The effects of dual tasks on gait in children with cerebral palsy

Lena Carcreff; Joel Fluss; Gilles Allali; Nathalie Valenza; Kamiar Aminian; Christopher J Newman; Stéphane Armand

doi:10.1016/j.gaitpost.2019.02.014

The effects of dual tasks on gait in children with cerebral palsy

Gait Posture. 2019 May:70:148-155. doi: 10.1016/j.gaitpost.2019.02.014. Epub 2019 Feb 21.

Authors

Lena Carcreff¹, Joel Fluss², Gilles Allali³, Nathalie Valenza⁴, Kamiar Aminian⁵, Christopher J Newman⁶, Stéphane Armand⁷

Affiliations

¹ Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva 1211, Switzerland; Laboratory of Movement Analysis and Measurement, EPFL, Lausanne 1015, Switzerland; Pediatric Neurology and Neurorehabilitation Unit, Department of Pediatrics, Lausanne University Hospital, Lausanne 1011, Switzerland. Electronic address: lena.carcreff@hcuge.ch.
² Pediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva 1211, Switzerland. Electronic address: joel.fluss@hcuge.ch.
³ Department of Neurology, Geneva University Hospitals and University of Geneva, Geneva 1211, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA. Electronic address: gilles.allali@hcuge.ch.
⁴ Pediatric Neurology Unit, Children's Hospital, Geneva University Hospitals, Geneva 1211, Switzerland. Electronic address: nathalie.valenza@hcuge.ch.
⁵ Laboratory of Movement Analysis and Measurement, EPFL, Lausanne 1015, Switzerland. Electronic address: kamiar.aminian@epfl.ch.
⁶ Pediatric Neurology and Neurorehabilitation Unit, Department of Pediatrics, Lausanne University Hospital, Lausanne 1011, Switzerland. Electronic address: christopher.newman@chuv.ch.
⁷ Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva 1211, Switzerland. Electronic address: stephane.armand@hcuge.ch.

PMID: 30875601
DOI: 10.1016/j.gaitpost.2019.02.014

Abstract

Aim: To assess the gait and cognitive performances of children with cerebral palsy (CP) during dual tasks (DT) in comparison to typically developing (TD) children.

Method: This prospective, observational, case-control study included 18 children with CP (7 girls, 11 boys; median age 12 [10:13] years and 19 controls (9 girls, 10 boys; median age 12 [10:13y6mo] years). Performances were recorded during a simple walking task, 5 DT (walking + cognitive tasks with increasing cognitive load), and 5 simple cognitive tasks (while sitting). Gait parameters were computed using an optoelectronic system during walking tasks. Six parameters were selected for analysis by a principal component analysis. Cognitive performance was measured for each cognitive task. The dual-task cost (DTC) was calculated for each DT.

Results: Gait performance decreased in both groups as DT cognitive load increased (e.g., walking speed normalized by leg length, in simple task: 1.25 [1.15:1.46] s^-1 for CP, 1.53 [1.38:1.62] s^-1 for TD; DT with highest load: 0.64 [0.53:0.80] s^-1 for CP, 0.95 [0.75:1.08] s^-1 for TD). The CP group performed significantly worse than TD group in every task (including the simple task), but DTC were similar in both groups. A task effect was found for the majority of the gait parameters.

Interpretation: The reduced gait performance induced by DT may generate underestimated difficulties for children with CP in daily-life situations, where DT are common. This should be considered in clinical assessments.

Keywords: Cerebral palsy; Cognitive-motor interference; Dual tasks; Gait.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Case-Control Studies
Cerebral Palsy / physiopathology*
Child
Cognition / physiology*
Female
Gait / physiology*
Humans
Male
Multitasking Behavior / physiology*
Principal Component Analysis
Prospective Studies
Task Performance and Analysis