Date Presented 03/23/24
Adults with dysvascular lower limb amputation fell into mutual interference or cognitive priority trade-off groups when going from single to dual tasking. There were no significant differences between repeated-fall (n = 15) and nonfall (n = 10) groups.
Primary Author and Speaker: Laura A. Swink
Contributing Authors: Kathryn A. Nearing, Elizabeth A. Juarez-Colunga, Arlene Schmid, Prudence Plummer, Cory L. Christiansen
PURPOSE: Adults with lower limb amputation (LLA) have difficulty dual-tasking, which is associated with higher fall risk. This study examined relationships between dual-tasking, falls, and instrumental activities of daily living (IADLs) for Veterans with dysvascular LLA.
DESIGN: Cross-sectional.
METHOD: To assess dual-task effects (DTE), serial subtraction was performed while walking, as well as each task alone (single-task) DTE were calculated as: ((dual task-single task)/single task)*100 for correct response rate (cognitive) and gait seed (motor). Cognitive and motor DTE were plotted to identify patterns of interference or tradeoff. Participants were grouped by non-faller (0-1 falls) and repeated faller (2+ falls) in past year. IADL participation was measured using the Frenchay Activities of Daily Living Scale (FAI). Descriptive statistics (mean±SD), normality testing, independent t-tests, and Pearson's correlations were used for analysis.
RESULTS: Twenty-five Veterans participated (66.2±7.8 years old, 5.6±7.8 years post-LLA). Fifteen (60%) of participants were repeated fallers, 10 (40%) were non-fallers, and the average number of falls was 7.6±19.7. Twenty-two participants (88%) experienced either mutual interference (n=12) or cognitive-priority trade-off (n=10) DTE. Both repeated fallers and non-fallers demonstrated gait speed decline when dual-tasking, but repeated fallers had greater gaitDTE decline (–26.7% vs. –16.9%, p=.2). For cognitive DTE, non-fallers had decline in correct response rate when dual-tasking and fallers had minimal change (–18.4% vs. 1.5%, p=.2). FAI scores were not correlated with gaitDTE (r= –.1, p=.8) or cognitiveDTE (r= .1, p=.6).
CONCLUSION: Individuals with LLA experienced mutual interference, cognitive priority trade off, or minimal change when dual-tasking.
IMPACT STATEMENT: We must examine interventions to improve dual-task ability for adults with dysvascular LLA to maximize safe and efficient participation in everyday life.
References
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