TY - JOUR
T1 - The Use of Augmented Reality on a Self-Paced Treadmill to Quantify Attention and Footfall Placement Variability in Middle-Aged to Older-Aged Adults with Multiple Sclerosis
AU - Hernandez, Manuel E.
AU - Holtzer, Roee
AU - Izzetoglu, Meltem
AU - Motl, Robert W.
N1 - This research received no external funding.
PY - 2025
Y1 - 2025
N2 - Background/Objectives: Footfall placement variability is associated with falls in older adults and neurological diseases. Thus, the study of dual-task gait impairment in middle-aged to older-aged adults with multiple sclerosis (MS) is clinically relevant, particularly in environments that mimic the obstacles experienced in daily ambulation. Methods: A total of 10 middle-aged to older-aged adults with MS (eight female, mean ± SD age = 56 ± 5 years), 12 healthy older adults (HOAs, nine female, age = 63 ± 4 years), and 10 healthy young adults (HYAs, five female, age = 22 ± 3) were asked to perform cued walking (CW) or obstacle walking (OW) tasks without or with a concurrent backward alphabet recitation task (CWT, OWT), or dual tasks. Gait performance and attentional demands were measured using hit rate, stride velocity, footfall placement bias and variance, and prefrontal cortex (PFC) oxygenated hemoglobin HbO levels. Results: A significant dual-task condition-by-cohort interaction was seen in footfall placement bias and variance as indicated by a higher footfall placement bias and variance in dual-task vs. single-task conditions seen in HOAs, in comparison to HYAs and adults with MS. Further, a significant walking condition-by-cohort interaction was seen in the HbO levels as indicated by the higher PFC HbO levels seen in OW vs. CW in adults with MS, compared to adults without MS. Conclusions: The decreased accuracy and increased attention in footfall placement to visual cues on the ground observed in adults with MS and HOAs, relative to HYAs, may provide a marker for gait impairment and fall risk in older adults with MS.
AB - Background/Objectives: Footfall placement variability is associated with falls in older adults and neurological diseases. Thus, the study of dual-task gait impairment in middle-aged to older-aged adults with multiple sclerosis (MS) is clinically relevant, particularly in environments that mimic the obstacles experienced in daily ambulation. Methods: A total of 10 middle-aged to older-aged adults with MS (eight female, mean ± SD age = 56 ± 5 years), 12 healthy older adults (HOAs, nine female, age = 63 ± 4 years), and 10 healthy young adults (HYAs, five female, age = 22 ± 3) were asked to perform cued walking (CW) or obstacle walking (OW) tasks without or with a concurrent backward alphabet recitation task (CWT, OWT), or dual tasks. Gait performance and attentional demands were measured using hit rate, stride velocity, footfall placement bias and variance, and prefrontal cortex (PFC) oxygenated hemoglobin HbO levels. Results: A significant dual-task condition-by-cohort interaction was seen in footfall placement bias and variance as indicated by a higher footfall placement bias and variance in dual-task vs. single-task conditions seen in HOAs, in comparison to HYAs and adults with MS. Further, a significant walking condition-by-cohort interaction was seen in the HbO levels as indicated by the higher PFC HbO levels seen in OW vs. CW in adults with MS, compared to adults without MS. Conclusions: The decreased accuracy and increased attention in footfall placement to visual cues on the ground observed in adults with MS and HOAs, relative to HYAs, may provide a marker for gait impairment and fall risk in older adults with MS.
KW - gait
KW - footfall variability
KW - augmented reality
KW - aging
U2 - 10.3390/sclerosis3010003
DO - 10.3390/sclerosis3010003
M3 - Article
SN - 2813-3064
VL - 3
JO - Sclerosis
JF - Sclerosis
IS - 1
ER -