Measures of postural control and mobility during dual-tasking as candidate markers of instability in Huntington's disease |
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| Institution: | 1. Department of Physical Therapy, Stony Brook University, Stony Brook, NY 11794-8201, United States of America;2. Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY 10027, United States of America;3. Centre for Trials Research, Cardiff University, Cardiff, UK;4. Program in Physical Therapy and Department of Neurology, Wayne State University, Detroit, MI, United States of America;1. Cognitive Neuroscience of Perception and Action, Faculty of Psychology, Philipps University Marburg, Marburg, Germany;2. Neuromotor Behavior Laboratory, Department of Psychology and Sport Science, Justus-Liebig-University Giessen, Giessen, Germany;3. Department of Psychology and Sports Sciences, Goethe-University Frankfurt/Main, Germany;1. Escola de Educação Física, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;2. Dept. Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;3. Faculty of Health and Medical Sciences, University of Copenhagen, Denmark;4. Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel;1. São Paulo State University (UNESP), School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Graduate Program in Movement Sciences, Bauru, SP, Brazil;2. Federal University of Espírito Santo (UFES), Center of Physical Education and Sports (CEFD), Vitória, ES, Brazil;1. CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal;2. CIMOSM, Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, 1959-007 Lisboa, Portugal |
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| Abstract: | 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. |
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