Maintaining gait stability during dual walking task: effects of age and neurological disorders

BACKGROUND: Dual task paradigm is a common mechanism of daily life, and it is often used for investigating the effect on cognitive processing of motor behavior. AIM: In the present study we investigate the dual task interference during walking on upright gait stability. DESIGN: Cross-sectional study. SETTING: Inpatient neurorehabilitation unit and children neurorehabilitation unit. POPULATION: Eighty-five subjects were enrolled, divided into five groups: healthy young, healthy elderly, children with typical development, children with cerebral palsy and adults with stroke in subacute phase. METHODS: All subjects had to walk through a pathway during which they had to hear a sound, turn the head to watch a number and verbalize it. Subjects wore an accelerometer on their lumbar spine to measure upright gait stability have been assessed by means of the Root Mean Square (RMS) of the trunk acceleration. RESULTS: All subjects showed a reduced speed when performing a dual task with respect to single task. This reduction was significantly different among groups (F(4,81) =12.253, P<0.001, effect size 0.377). The RMS appeared to be increased along the latero-lateral axis, and reduced along the anterio-posterior and the cranio-caudal axes during the dual task walking. CONCLUSIONS: These accelerations were significantly related to the changes in speed that were managed in a different way in subjects affected by cerebral palsy and stroke. CLINICAL REHABILITATION IMPACT: The information obtained in this study may be used to support specific rehabilitation techniques in subjects with poor balance ability.