The Effects of Cognitive Training on Balance and Mobility in Adults with Multiple Sclerosis

Presenter's Name(s)

Kaley AhernFollow

Conference Year

January 2019

Abstract

Background:

Individuals with multiple sclerosis (MS) experience both cognitive and movement deficits which negatively impact functioning. Given that a majority of tasks require simultaneously thinking and moving (i.e., dual-tasking), these disease-related impairments significantly increase fall risk in those with the disease. The purpose of this project was to examine the feasibility and effects of a home-based cognitive training (CT) program on balance and mobility in adults with MS.

Methods:

Three individuals with MS completed four cognitive functioning tests as well as three motor tasks (self-paced walking, timed up and go (TUG), and upright stance), prior to and post six weeks of CT. Instrumented measures of balance and gait were collected under single and dual task conditions to assess changes in cognitive-motor interference. For walking, outcome variables included cadence, double limb support, gait speed, and stride length, while for standing balance, outcome variables included jerk, mean velocity, path length, sway, and range. Total duration for the TUG was also assessed. Pre-post percent change in dual-task cost was computed for each variable.

Results:

For all participants, results indicated improvement in double support time and gait speed while walking and total duration during the TUG. Two participants demonstrated improvements in jerk, path length, and sway variability during upright stance. Additionally, all participants improved in the visual-graphic memory test and two participants showed improvements in the other cognitive tests. Results revealed that participants prioritized the motor task over the cognitive task when dual-tasking.

Implications:

Practitioners may want to consider the intersect between motor and cognitive complexity when offering balance training interventions for people with MS. This study offers preliminary insight into a model of rehabilitation that may decrease fall risk in those with the disease, although a more rigorous randomized controlled trial of CT is warranted.

Primary Faculty Mentor Name

Susan Kasser

Status

Graduate

Student College

College of Nursing and Health Sciences

Program/Major

Exercise Science

Primary Research Category

Health Sciences

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The Effects of Cognitive Training on Balance and Mobility in Adults with Multiple Sclerosis

Background:

Individuals with multiple sclerosis (MS) experience both cognitive and movement deficits which negatively impact functioning. Given that a majority of tasks require simultaneously thinking and moving (i.e., dual-tasking), these disease-related impairments significantly increase fall risk in those with the disease. The purpose of this project was to examine the feasibility and effects of a home-based cognitive training (CT) program on balance and mobility in adults with MS.

Methods:

Three individuals with MS completed four cognitive functioning tests as well as three motor tasks (self-paced walking, timed up and go (TUG), and upright stance), prior to and post six weeks of CT. Instrumented measures of balance and gait were collected under single and dual task conditions to assess changes in cognitive-motor interference. For walking, outcome variables included cadence, double limb support, gait speed, and stride length, while for standing balance, outcome variables included jerk, mean velocity, path length, sway, and range. Total duration for the TUG was also assessed. Pre-post percent change in dual-task cost was computed for each variable.

Results:

For all participants, results indicated improvement in double support time and gait speed while walking and total duration during the TUG. Two participants demonstrated improvements in jerk, path length, and sway variability during upright stance. Additionally, all participants improved in the visual-graphic memory test and two participants showed improvements in the other cognitive tests. Results revealed that participants prioritized the motor task over the cognitive task when dual-tasking.

Implications:

Practitioners may want to consider the intersect between motor and cognitive complexity when offering balance training interventions for people with MS. This study offers preliminary insight into a model of rehabilitation that may decrease fall risk in those with the disease, although a more rigorous randomized controlled trial of CT is warranted.