Effects of dual-task conditions on cervical spine movement variability

Abstract

BACKGROUND:

The potential to accurately perform cervical movements during more challenging tasks might be of importance to prevent dysfunctional motion characteristics. Although sensorimotor function during dual-task conditions are of increasing interest in biomedical and rehabilitation research, effects of such conditions on movement consistency of the neck have not yet been investigated.

OBJECTIVE:

In this crossover MiSpEx(Medicine in Spine Exercise)-diagnostic study, we aimed to explore differences between single and dual-task conditions on cervical movement variability.

METHODS:

Nineteen healthy participants (9 male; 24.5 $\pm$ 3.3 y) performed 10 repetitive maximal cervical movements in (1) flexion/extension and (2) lateral flexion, during one single- and during two dual-task test conditions (cognitive, motor) in a randomised and cross-over sequence. Latter consisted of a working memory n-back task ( $n=$ 2) and a repetitive ankle movement task. Range of motion (RoM) was assessed using an external three-dimensional ultrasonic movement analysis system. Coefficient of variation (CV) for repetitive RoM was analysed for differences between conditions and controlled for variances in intra-individual movement characteristics.

RESULTS:

Friedman and post-hoc Bonferroni-adjusted confidence intervals for differences from single- to dual-task values revealed changes in CV in flexion/extension from single-task to motor dual-task ( $+$ 0.02 $\pm$ 0.02 (97.5%CI: 0.01; 0.03); $p<$ 0.05) but not to cognitive dual-task condition ( $+$ 0.01 $\pm$ 0.02 (97.5%CI: 0.003; 0.02)) nor for lateral flexion ( $p>$ 0.05). Pearson regression analyses revealed a linear negative ( $p<$ 0.01) influence of CV in flexion/extension on differences from single to both cognitive (R ${}^2=$ 0.47) and motor dual-task (R ${}^2=$ 0.55). Results for lateral flexion are comparable, baseline CV negatively impacts differences to cognitive (R ${}^2=$ 0.2) and motor dual-task performance (R ${}^2=$ 0.76; $p<$ 0.01).

CONCLUSIONS:

Participants with comparable low cervical CV at single-task display a profound increase during dual-task conditions while participants with a higher variability remained almost stable or showed a decrease. The results point toward a complex interrelationship of motion patterns and adaptation processes during challenging tasks in respect of cervical CV.