Dual-Task Cost and Related Clinical Features in Patients With Multiple Sclerosis

in Motor Control

Click name to view affiliation

Cagla Ozkul Gazi University

Search for other papers by Cagla Ozkul in
Current site
Google Scholar
PubMed Close
*
,
Arzu Guclu-Gunduz Gazi University

Search for other papers by Arzu Guclu-Gunduz in
Current site
Google Scholar
PubMed Close
*
,
Kader Eldemir Gazi University

Search for other papers by Kader Eldemir in
Current site
Google Scholar
PubMed Close
*
,
Yasemin Apaydin Gazi University

Search for other papers by Yasemin Apaydin in
Current site
Google Scholar
PubMed Close
*
,
Cagri Gulsen Gazi University

Search for other papers by Cagri Gulsen in
Current site
Google Scholar
PubMed Close
*
,
Gokhan Yazici Gazi University

Search for other papers by Gokhan Yazici in
Current site
Google Scholar
PubMed Close
*
,
Fatih Soke Gazi University

Search for other papers by Fatih Soke in
Current site
Google Scholar
PubMed Close
*
, and
Ceyla Irkec Gazi University

Search for other papers by Ceyla Irkec in
Current site
Google Scholar
PubMed Close
*
DOI:
https://doi.org/10.1123/mc.2020-0035
Keywords:
balance; cognition; manual dexterity; walking
First Published Online:
12 Jan 2021
In Print:
Volume 25: Issue 2
Page Range:
211–233
Restricted access

This study aimed to investigate the dual-task cost of both motor and cognitive performances in patients with multiple sclerosis (PwMS) and in healthy controls and to determine their relationships with clinical features in PwMS. The participants performed motor tasks (postural stability, walking, and manual dexterity) and cognitive tasks (mental tracking and verbal fluency) under single- and dual-task conditions. The results showed that postural stability under dual-task conditions did not change, whereas walking and manual dexterity deteriorated, regardless of the concurrent cognitive task, in PwMS (median Expanded Disability Status Scale score: 1) and the healthy controls. Verbal fluency decreased during postural stability, whereas it increased during walking, and it was maintained during manual dexterity in both groups. Mental tracking did not change during walking; it declined during manual dexterity in both groups. Mental tracking during postural stability deteriorated in PwMS, while it did not change in the healthy controls. In general, dual-task costs were associated with baseline performances of tasks rather than clinical features. Therefore, baseline performances of both tasks should be increased for improving dual-task performance in PwMS.

Ozkul, Guclu-Gunduz, Eldemir, Apaydin, Gulsen, Yazici, and Soke are with the Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey. Irkec is with the Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey. Irkec is now with the Department of Neurology, Lokman Hekim Hospital, Ankara, Turkey.

Ozkul (caglaozkul@hotmail.com, caglaozkul@gazi.edu.tr) is corresponding author.

Supplementary Materials

    • Supplementary Material (PDF 303 KB)
  • Collapse
  • Expand

Motor Control

Cover Motor Control

  • Allali, G., Laidet, M., Assal, F., Armand, S., & Lalive, P.H. (2014). Walking while talking in patients with multiple sclerosis: The impact of specific cognitive loads. Neurophysiologie Clinique, 44(1), 87–93. PubMed ID: 24502909 doi:10.1016/j.neucli.2013.10.136

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Baddeley, A., Della Sala, S., Gray, C., Papagno, C., & Spinnler, H. (2004). Testing central executive functioning with a pencil-and-paper test. In Rabbitt, P. (Ed.), Methodology of frontal and executive function (pp. 61–86). Hove, UK: Psychology Press.

    • Search Google Scholar
    • Export Citation

  • Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571. PubMed ID: 13688369 doi:10.1001/archpsyc.1961.01710120031004

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B (Methodological), 57(1), 289–300. doi:10.1111/j.2517-6161.1995.tb02031.x

    • Search Google Scholar
    • Export Citation

  • Butchard-MacDonald, E., Paul, L., & Evans, J.J. (2018). Balancing the demands of two tasks: An investigation of cognitive-motor dual-tasking in relapsing remitting multiple sclerosis. Journal of the International Neuropsychological Society, 24(3), 247–258. PubMed ID: 28934996 doi:10.1017/S1355617717000947

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Buysse, D.J., Reynolds, C.F., 3rd, Monk, T.H., Berman, S.R., & Kupfer, D.J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. PubMed ID: 2748771 doi:10.1016/0165-1781(89)90047-4

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Cachupe, W.J., Shifflett, B., Kahanov, L., & Wughalter, E.H. (2001). Reliability of biodex balance system measures. Measurement in Physical Education and Exercise Science, 5(2), 97–108. doi:10.1207/S15327841MPEE0502_3

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Cattaneo, D., Lamers, I., Bertoni, R., Feys, P., & Jonsdottir, J. (2017). Participation restriction in people with multiple sclerosis: Prevalence and correlations with cognitive, walking, balance, and upper limb impairments. Archives of Physical Medicine and Rehabilitation, 98(7), 1308–1315. PubMed ID: 28336344 doi:10.1016/j.apmr.2017.02.015

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Cevallos, C., Zarka, D., Hoellinger, T., Leroy, A., Dan, B., & Cheron, G. (2015). Oscillations in the human brain during walking execution, imagination and observation. Neuropsychologia, 79(Pt B), 223–232. PubMed ID: 26164473 doi:10.1016/j.neuropsychologia.2015.06.039

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Chen, A., Kirkland, M.C., Wadden, K.P., Wallack, E.M., & Ploughman, M. (2020). Reliability of gait and dual-task measures in multiple sclerosis. Gait Posture, 78, 19–25. PubMed ID: 32179457 doi:10.1016/j.gaitpost.2020.03.004

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Ciol, M.A., Matsuda, P.N., Khurana, S.R., Cline, M.J., Sosnoff, J.J., & Kraft, G.H. (2017). Effect of cognitive demand on functional mobility in ambulatory individuals with multiple sclerosis. International Journal of MS Care, 19(4), 217–224. PubMed ID: 28835746 doi:10.7224/1537-2073.2016-120

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Coghe, G., Pilloni, G., Zucca, E., Porta, M., Corona, F., Frau, J., … Cocco, E. (2018). Exploring cognitive motor interference in multiple sclerosis by the visual Stroop test. Multiple Sclerosis and Related Disorders, 22, 8–11. PubMed ID: 29501850 doi:10.1016/j.msard.2018.02.026

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Collie, A., Maruff, P., Darby, D.G., & McStephen, M. (2003). The effects of practice on the cognitive test performance of neurologically normal individuals assessed at brief test-retest intervals. Journal of the International Neuropsychological Society, 9(3), 419–428. PubMed ID: 12666766 doi:10.1017/S1355617703930074

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Curtin, F., & Schulz, P. (1998). Multiple correlations and Bonferroni’s correction. Biological Psychiatry, 44(8), 775–777. PubMed ID: 9798082 doi:10.1016/S0006-3223(98)00043-2

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Downer, M.B., Kirkland, M.C., Wallack, E.M., & Ploughman, M. (2016). Walking impairs cognitive performance among people with multiple sclerosis but not controls. Human Movement Science, 49, 124–131. PubMed ID: 27371919 doi:10.1016/j.humov.2016.06.010

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. PubMed ID: 19897823 doi:10.3758/BRM.41.4.1149

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Feys, P., Lamers, I., Francis, G., Benedict, R., Phillips, G., LaRocca, N., … Multiple Sclerosis Outcome Assessments Consortium. (2017). The Nine-Hole Peg Test as a manual dexterity performance measure for multiple sclerosis. Multiple Sclerosis, 23(5), 711–720. PubMed ID: 28206826 doi:10.1177/1352458517690824

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hamilton, F., Rochester, L., Paul, L., Rafferty, D., O’Leary, C.P., & Evans, J.J. (2009). Walking and talking: An investigation of cognitive-motor dual tasking in multiple sclerosis. Multiple Sclerosis, 15(10), 1215–1227. PubMed ID: 19667011 doi:10.1177/1352458509106712

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kalron, A., Dvir, Z., & Achiron, A. (2010). Walking while talking--difficulties incurred during the initial stages of multiple sclerosis disease process. Gait Posture, 32(3), 332–335. PubMed ID: 20594850 doi:10.1016/j.gaitpost.2010.06.002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kirkland, M.C., Wallack, E.M., Rancourt, S.N., & Ploughman, M. (2015). Comparing three dual-task methods and the relationship to physical and cognitive impairment in people with multiple sclerosis and controls. Multiple Sclerosis International, 2015, 650645. PubMed ID: 26682069 doi:10.1155/2015/650645

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46(10), 1121–1123. PubMed ID: 2803071 doi:10.1001/archneur.1989.00520460115022

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Learmonth, Y.C., Ensari, I., & Motl, R.W. (2017). Cognitive motor interference in multiple sclerosis: Insights from a systematic quantitative review. Archives of Physical Medicine and Rehabilitation, 98(6), 1229–1240. PubMed ID: 27543046 doi:10.1016/j.apmr.2016.07.018

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Learmonth, Y.C., Pilutti, L.A., & Motl, R.W. (2015). Generalised cognitive motor interference in multiple sclerosis. Gait Posture, 42(1), 96–100. PubMed ID: 25957651 doi:10.1016/j.gaitpost.2015.04.014

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Learmonth, Y.C., Sandroff, B.M., Pilutti, L.A., Klaren, R.E., Ensari, I., Riskin, B.J., … Motl, R.W. (2014). Cognitive motor interference during walking in multiple sclerosis using an alternate-letter alphabet task. Archives of Physical Medicine and Rehabilitation, 95(8), 1498–1503. PubMed ID: 24681387 doi:10.1016/j.apmr.2014.03.007

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Lemmens, J., Ferdinand, S., Vandenbroucke, A., Ilsbroukx, S., & Kos, D. (2018). Dual-task cost in people with multiple sclerosis: A case–control study. British Journal of Occupational Therapy, 81(7), 384–392. doi:10.1177/0308022618757936

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Motl, R.W., Sosnoff, J.J., Dlugonski, D., Pilutti, L.A., Klaren, R., & Sandroff, B.M. (2014). Walking and cognition, but not symptoms, correlate with dual task cost of walking in multiple sclerosis. Gait Posture, 39(3), 870–874. PubMed ID: 24378281 doi:10.1016/j.gaitpost.2013.11.023

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Oppezzo, M., & Schwartz, D.L. (2014). Give your ideas some legs: The positive effect of walking on creative thinking. Journal of Experimental Psychology: Learning, Memory, and Cognition, 40(4), 1142. PubMed ID: 24749966 doi:10.1037/a0036577

    • Search Google Scholar
    • Export Citation

  • Pashler, H. (1994). Dual-task interference in simple tasks: Data and theory. Psychological Bulletin, 116(2), 220–244. PubMed ID: 7972591 doi:10.1037/0033-2909.116.2.220

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Plummer, P., & Eskes, G. (2015). Measuring treatment effects on dual-task performance: A framework for research and clinical practice. Frontiers in Human Neuroscience, 9, 225. PubMed ID: 25972801 doi:10.3389/fnhum.2015.00225

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Postigo-Alonso, B., Galvao-Carmona, A., Benitez, I., Conde-Gavilan, C., Jover, A., Molina, S., … Aguera, E. (2018). Cognitive-motor interference during gait in patients with Multiple Sclerosis: A mixed methods Systematic Review. Neuroscience & Biobehavioral Reviews, 94, 126–148. PubMed ID: 30189226 doi:10.1016/j.neubiorev.2018.08.016

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Postigo-Alonso, B., Galvao-Carmona, A., Conde-Gavilan, C., Jover, A., Molina, S., Pena-Toledo, M.A., … Aguera, E. (2019). The effect of prioritization over cognitive-motor interference in people with relapsing-remitting multiple sclerosis and healthy controls. PLoS One, 14(12), e0226775. PubMed ID: 31869375 doi:10.1371/journal.pone.0226775

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Powell, L.E., & Myers, A.M. (1995). The Activities-specific Balance Confidence (ABC) scale. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 50A(1), M28–M34. PubMed ID: 7814786 doi:10.1093/gerona/50a.1.m28

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Prosperini, L., Castelli, L., De Luca, F., Fabiano, F., Ferrante, I., & De Giglio, L. (2016). Task-dependent deterioration of balance underpinning cognitive-postural interference in MS. Neurology, 87(11), 1085–1092. PubMed ID: 27521436 doi:10.1212/WNL.0000000000003090

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Prosperini, L., Castelli, L., Sellitto, G., De Luca, F., De Giglio, L., Gurreri, F., & Pozzilli, C. (2015). Investigating the phenomenon of “cognitive-motor interference” in multiple sclerosis by means of dual-task posturography. Gait Posture, 41(3), 780–785. PubMed ID: 25770078 doi:10.1016/j.gaitpost.2015.02.002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Raats, J., Lamers, I., Baert, I., Willekens, B., Veldkamp, R., & Feys, P. (2018). Cognitive-motor interference in persons with multiple sclerosis during five upper limb motor tasks with different complexity. Multiple Sclerosis, 25(13), 1736–1745. PubMed ID: 30417718 doi:10.1177/1352458518808194

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Rao, S.M., Leo, G.J., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 41(5), 685–691. PubMed ID: 2027484 doi:10.1212/WNL.41.5.685

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Rooney, S., Ozkul, C., & Paul, L. (2020). Correlates of dual-task performance in people with multiple sclerosis: A systematic review. Gait Posture, 81, 172–182. PubMed ID: 32750612 doi:10.1016/j.gaitpost.2020.07.069

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Ruggieri, S., Fanelli, F., Castelli, L., Petsas, N., De Giglio, L., & Prosperini, L. (2018). Lesion symptom map of cognitive-postural interference in multiple sclerosis. Multiple Sclerosis, 24(5), 653–662. PubMed ID: 28337941 doi:10.1177/1352458517701313

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sandroff, B.M., Benedict, R.H., & Motl, R.W. (2015). Nonsignificant associations between measures of inhibitory control and walking while thinking in persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 96(8), 1518–1524. PubMed ID: 25944499 doi:10.1016/j.apmr.2015.04.015

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Schober, P., Boer, C., & Schwarte, L.A. (2018). Correlation coefficients: Appropriate use and interpretation. Anesthesia & Analgesia, 126(5), 1763–1768. PubMed ID: 29481436 doi:10.1213/ANE.0000000000002864

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sebastiao, E., Sandroff, B.M., Learmonth, Y.C., & Motl, R.W. (2016). Validity of the timed up and go test as a measure of functional mobility in persons with multiple sclerosis. Archives of Physical Medicine and Rehabilitation, 97(7), 1072–1077. PubMed ID: 26944709 doi:10.1016/j.apmr.2015.12.031

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sepulcre, J., Peraita, H., Goñi, J., Arrondo, G., Martincorena, I., Duque, B., … Villoslada, P. (2011). Lexical access changes in patients with multiple sclerosis: A two-year follow-up study. Journal of Clinical and Experimental Neuropsychology, 33(2), 169–175. PubMed ID: 20835944 doi:10.1080/13803395.2010.499354

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Sosnoff, J.J., Socie, M.J., Sandroff, B.M., Balantrapu, S., Suh, Y., Pula, J.H., & Motl, R.W. (2014). Mobility and cognitive correlates of dual task cost of walking in persons with multiple sclerosis. Disability and Rehabilitation, 36(3), 205–209. PubMed ID: 23597000 doi:10.3109/09638288.2013.782361

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Thompson, A.J., Banwell, B.L., Barkhof, F., Carroll, W.M., Coetzee, T., Comi, G., … Freedman, M.S. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology, 17(2), 162–173. PubMed ID: 29275977 doi:10.1016/S1474-4422(17)30470-2

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tombu, M., & Jolicœur, P. (2003). A central capacity sharing model of dual-task performance. Journal of Experimental Psychology: Human Perception and Performance, 29(1), 3–18. PubMed ID: 12669744 doi:10.1037//0096-1523.29.1.3

    • Search Google Scholar
    • Export Citation

  • Wajda, D.A., Motl, R.W., & Sosnoff, J.J. (2014). Correlates of dual task cost of standing balance in individuals with multiple sclerosis. Gait Posture, 40(3), 352–356. PubMed ID: 24909581 doi:10.1016/j.gaitpost.2014.04.209

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Wajda, D.A., Roeing, K.L., McAuley, E., Motl, R.W., & Sosnoff, J.J. (2016). The relationship between balance confidence and Cognitive motor interference in individuals with multiple sclerosis. Journal of Motor Behavior, 48(1), 66–71. PubMed ID: 25988565 doi:10.1080/00222895.2015.1040110

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Yogev-Seligmann, G., Hausdorff, J.M., & Giladi, N. (2012). Do we always prioritize balance when walking? Towards an integrated model of task prioritization. Movement Disorders, 27(6), 765–770. PubMed ID: 22419512 doi:10.1002/mds.24963

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 3183 1069 41
Full Text Views 17 6 3
PDF Downloads 15 4 0