TY - JOUR
T1 - Walking and cognition, but not symptoms, correlate with dual task cost of walking in multiple sclerosis
AU - Motl, Robert W.
AU - Sosnoff, Jacob J.
AU - Dlugonski, Deirdre
AU - Pilutti, Lara A.
AU - Klaren, Rachel
AU - Sandroff, Brian M.
N1 - Funding Information:
This project was funded by a pilot grant from the National Multiple Sclerosis Society ( PP1695 ). RWM is a consultant and funded researcher for Biogen Idec and Acorda Therapeutics.
PY - 2014/3
Y1 - 2014/3
N2 - Background: Performing a cognitive task while walking results in a reduction of walking performance among persons with MS. To date, very little is known about correlates of this dual task cost (DTC) of walking in MS. Purpose: We examined walking performance, cognitive processing speed, and symptoms of fatigue, depression, anxiety, and pain as correlates of DTC of walking in MS. Methods: 82 persons with MS undertook a 6-min walk test (6MWT) and completed the Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), Short-form of the McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale (HADS), and self-reported Expanded Disability Status Scale (SR-EDSS). The participants completed 4 trials of walking at a self-selected pace on an electronic walkway that recorded spatiotemporal parameters of gait. The first 2 trials were performed without a cognitive task, whereas the second 2 trials were completed while performing a modified Word List Generation task. Results: There were significant and large declines in gait performance with the addition of a cognitive task for velocity (p<.001, η2=.52), cadence (p<.001, η2=.49), and step length (p<.001, η2=.23). 6MWT and SDMT scores correlated with DTC for velocity (r=-.41, p<.001 and r=-.32, p<.001, respectively) and step length (r=-.45, p<.001 and r=-.37, p<.001, respectively); there were no significant associations between FSS, SF-MPQ, and HADS scores with the DTC of walking. Regression analyses indicated that 6MW, but not SDMT, explained variance in DTC for velocity (δR2=.11, p<.001) and step length (δR2=.13, p<.001), after controlling for SR-EDSS scores. Conclusion: Walking performance might be a target of interventions for reducing the DTC of walking in MS.
AB - Background: Performing a cognitive task while walking results in a reduction of walking performance among persons with MS. To date, very little is known about correlates of this dual task cost (DTC) of walking in MS. Purpose: We examined walking performance, cognitive processing speed, and symptoms of fatigue, depression, anxiety, and pain as correlates of DTC of walking in MS. Methods: 82 persons with MS undertook a 6-min walk test (6MWT) and completed the Symbol Digit Modalities Test (SDMT), Fatigue Severity Scale (FSS), Short-form of the McGill Pain Questionnaire (SF-MPQ), Hospital Anxiety and Depression Scale (HADS), and self-reported Expanded Disability Status Scale (SR-EDSS). The participants completed 4 trials of walking at a self-selected pace on an electronic walkway that recorded spatiotemporal parameters of gait. The first 2 trials were performed without a cognitive task, whereas the second 2 trials were completed while performing a modified Word List Generation task. Results: There were significant and large declines in gait performance with the addition of a cognitive task for velocity (p<.001, η2=.52), cadence (p<.001, η2=.49), and step length (p<.001, η2=.23). 6MWT and SDMT scores correlated with DTC for velocity (r=-.41, p<.001 and r=-.32, p<.001, respectively) and step length (r=-.45, p<.001 and r=-.37, p<.001, respectively); there were no significant associations between FSS, SF-MPQ, and HADS scores with the DTC of walking. Regression analyses indicated that 6MW, but not SDMT, explained variance in DTC for velocity (δR2=.11, p<.001) and step length (δR2=.13, p<.001), after controlling for SR-EDSS scores. Conclusion: Walking performance might be a target of interventions for reducing the DTC of walking in MS.
KW - Cognition
KW - Fatigue
KW - Gait
KW - Multiple sclerosis
KW - Walking
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U2 - 10.1016/j.gaitpost.2013.11.023
DO - 10.1016/j.gaitpost.2013.11.023
M3 - Article
C2 - 24378281
AN - SCOPUS:84895870060
SN - 0966-6362
VL - 39
SP - 870
EP - 874
JO - Gait and Posture
JF - Gait and Posture
IS - 3
ER -