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Increased alertness, better than posture prioritization, explains dual-task performance in prosthesis users and
Charla L Howard1,2, Bonnie Perry3, John W Chow3
1Division of Orthotics and Prosthetics, Methodist Rehabilitation Center, 1350 E. Woodrow Wilson Drive, Jackson, MS, 39216, USA. choward@mmrcrehab.org.
Experimental Brain Research
|September 2, 2017
Summary
Prosthesis users prioritized concurrent tasks over balance during dual-task standing, unlike controls who prioritized balance. Both groups showed improved performance under increased challenge, suggesting cognitive-motor facilitation via heightened alertness.
Area of Science:
- Biomechanics
- Neuroscience
- Rehabilitation Science
Background:
- Sensorimotor impairments post-limb amputation significantly impact postural stability.
- Individuals commonly employ posture-first or posture-second strategies to manage balance during concurrent tasks.
Purpose of the Study:
- To investigate balance control strategies in below-knee prosthesis users versus controls during dual-task standing.
- To examine the influence of increasing postural and cognitive challenges on these strategies.
Main Methods:
- 13 below-knee prosthesis users and 15 controls performed single and dual-task standing on force platforms.
- Conditions included usual (hard surface/eyes open) and difficult (soft surface/eyes closed) environments.
- Cognitive tasks were administered with and without prioritization instructions.
Main Results:
- Prosthesis users favored the posture-second strategy, increasing sway during dual-tasking without prioritization.
- Controls exhibited the posture-first strategy, reducing sway under greater postural challenge.
- Both groups demonstrated improved performance (reduced sway and/or better cognitive scores) under increased challenge, indicating cognitive-motor facilitation.
Conclusions:
- Prosthesis users and controls may rely on cognitive-motor facilitation (increased alertness) rather than strict posture prioritization for dual-task stability.
- Understanding these strategies is crucial for designing effective rehabilitation interventions for individuals with limb amputations.
