The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Effects of Dual Tasks on Balance Ability in Patients with Cerebellar Ataxia

  • Kang, Bangsoo (Department of Physical Education, College of Education, Korea University) ;
  • Park, Jin-Hoon (Department of Physical Education, College of Education, Korea University)
  • Received : 2015.09.15
  • Accepted : 2015.10.19
  • Published : 2015.10.25
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Abstract

Purpose: The purpose of this study was to examine the effects of dual tasks on balance and postural control during standing in patients with cerebellar ataxia (CA). It was hypothesized that CA patients would exhibit different sway characteristics of the center of mass (COM) depending on the complexity of the secondary cognitive tasks compared with normal control subjects. Methods: A total of 8 patients with CA and age-matched healthy control subjects participated in this study. They were instructed to perform two balance tasks (non-dual and dual movement) with 3 different complexity of dual tasks. Range, variability, and velocity of COMs were measured. Results: According to the results CA patients showed deficits in balance and postural control with increased dual-task complexity during the static balance task in saggital sway movements. However, there was no significant difference in static balance in frontal sway. With higher difficulty in the cognitive task, CA patients took longer to stabilize their body center, while normal control subjects showed no change between conditions. In addition, CA patients had a greater COM resultant velocity during recovery in the dual-task condition compared with the single-task condition. These findings indicate that CA patients had defendable compensatory strategies in performing dual tasks. Conclusion: In conclusion, CA patients appeared to manage the priority to balance and postural control. Particularly in a situation with a postural threat such as when potential consequences of the loss of stability increase, they appeared to prioritize the control of balance and posture over the performance of the secondary task.

Keywords

References

  1. Shumway-Cook A, Woollacott MH. Motor control: Theory and practical application. 2nd ed. Baltimore, Williams & Wilkins, 2001:197-228.
  2. Manchester D, Woollacott M, Zederbauer-Hylton N et al. Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol. 1989;44(4):M118-M27. https://doi.org/10.1093/geronj/44.5.M118
  3. Kim JH. Relationship between gait symmetry and functional balance, walking performance in subjects with stroke. J Kor Phys Ther. 2014;26(1):15-20. https://doi.org/10.1589/jpts.26.15
  4. Aruin AS, Latash ML. The role of motor action in anticipatory postural adjustments studied with self-induced and externally triggered perturbations. Exp Brain Res. 1995;106(2):291-300.
  5. Chae YW, Park JW, Park s. Effects of knee malalignment on static and dynamic postural stability. J Kor Phys Ther. 2015;27(1):7-11.
  6. Horak FB, MacPherson JM, Peterson BW. Postural orientation and equilibrium. New York, Published for the American Physiological Society by Oxford University Press, 1996.
  7. Winter DA, Prince F, Frank JS et al. Unified theory regarding A/P and M/L balance in quiet stance. J Neurophysiol. 1996;75(6):2334-43. https://doi.org/10.1152/jn.1996.75.6.2334
  8. Yang DJ, Park SK, Kang JI et al. Effects of changes in postural alignment on foot pressure and balance of patients with stroke. J Kor Phys Ther. 2014;26(6):226-33.
  9. McCollum G, Leen TK. Form and exploration of mechanical stability limits in erect stance. J Mot Behav. 1989;21(3):225-44. https://doi.org/10.1080/00222895.1989.10735479
  10. Song HS, Kim JY. Clinical feasibility of mental practice for gait ability improvement of Parkinson disease patients: ABA single subject design. J Kor Phys Ther. 2014;26(6):398-402.
  11. Lee KS, Kim K, Lee NK. The effects of lower limb training using sliding rehabilitation machine on the foot motion and stability in stroke patients. J Kor Phys Ther. 2015;27(1):24-9. https://doi.org/10.18857/jkpt.27.1.24
  12. Bensoussan L, Viton JM, Schieppati M et al. Changes in postural control in hemiplegic patients after stroke performing a dual task. Arch Phys Med Rehabil. 2007;88(8):1009-15. https://doi.org/10.1016/j.apmr.2007.05.009
  13. Morris M, Iansek R, Smithson F et al. Postural instability in Parkinson's disease: a comparison with and without a concurrent task. Gait Posture. 2000;12(3):205-16. https://doi.org/10.1016/S0966-6362(00)00076-X
  14. Morton SM, Bastian AJ. Cerebellar contributions to locomotor adaptations during splitbelt treadmill walking. J Neurosci. 2006;26(36):9107-16. https://doi.org/10.1523/JNEUROSCI.2622-06.2006
  15. Kwon YH, Kim CS. Comparison of Motor Function and Skill between Stroke Patients with Cerebellar and Non-cerebellar Lesion in Sub-acute. J Kor Phys Ther. 2012;24(6):423-27. https://doi.org/10.1589/jpts.24.423
  16. Inhoff AW, Diener HC, Rafal RD et al. The role of cerebellar structures in the execution of serial movements. Brain. 1989;112(3):565-81. https://doi.org/10.1093/brain/112.3.565
  17. Morton SM, Bastian AJ. Cerebellar control of balance and locomotion. Neuroscientist. 2004;10(3):247-59. https://doi.org/10.1177/1073858404263517
  18. Nashner LM. Fixed patterns of rapid postural responses among leg muscles during stance. Exp Brain Res. 1977;30(1):13-24.
  19. Horak FB, Nashner LM. Central programming of postural movements: adaptation to altered support-surface configurations. J Neurophysiol. 1986;55(6):1369-81. https://doi.org/10.1152/jn.1986.55.6.1369
  20. Pellecchia GL. Postural sway increases with attentional demands of concurrent cognitive task. Gait Posture. 2003;18(1):29-34. https://doi.org/10.1016/S0966-6362(02)00138-8
  21. Yardley L, Gardner M, Lavie N et al. Attentional demands of perception of passive self-motion in darkness. Neuropsychologia. 1999;37(11):1293-301. https://doi.org/10.1016/S0028-3932(99)00024-X
  22. Morton SM, Bastian AJ. Relative contributions of balance and voluntary leg coordination deficits to cerebellar gait ataxia. J Neurophysiol. 2003;89:1844-56. https://doi.org/10.1152/jn.00787.2002
  23. Benjuya N, Melzer I, Kaplanski J. Aging-induced shifts from a reliance on sensory input to muscle cocontraction during balanced standing. J Gerontol A Biol Sci Med Sci. 2004;59(2):M166-M71. https://doi.org/10.1093/gerona/59.2.M166