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Dual task effect on postural control in patients with degenerative cerebellar disorders.

Jacobi H, Alfes J, Minnerop M, Konczak J, Klockgether T, Timmann D - Cerebellum Ataxias (2015)

Bottom Line: The cerebellum plays an important role for balance control and the coordination of voluntary movements.Beyond that there is growing evidence that the cerebellum is also involved in cognitive functions.How ataxic motor symptoms are influenced by simultaneous performance of a cognitive task, however, has rarely been assessed and some of the findings are contradictory.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University Hospital of Bonn, Bonn, Germany.

ABSTRACT

Background: The cerebellum plays an important role for balance control and the coordination of voluntary movements. Beyond that there is growing evidence that the cerebellum is also involved in cognitive functions. How ataxic motor symptoms are influenced by simultaneous performance of a cognitive task, however, has rarely been assessed and some of the findings are contradictory. We assessed stance in 20 patients with adult onset degenerative almost purely cerebellar disorders and 20 healthy controls during single and dual task conditions (verbal working memory task). To objectively measure postural sway and the impact of somatosensory, visual and vestibular inputs we used static and dynamic posturography with the Sensory Organization Test (SOT).

Results: In both groups, cerebellar patients and controls, dual tasking reduced all sway parameters. Reduction of sway path was higher in cerebellar patients and increased with the difficulty of the postural task. The frequency of falls was higher in the patients group especially during the more challenging conditions and dual task performance in particular increased the risk of falls in cerebellar patients.

Conclusion: Dual task conditions had a larger impact on sway parameters in patients with chronic cerebellar disorders than in healthy controls and lead to an increased risk of falls. As performing two tasks simultaneously is common and therefore important in daily life dual task exercises should be part of physical therapy programs for cerebellar patients.

No MeSH data available.


Related in: MedlinePlus

Percentage error in the cognitive task during dual task for all stance conditions (given as mean values with standard deviation); modified according to [18]. Percentage error of cerebellar patients is marked green, of controls grey.
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Fig4: Percentage error in the cognitive task during dual task for all stance conditions (given as mean values with standard deviation); modified according to [18]. Percentage error of cerebellar patients is marked green, of controls grey.

Mentions: Errors in the cognitive task were calculated as percentage error of all target letters to be counted. The mean error was numerically higher in the patient group (75 vs. 39 miscounted letters in patients vs. controls), but this difference was not significant (p = 0.105; 2 Groups (controls vs. cerebellar) x 2 Sets (single vs. dual task) x 6 Sway Conditions (6 SOT conditions) ANOVA) (Figure 4). However, because falls of cerebellar patients during condition 5 and 6 were so frequent and patients stopped counting, these trials had to be excluded from this analysis. Hence error ratio in the patient group actually underestimates the effect of the dual task on memory error.Figure 4


Dual task effect on postural control in patients with degenerative cerebellar disorders.

Jacobi H, Alfes J, Minnerop M, Konczak J, Klockgether T, Timmann D - Cerebellum Ataxias (2015)

Percentage error in the cognitive task during dual task for all stance conditions (given as mean values with standard deviation); modified according to [18]. Percentage error of cerebellar patients is marked green, of controls grey.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4552271&req=5

Fig4: Percentage error in the cognitive task during dual task for all stance conditions (given as mean values with standard deviation); modified according to [18]. Percentage error of cerebellar patients is marked green, of controls grey.
Mentions: Errors in the cognitive task were calculated as percentage error of all target letters to be counted. The mean error was numerically higher in the patient group (75 vs. 39 miscounted letters in patients vs. controls), but this difference was not significant (p = 0.105; 2 Groups (controls vs. cerebellar) x 2 Sets (single vs. dual task) x 6 Sway Conditions (6 SOT conditions) ANOVA) (Figure 4). However, because falls of cerebellar patients during condition 5 and 6 were so frequent and patients stopped counting, these trials had to be excluded from this analysis. Hence error ratio in the patient group actually underestimates the effect of the dual task on memory error.Figure 4

Bottom Line: The cerebellum plays an important role for balance control and the coordination of voluntary movements.Beyond that there is growing evidence that the cerebellum is also involved in cognitive functions.How ataxic motor symptoms are influenced by simultaneous performance of a cognitive task, however, has rarely been assessed and some of the findings are contradictory.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, University Hospital of Bonn, Bonn, Germany.

ABSTRACT

Background: The cerebellum plays an important role for balance control and the coordination of voluntary movements. Beyond that there is growing evidence that the cerebellum is also involved in cognitive functions. How ataxic motor symptoms are influenced by simultaneous performance of a cognitive task, however, has rarely been assessed and some of the findings are contradictory. We assessed stance in 20 patients with adult onset degenerative almost purely cerebellar disorders and 20 healthy controls during single and dual task conditions (verbal working memory task). To objectively measure postural sway and the impact of somatosensory, visual and vestibular inputs we used static and dynamic posturography with the Sensory Organization Test (SOT).

Results: In both groups, cerebellar patients and controls, dual tasking reduced all sway parameters. Reduction of sway path was higher in cerebellar patients and increased with the difficulty of the postural task. The frequency of falls was higher in the patients group especially during the more challenging conditions and dual task performance in particular increased the risk of falls in cerebellar patients.

Conclusion: Dual task conditions had a larger impact on sway parameters in patients with chronic cerebellar disorders than in healthy controls and lead to an increased risk of falls. As performing two tasks simultaneously is common and therefore important in daily life dual task exercises should be part of physical therapy programs for cerebellar patients.

No MeSH data available.


Related in: MedlinePlus