Evidence for Cognitive Processes Involved in the Control of Steady State of Walking in Healthy Subjects and after Cerebral Damage

Abstract

Objective. The involvement of cognitive processes in the control of walking at steady state was studied in 10 healthy subjects and 18 subjects after unilateral vascular brain damage. A dual task paradigm was used to compare the performance level of a probe reaction time (RT) in sitting (simple task) and during standing or walking on a treadmill (dual task conditions). In this latter condition, RTs were classified and analyzed in relation to the different phases of the gait cycle. Results. The results show a marked increase in RT while walking compared to sitting and standing only in stroke subjects. Specific changes in RTs related to the gait cycle phases were observed in both healthy subjects and those after brain damage. It is concluded that walking at steady state is attentionally demanding. The phase-dependent modulations of the RTs suggest that cognitive processes may play a role in the control of the step cycle. The increase of attentional demand during walking in subjects who had suffered a stroke varies, depending on severity of impairments of walking but also on a reduced general attentional capacity. The dual task paradigm provides a sensitive tool in the assessment of walking ability in stroke subjects.

Keywords

Locomotion cognitive processes reaction time interference motor control

References

MacKay-Lyons M. Central pattern generation of locomotion: a review of the evidence. Phys Ther 2002;82:69-83.

Abernethy B. Dual-task methodology and motor skills research: some applications and methodological constraints. J Hum Mov Studies 1988;14:101-132.

Dault MC , Yardley L , Frank JS . Does articulation contribute to modifications of postural control during dual-task paradigms? Brain Res Cogn Brain Res 2003;16:434-440.

Lang C , Bastian A. Cerebellar damage impairs automaticity of a recently practiced movement. J Neurophysiol 2002;87:1336-1347.

Lorist MM , Kernell D , Meijman T , Zijdewind I. Motor fatigue and cognitive task performance in humans. J Physiol 2002;545.1:313-319.

Monno A , Chardenon A , Temprado JJ , Zanone PG , Laurent M. Effects of attention on phase transitions between bimanual coordination patterns: a behavioural and cost analysis in humans. Neurosci Lett 2000;283:93-96.

Platz T , Bock S , Prass K. Reduced skilfulness of arm motor behaviour among motor stroke patients with good clinical recovery: does it indicate reduced automaticity? Can it be improved by unilateral or bilateral training? A kinematic motion analysis study. Neuropsychologia 2001;39:687-698.

Schneider W , Schiffrin RM . Controlled and automatic information processing: I. Detection, search and attention. Psychol Rev 1977;84:1-66.

Abernethy B , Hanna A , Plooy A. The attentional demands of preferred and non-preferred gait patterns. Gait Posture 2002;15:256-265.

10.

Pashler H. Dual task interference in simple tasks: data and theory. Psychol Bull 1994;16:220-244.

11.

Schmidt RA , Wrisberg CA . Motor learning and performance. 3rd ed. Champaign, IL: Human kinetics; 2004.

12.

Woollacott M , Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002;16:1-14.

13.

Lundin-Olsson L , Nyberg L , Gustafson Y. Stop walking when talking as a predictor of falls in ederly people. Lancet 1997;349:617.

14.

Goldie PA , Matyas TA , Evans OM . Gait after stroke: initial deficit and changes in temporal patterns for each gait phases. Arch Phys Med Rehabil 2001;82:1057-1065.

15.

Bardy B , Laurent M. Visual cues and attention demand in locomotion positioning. Percept Motor Skills 1991;72:915-926.

16.

Sparrow WA , Bradshaw AJ , Lamoureux E , Tirosh O. Ageing effects on the attention demands of walking. Hum Mov Sci 2002;21:961-972.

17.

Bond JM , Morris M. Goal-directed secondary motor tasks: their effects on gait in subjects with Parkinson disease. Arch Phys Med Rehabil 2000;81:110-116.

18.

Lajoie Y , Barbeau H , Hamelin M. Attentional requirements of walking in spinal cord injured patients compared to normal subjects. Spinal Cord 1999;37:245-250.

19.

Haggard P , Cockburn J , Cock J , Fordham C , Wade D. Interference between gait and cognitive tasks in a rehabilitating neurological population. J Neurol Neurosurg Psychiatry 2000;69:479-486.

20.

Ebersbach G , Dimtrijevic M , Poewe W. Influence of concurrent task on gait: a dual task approach. Percept Motor Skills 1995;81:107-113.

21.

Yardley L , Gardner M , Leadbetter A , Lavie N. Effect of articulatory and mental tasks on postural control. Neuroreport 1999;10:215-219.

22.

Lajoie Y , Teasdale N , Bard C , Fleury M. Attentional demands for static and dynamic equilibrium. Exp Brain Res 1993;97:139-144.

23.

Hollander M , Wolfe AD . Nonparametrics statistical methods. 2nd ed. [Wiley series in probability and statistics. Applied probability and statistics section (eds)]. New York: Wiley-Interscience; 1999:416-457.

24.

Bowen A , Wenman R , Mickelborough J , Foster J , Hill E , Tallis R. Dual-task effects of talking while walking on velocity and balance following stroke. Age Ageing 2000;30:319-323.

25.

Camicioli R , Howieson D , Lehman S , Kaye J. Talking while walking: the effect of a dual task in aging and Alzheimer’s disease. Neurology 1997;48:955-958.

26.

O’Shea S , Morris ME , Iansek R. Dual task interference during gait in people with Parkinson disease; effect of motor versus cognitive secondary tasks. Phys Ther 2002;82:888-897.

27.

Kurosawa K. Effects of various walking speeds on probe reaction time during treadmill walking. Percept Motor Skills 1994;78:768-770.

28.

Brown LA , Sleik R , Winder T. Attentional demands for static postural control after stroke. Arch Phys Med Rehabil 2002;83:1732-1735.

29.

Yardley L , Gardner M , Bronstein A , Davies R , Buckwell D , Luxon L. Interference between postural control and mental task performance in patients with vestibular disorder and healthy controls. J Neurol Neurosurg Psychiatry 2001;71:48-52.

30.

Brown RG , Mardsen CD . Dual task performance and processing resources in normal subjects and patients with Parkinson’s disease. Brain 1991;114:215-231.

31.

Camus M , Pailhous J , Bonnard M. Cognitive tuning of corticospinal excitability during human gait: adaptation to the phase. Eur J Neurosci 2004;10(4):1101-1107.