age-matched healthy subjects performed a visuomotor grip force-tracking task in single- and dual-task conditions, requiring divided attention (resisting visual distraction) and working memory (mental addition of transiently displayed numbers). Gaze was simultaneously recorded to probe cognitive performance through saccades. Dexterity impairments were separately quantified using a kinetic device. Results Stroke patients had increased visuomotor tracking error but did not show significantly increased change in visuomotor tracking error during the dual-task, with no significant difference between single task condition vs. divided attention or vs. working memory dual-task conditions. In contrast, age-matched healthy controls did show the expected difference with significantly higher dual-task force-tracking error. The between-group analysis only revealed a significant group difference (Stroke vs. Control) with stroke patients producing twice as much tracking error in both single and dual-task conditions. Stroke participants showed significantly reduced dual-task saccade modulation, with a reduced difference in saccades to displayed numbers (similar in both groups) vs. to distractors (higher in stroke) (median ± IQR: stroke 14.6 ± 18.75%; controls: 26.4 ± 32.41%). Non-inhibited saccades to distractors explained certain dexterity group differences (force control and timing of finger movements). Conclusion The visuomotor force-tracking error, although increased, did not show enhanced cognitive-motor interaction in stroke. However, the task-related saccade analysis did detect impaired divided attention post-stroke, that may contribute to impaired dexterity, particularly in tasks requiring on-line sensorimotor integration. Upper limb dual-tasking practice may be relevant for engaging attention and enhancing post-stroke activities in daily life. Trial registration ClinicalTrials.gov ID NCT05454748.

The study examined the impact of visual predictability on dual-task performance in driving and tracking tasks. Participants (N = 27) performed a simulated driving task and a pursuit tracking task. In either task, visual predictability was manipulated by systematically varying the amount of advance visual information: in the driving task, participants drove at night with low beam, at night with high beam, or in daylight; in the tracking task, participants saw a white line that specified the future target trajectory for 200, 400 or 800 ms. Concurrently with driving or tracking, participants performed an auditory task. They had to discriminate between two sounds and press a pedal upon hearing the higher sound. Results show that in general, visual predictability benefited driving and tracking; however, dual-task driving performance was best with highest visual predictability (daylight), dual-task tracking performance was best with medium visual predictability (400 ms). Braking/reaction times were higher in dual tasks compared to single tasks, but were unaffected by visual predictability, showing that its beneficial effects did not transfer to the auditory task. In both tasks, manual accuracy decreased around the moment the foot pressed the pedal, indicating interference between tasks. We, therefore, conclude that despite a general beneficial impact of predictability, the integration of visual information seems to be rather task specific, and that interference between driving and audiomotor tasks, and tracking and audiomotor tasks, seems comparable.

Abstract Background and purposeDual-task manual dexterity is required to perform activities of daily living and is affected by cognitive functions. This study aimed to investigate the effects of two main treatment options, subthalamic nucleus deep brain stimulation (STN-DBS) and dopaminergic treatment (DT), on dual-task manual dexterity and cognitive functions of people with Parkinson’s disease (PwPD).MethodsTwenty-one PwPD were assessed in four different conditions as medication “on–off” and STN-DBS “on–off” in random order. Motor symptoms were measured with the Movement Disorder Society–Unified Parkinson Disease Rating Scale, motor section (MDS-UPDRS-III). Single and dual-task manual dexterity was assessed with the Nine-Hole Peg Test (NHPT) and cognitive functions were assessed with the Stroop Test (ST) and the Trail Making Test (TMT).ResultsBoth DT and STN-DBS enhanced MDS-UPDRS-III, and the combination of DT and STN-DBS provided further improvement. Only STN-DBS enhanced dominant hand single-task NHPT scores. Non-dominant single-task NHPT scores and dual-task NHPT scores improved with both treatments alone; however, STN-DBS resulted in more improvement than DT. Dual-task interference, ST, and TMT scores improved with both treatments alone; however, combining DT and STN-DBS did not provide more improvement.ConclusionDT, STN-DBS, and combining both treatments have different effects on motor symptoms, single and dual-task manual dexterity, dual-task interference, and cognitive functions. These results indicate that DT and STN-DBS may affect motor and cognitive functions via different mechanisms. Effects of DT and STN-DBS on manual dexterity may depend on the degree of cognitive involvement in manual dexterity tasks.

This study compared the effect of stability constraints imposed by a manual task on the adaptation of postural responses between 16 healthy elderly (mean age = 71.56 years, SD = 7.38) and 16 healthy young (mean age = 22.94 years, SD = 4.82) individuals. Postural stability was perturbed through unexpected release of a load attached to the participant's trunk while performing two versions of a voluntary task: holding a tray with a cylinder placed with its flat side down (low constraint) or with its rolling round side down (high constraint). Low and high constraint tasks were performed in alternate blocks of trials. Results showed that young participants adapted muscular activation and kinematics of postural responses in association with previous experience with the first block of manual task constraint, whereas the elderly modulated postural responses based on the current manual constraint. This study provides evidence for flexibility of postural strategies in the elderly to deal with constraints imposed by a manual task.