Highlights
- •Relations between DT walking performance and clinical characteristics were analysed.
- •Relations depend on type of motor and cognitive task used in the dual task.
- •Better mobility in MS is related to higher DT walking speed.
- •Faster information processing speed related to lower DTC.
Abstract
Background: In persons with Multiple Sclerosis (pwMS) performing a simultaneous cognitive
task while walking often results in slower gait. Clinical characteristics associated
with reduced dual task (DT) performance are not yet entirely clear. This multi-centre
study aimed to determine the relationship between clinical and demographical characteristics
with dual task (DT) walking performance in pwMS during multiple DT conditions.
Methods: Nine DT conditions were analysed, consisting of combinations of three types
of cognitive (‘digit span’, ‘subtraction’, ‘vigilance’) and three types of walking
(‘walk’, ‘walk with cup’, ‘walk over obstacles’) conditions. Primary outcomes were
DT gait speed (m/s) and motor DT cost of gait speed (DTCmotor, %). Secondary outcomes
were clinical tests of physical and cognitive functioning and patient-reported and
demographical outcomes. Firstly, univariate analyses and, subsequently, multivariate
analyses with backward modelling, were conducted for each type of walking DT condition
separately. Cognitive DT conditions were included in the models as main and as interaction
effect with the secondary outcomes.
Results: Analysis were performed in 81 pwMS (EDSS 3.3 ± 1.0). In the final models
of DTCmotor, the significant main effects were in ‘walk’ DT-conditions the Symbol
Digit Modalities Test (SDMT), in ‘cup’ conditions the SDMT and Dynamic Gait Index
and in ‘obstacles’ conditions age. For DT gait speed, main effects were found for
the 2-Minute Walking Test (2MWT) and the Multiple Sclerosis Walking Scale for all
walking conditions. Additionally, interactions between cognitive DT-conditions and
SDMT, age and 2MWT were found.
Conclusion: Clinical characteristics related to DT walking performance differed according
to cognitive-motor DT-condition used. Still, in general, pwMS with a better mobility
demonstrated higher DT gait speed, while a faster information processing speed was
related to a lower DTCmotor.
Key words
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Article info
Publication history
Published online: August 28, 2021
Accepted:
August 27,
2021
Received in revised form:
August 16,
2021
Received:
March 19,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
