Research Article| Volume 56, 103230, November 2021

Associations between clinical characteristics and dual task performance in Multiple Sclerosis depend on the cognitive and motor dual tasks used.

Published:August 28, 2021DOI:


      • 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.


      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.

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