Age and walking conditions differently affect domains of gait

IntroductionAnalysing gait in controlled conditions that resemble daily life walking could overcome the limitations associated with gait analysis in uncontrolled real-world conditions. Such analyses could potentially aid the identification of a walking condition that magnifies age-differences in gait. Therefore, the aim of the current study was to determine the effects of age and walking conditions on gait performance.MethodsTrunk accelerations of young (n = 27, age: 21.6) and older adults (n = 26, age: 68.9) were recorded for 3 min in four conditions: walking up and down a university hallway on a track of 10 m; walking on a specified path, including turns, in a university hallway; walking outside on a specified path on a pavement including turns; and walking on a treadmill. Factor analysis was used to reduce 27 computed gait measures to five independent gait domains. A multivariate analysis of variance was used to examine the effects of age and walking condition on these gait domains.ResultsFactor analysis yielded 5 gait domains: variability, pace, stability, time & frequency, complexity, explaining 64% of the variance in 27 gait outcomes. Walking conditions affected all gait domains (p < 0.01) but age only affected the time & frequency domain (p < 0.05). Age and walking conditions differently affected the domains variability, stability, time & frequency. The largest age-differences occurred mainly during straight walking in a hallway (variability: 31% higher in older adults), or during treadmill walking (stability: 224% higher, time&frequency: 120% lower in older adults).ConclusionWalking conditions affect all domains of gait independent of age. Treadmill walking and walking on a straight path in a hallway, were the most constrained walking conditions in terms of limited possibilities to adjust step characteristics. The age by condition interaction suggests that for the gait domains variability, stability, and time & frequency, the most constrained walking conditions seem to magnify the age-differences in gait.     

Handedness and sex differences in hemispheric asymmetry

A study was designed to assess the contributions of the factors of sex and familial history to cerebral dominance, where cerebral dominance was inferred from laterality on a dichotic listening task. The 144 subjects were selected from a larger sample on the basis of handedness, sex, and familial history of sinistrality, and tested on a task involving the dichotic presentation of CV syllables. Analysis of the data indicated that in female subjects, the presence of familial sinistrality increased the likelihood that they present atypical left-ear superiorities, while in males the converse was the case. Moreover, there was a significant sex difference overall, such that males were more clearly lateralized than females. A review of other dichotic listening studies provided support for the reliability of this sex difference for dichotic tasks using verbal material. A review of the clinical literature indicated that the hypothesis of a sex difference is at least tenable and merits further investigation. However, the possibility that there is a sex difference in the cognitive strategy used in dichotic listening cannot be ruled out.     

Effects of Age on Dual-Task Walking While Listening

This study examined the effects of age on single- and dual-task listening and walking during virtual street crossing. Seventeen younger and 12 older adults participated. In each listening trial, three sentences were presented simultaneously from separate locations. Participants were instructed to report the target sentence. Predictability of the target sentence location was varied. Treadmill walking was measured using motion analysis. Measures included word recognition accuracy, head and trunk angles, and spatiotemporal gait parameters. Older adults exhibited a more upright head alignment and less variability in stride time during dual-tasking, particularly under less certain target sentence location conditions. Younger adults’ walking was unaffected by dual-task demands. Together, the results indicate greater postural prioritization in older adults than young.     

Psychometric and behavioral measures of central auditory function: the relationship between dichotic listening and digit span tasks.

We hypothesized that the Digit Span (DS) subtest and component tasks (Wechsler, 1991) would show strong relationships with a dichotic listening test (Musiek, 1983). In two sets of archival clinical data (N = 74 and N = 51) we demonstrated that: (a) individuals with central auditory deficits had lower DS scores, F(1, 72) = 7.34, p = .008; eta2 = .09; and (b) left-ear dichotic deficits impacted forward span, F(2, 48) = 8.45, p = .001. Right-ear dichotic listening performance also accounted for significant variance in digit forward span (R2 = 0.17, p = .003). While limited in scope, the studies conclude that forward but not reverse span performance is strongly related to dichotic listening, and can serve as a marker for possible central auditory deficits.     

ERP evidence of early cross-modal links between auditory selective attention and visuo-spatial memory

Previous dual-task research pairing complex visual tasks involving non-spatial cognitive processes during dichotic listening have shown effects on the late component (Ndl) of the negative difference selective attention waveform but no effects on the early (Nde) response suggesting that the Ndl, but not the Nde, is affected by non-spatial processing in a dual-task. Thus to further explore the nature of this dissociation and whether the Nd waveform is affected by spatial processing; fourteen adult participants performed auditory dichotic listening in conjunction with visuo-spatial memory in a cross-modal dual-task paradigm. The results showed that the visuo-spatial memory task decreased both the Nde and Ndl waveforms, and also attenuated P300 and increased its latency. This pattern of results suggests that: (1) the Nde reflects a memory trace that is shared with vision when the information is spatial in nature, and (2) P300 latency appears to be influenced by the discriminability of stimuli underlying the Nde and Ndl memory trace.     

Decision making in dual-task environments: analysis of hemispheric competition effects

Performance degradations in multitasking situations have been reported frequently as a predictable effect of competition that arises from different processing demands whose hemispheric locations are too proximal. This model might be useful in explaining performance deficits in complex workplaces. To test this assertion, a laboratory study was designed to create an analogue of the processing demands required by a tactical decision-making task performed by 24 right-handed men. Vocalization, dichotic listening and decision-making performance were assessed under single- and dual-task conditions. The results were consistent with the predictions from hemispheric competition in the case of dichotic listening but not with vocalization. The results are discussed in terms of their implications for both research and systems design.     

Comment on delayed left-ear accuracy in dichotic listening

Moulden and Persinger recently reported on the emergence of left-ear accuracy during childhood and adolescence. This commentary briefly discusses their findings with reference to previous studies that have reported on dichotic listening paradigms and, in particular, those in which a left-ear focus was used as a behavioral probe sensitive to developmental sex differences.     

Relationships between dual-task related changes in stride velocity and stride time variability in healthy older adults

Dual-task related gait changes have been previously reported for healthy older adults, suggesting that gait control requires attention. Compared to balance control, the involvement of attention in the control of the rhythmic stepping mechanism, as reflected by stride time variability, is not well known. In particular, under dual-task, the relative contributions of a second, attention-demanding task and changes in walking speed remain unclear. Thus, the aims of this study were (1) to assess whether walking with a slow-selected speed or walking while performing an attention-demanding task affected stride time variability in a sample of healthy older participants, and (2) to establish whether stride time variability under dual-task conditions is related either to the decrease of walking speed or the simultaneous attention-demanding task, or to both. Forty-five healthy older participants performed four experimental conditions: (1) walking at a normal self-selected speed, (2) walking at a slow self-selected speed, (3) performing a verbal fluency task when sitting on a chair, and (4) performing the verbal fluency task while walking at self-selected walking speed. Gait parameters were recorded across 15 meters, using Physilog. Results showed a significant dual-task related decrease in mean values of stride velocity, as well as a significant increase in mean values and coefficients of variation of stride time. These dual-task related changes in stride time were explained by the simultaneous performance of the verbal fluency task, the decrease of gait speed and the variability between participants. Although a relationship exists between decreased walking speed and increased stride time variability, the dual-task related increase of stride time variability was also significantly associated with the attention-demanding task, suggesting some attentional control for the rhythmic stepping mechanism of walking in healthy older adults.     

Influence of cognitive and motor tasks using smartphone during gait: EMG and gait performance analysis – Dual-task study

Previous studies reported changes in spatiotemporal gait parameters during dual-task performance while walking using a smartphone compared to walking without a smartphone. However, studies that assess muscle activity while walking and simultaneously performing smartphone tasks are scarce. So, this study aimed to assess the effects of motor and cognitive tasks using a smartphone while simultaneously performing gait on muscle activity and gait spatiotemporal parameters in healthy young adults. Thirty young adults (22.83 ± 3.92 years) performed five tasks: walking without a smartphone (single-task, ST); typing on a smartphone keyboard in a sitting position (secondary motor single-task); performing a cognitive task on a smartphone in a sitting position (cognitive single-task); walking while typing on a smartphone keyboard (motor dual-task, mot-DT) and walking while performing a cognitive task on a smartphone (cognitive dual-task, cog-DT). Gait speed, stride length, stride width and cycle time were collected using an optical motion capture system coupled with two force plates. Muscle activity was recorded using surface electromyographic signals from bilateral biceps femoris, rectus femoris, tibialis anterior, gastrocnemius medialis, gastrocnemius lateralis, gluteus maximus and lumbar erector spinae. Results showed a decrease in stride length and gait speed from the single-task to cog-DT and mot-DT (p < 0.05). On the other hand, muscle activity increased in most muscles analyzed from single- to dual-task conditions (p < 0.05). In conclusion, performing a cognitive or motor task using a smartphone while walking promote a decline in spatiotemporal gait parameters performance and change muscle activity pattern compared to normal walking.     

Psychometric and Behavioral Measures of Central Auditory Function: The Relationship Between Dichotic Listening and Digit Span Tasks

We hypothesized that the Digit Span (DS) subtest and component tasks (Wechsler, 1991) would show strong relationships with a dichotic listening test (Musiek, 1983). In two sets of archival clinical data (N = 74 and N = 51) we demonstrated that: (a) individuals with central auditory deficits had lower DS scores, F(1, 72) = 7.34, p = .008; η² = .09; and (b) left-ear dichotic deficits impacted forward span, F(2, 48) = 8.45, p = .001. Right-ear dichotic listening performance also accounted for significant variance in digit forward span (R ² = 0.17, p = .003). While limited in scope, the studies conclude that forward but not reverse span performance is strongly related to dichotic listening, and can serve as a marker for possible central auditory deficits.     

Attention and the right-ear advantage: What is the connection?

Dichotic listening originally was a means of studying attention. Half a century ago Doreen Kimura parlayed the dichotic method into a noninvasive indicator of lateralized cerebral language representation. The ubiquitous right-ear advantage (REA) for verbal material was accepted as a concomitant of left-sided language lateralization and preferential conduction of right-ear messages to the left hemisphere. As evidence has accumulated over the past 50years showing the REA to be dynamic and modifiable, the concept of attention has become essential for interpreting the findings. Progress in understanding the role of attention has been manifested as a transition from efforts to document attention effects to efforts to characterize their mechanisms. We summarize the relevant evidence, trace the evolution of explanatory models, and outline contemporary accounts of the role of attention in dichotic listening.     

Dichotic listening during forced-attention in a patient with left hemispherectomy

A young left-handed girl with an extensive posttraumatic lesion in the left hemisphere was tested with dichotic listening (DL) under three different attentional instructions. The major aim of the study was to evaluate a structural vs attentional explanation for dichotic listening. As both her expressive and receptive language functions were intact after the lesion, it was assumed that the right hemisphere was the language-dominant one. In the free-report condition, she was free to divert attention to and to report from both ear inputs. In the forced-right condition, she was instructed to attend to and report only from the right ear input. In the forced-left condition, she was instructed to attend to and to report only from the left-ear input. Her performance was compared with data from a previously collected sample of normal left-handed females. Analysis showed that the patient, in contrast to the normal sample, revealed a complete right-ear extinction phenomenon, irrespective of attentional instruction. Furthermore, she showed superior correct reports from the left ear, compared with those of the normal sample, also irrespective of attentional instruction. It is concluded that these results support a structural, rather than attentional explanation for the right-ear advantage (REA) typically observed in dichotic listening. The utility of validating the dichotic listening technique on patients with brain lesions is discussed.     

Left ear (right temporal lobe) suppressions during dichotic listening, ego-alien intrusion experiences and spiritualistic beliefs in normal women.

Beliefs in spiritualism, a history of a sensed presence, and mental diplopia may share a common source of psychometric variance. We hypothesized that this variance should be specifically associated with right temporal-lobe function. Inferences of temporal lobe signs, hemisphericity (Vingiano's quotient) and self-esteem as well as dichotic listening measures were obtained for 26 university women. As predicted, the numbers of left-ear suppressions (right temporal-lobe function) but not of right-ear suppressions were specifically and moderately (rho = 0.64) correlated with the intensity of Tobacyk's spiritualistic beliefs and a history of sensed presences and ego-alien intrusions. However, the negative association (rhos about -0.45) between indices of left-right hemisphericity and self-esteem was related to a separate factor.     

Multitask investigation of individual differences in hemispheric asymmetry

Right-handed subjects (N = 120) participated in four different laterality tasks designed to measure aspects of cerebral hemisphere asymmetry: identification of dichotically presented consonant-vowel syllables (CVs), examination of the effects of concurrent repetition of CVs and concurrent anagram solution on finger-tapping by the right and left hands, lateralized identification of CVs presented tachistoscopically to the left and right visual fields, and left/right biases on a free-vision face task involving judgments of emotion. Ear differences in the dichotic listening task were related to the pattern of lateralized interference in the dual-task finger-tapping paradigm. There were no other significant relations between pairs of tasks, but when the present results are considered in the light of other recent experiments, there appears to be a relation between lateral bias on the free-vision face task and visual field differences in tachistoscopic identification. The pattern of results has implications for hypothesized individual differences among right-handers in cerebral dominance for verbal processes, input pathway dominance, and asymmetric arousal of the two cerebral hemispheres.     

Differences in cognitive control in children and adolescents with combined and inattentive subtypes of ADHD

The aim of the present study was to investigate the ability of children with attention deficit/hyperactivity disorder-combined subtype (ADHD-C) and predominantly inattentive subtype (ADHD-PI) to direct their attention and to exert cognitive control in a forced attention dichotic listening (DL) task. Twenty-nine, medication-naive participants with ADHD-C, 42 with ADHD-PI, and 40 matched healthy controls (HC) between 9 and 16 years were assessed. In the DL task, two different auditory stimuli (syllables) are presented simultaneously, one in each ear. The participants are asked to report the syllable they hear on each trial with no instruction on focus of attention or to explicitly focus attention and to report either the right- or left-ear syllable. The DL procedure is presumed to reflect different cognitive processes: perception (nonforced condition/NF), attention (forced-right condition/FR), and cognitive control (forced-left condition/FL). As expected, all three groups had normal perception and attention. The children and adolescents with ADHD-PI showed a significant right-ear advantage also during the FL condition, while the children and adolescents in the ADHD-C group showed a no-ear advantage and the HC showed a significant left-ear advantage in the FL condition. This suggests that the ADHD subtypes differ in degree of cognitive control impairment. Our results may have implications for further conceptualization, diagnostics, and treatment of ADHD subtypes.     

Cerebral specialization and verbal-motor integration in adults with and without Down syndrome

Persons with Down syndrome (DS) tend to exhibit an atypical left ear-right hemisphere advantage (LEA) for the perception of speech sounds. In the present study, a recent adaptation of the dichotic listening procedure was employed to examine interhemispheric integration during the performance of a lateralized verbal-motor task. Although adults with DS (n = 13) demonstrated a right ear-left hemisphere advantage in the dichotic-motor task similar to their peers with (n = 14) and without undifferentiated developmental disabilities (n = 14), they showed an LEA in a free recall dichotic listening task. Based on a comparison of the laterality indices obtained from both dichotic listening procedures, it appears that the manifestation of lateral ear advantages in persons DS may dependent on the response requirements of the task.     

Measures of postural control and mobility during dual-tasking as candidate markers of instability in Huntington's disease

BackgroundIndividuals with Huntington's disease (HD) have impairments in performing dual-tasks, however, there is limited information about the effects of changing postural and cognitive demands as well as which measures are best suited as markers of underlying motor-cognitive interference.MethodsForty-three individuals with HD and 15 healthy controls (HC) completed single tasks of walking (Timed Up & Go (TUG), 7 m walk), standing (feet together, feet apart and foam surface) and seated cognitive performance (Stroop, Symbol Digit Modalities Test (SDMT), Delis-Kaplan Executive Function System (DKEFS) Sorting test) and dual cognitive-motor tasks while standing (+ Stroop) and walking (+ DKEFS, TUG cognitive). APDM Opal sensors recorded measures of postural sway and time to complete motor tasks.ResultsIndividuals with HD had a greater increase in standing postural sway compared to HC from single to dual-tasks and with changes to support surface. Both groups demonstrated a decrease in gait performance during the TUG cognitive, however, this difference was greater in people with HD compared to HC. While those with HD showed a greater dual-task motor cost compared to HC, both groups behaved similarly as condition complexity increased.ConclusionsStanding postural sway is a more sensitive marker of instability than change in standard gait speed, particularly under dual-task conditions. The more complex TUG cognitive is a sensitive measure of walking dual-task performance. The results of this study provide insights about the nature of motor-cognitive impairments in HD and provide support for a distinction between static and dynamic postural control mechanisms during performance of dual-tasks.     

Characterizing attentional resources

Other studies have found that it is easier to divide attention when messages can be discriminated on the basis of stimulus and response features. The present study extended these results and explored whether dual-task performance is a function of similarity of central processing and, more specifically, the semantic similarity of the competing messages. In a dichotic listening task, subjects detected targets in concurrent messages that either differed semantically and required different central processing (the mixed condition) or were semantically similar and required similar central processing (the same condition). Three criteria are developed to determine whether the tasks in the mixed condition call upon distinct resources. The results are discussed in terms of three metaphors for resources: fuel, structure, and skills.     

“The threat is in the head,not in the legs”: Activating negative age stereotypes generates extra cognitive load during walking

ObjectiveActivating negative age stereotypes has been consistently shown to impair cognitive performance in older adults, but not motor performance, especially on mobility tasks. We tested the hypothesis that older adults may still experience stereotype threat, even if mobility performance is not affected. To do so, we examined whether inducing negative stereotypes may increase cognitive load during a walking task.MethodThis question was investigated in a dual-task paradigm: older adults performed simultaneously a walking task and a Stroop task, in stereotype and control conditions.ResultsResults showed that the stereotype induction did not affect walking parameters but decreased performance on the Stroop task, indicating that this induction increased cognitive load during walking.DiscussionThese results suggest that negative age stereotypes may be damaging even if walking parameters are not affected, by altering older adults' attention to their walking environment. We conclude by highlighting theoretical and practical implications.