Article

People with lower limb amputation are unable to reliably sense ground
characteristics due to compromised sensory inputs from the missing limb. As a
result, they may rely on compensatory strategies, such as use of cognitive
resources, when walking over complex surfaces.
This study examined interactions
between cognition and walking over a compliant surface in 14 people with
transfemoral amputation (TFA) and 14 controls using a dual-task paradigm. Walking
was assessed with quantitative motion analysis in both single-task (walking
alone) and dual-task (walking while performing a cognitive task) conditions over
a compliant foam surface. Outcomes were walking speed, step width, step time
asymmetry, step time variability, and the speed and accuracy of cognitive task
performance. For each outcome, effects of task (single-task, dual-task) and group
(TFA, control) were examined with repeated-measures analysis of variance. No
significant group-by-task interactions were observed for cognitive task
performance. A significant group-by-task interaction for step time asymmetry
indicated that participants with TFA increased temporal asymmetry in dual-task
relative to single-task conditions, while control participants maintained
symmetrical gait. The addition of a concurrent cognitive task did not
differentially affect other aspects of gait between groups. Significant main
effects of group for all walking outcomes indicated that participants with TFA
walked slower, with wider, more asymmetric, and more variable steps than
controls. Results suggest that gait quality degrades in challenging dual-task
conditions for people with TFA, but not controls, consistent with the idea that
people with TFA may use increased cognitive resources to control walking in
complex environments.
CI - Copyright (c) 2017 Elsevier B.V. All rights reserved.

Langue : ANGLAIS