Biomechanical and neurocognitive performance outcomes of walking with transtibial limb loss while challenged by a concurrent task.

Autor: Pruziner AL; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA. alison.l.pruziner.civ@mail.mil.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA. alison.l.pruziner.civ@mail.mil.; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. alison.l.pruziner.civ@mail.mil., Shaw EP; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.; Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA., Rietschel JC; Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.; Baltimore Veterans Administration Medical Center, Baltimore, MD, USA., Hendershot BD; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA., Miller MW; Center for Neuroscience, School of Kinesiology, Auburn University, Auburn, AL, USA., Wolf EJ; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA., Hatfield BD; Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA., Dearth CL; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA.; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA., Gentili RJ; Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA.; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA.; Maryland Robotics Center, University of Maryland, College Park, MD, USA.
Jazyk: angličtina
Zdroj: Experimental brain research [Exp Brain Res] 2019 Feb; Vol. 237 (2), pp. 477-491. Date of Electronic Publication: 2018 Nov 20.
DOI: 10.1007/s00221-018-5419-8
Abstrakt: Individuals who have sustained loss of a lower limb may require adaptations in sensorimotor and control systems to effectively utilize a prosthesis, and the interaction of these systems during walking is not clearly understood for this patient population. The aim of this study was to concurrently evaluate temporospatial gait mechanics and cortical dynamics in a population with and without unilateral transtibial limb loss (TT). Utilizing motion capture and electroencephalography, these outcomes were simultaneously collected while participants with and without TT completed a concurrent task of varying difficulty (low- and high-demand) while seated and walking. All participants demonstrated a wider base of support and more stable gait pattern when walking and completing the high-demand concurrent task. The cortical dynamics were similarly modulated by the task demand for both groups, to include a decrease in the novelty-P3 component and increase in the frontal theta/parietal alpha ratio power when completing the high-demand task, although specific differences were also observed. These findings confirm and extend prior efforts indicating that dual-task walking can negatively affect walking mechanics and/or neurocognitive performance. However, there may be limited additional cognitive and/or biomechanical impact of utilizing a prosthesis in a stable, protected environment in TT who have acclimated to ambulating with a prosthesis. These results highlight the need for future work to evaluate interactions between these cognitive-motor control systems for individuals with more proximal levels of lower limb loss, and in more challenging (ecologically valid) environments.
Databáze: MEDLINE
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