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Cognitive-Motor Dual-Task Costs on Postural Sway During Sit-to-Stand Movement in Children With Cerebral Palsy
Camila Resende Gâmbaro Lima1, Sílvia Leticia Pavão1,2, Bruna Romão da Silva1
1Department of Physiotherapy, Neuropediatrics Section, Federal University of São Carlos, São Carlos, São Paulo, Brazil.
Insights
Children with cerebral palsy (CP) and typical development (TD) experience different cognitive-motor dual-task costs (DTCs) during sit-to-stand. CP demonstrated lower DTCs, while TD children showed increased costs with higher cognitive task complexity.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Biomechanical Engineering
Background:
- Children with cerebral palsy (CP) often exhibit motor control deficits, impacting their ability to perform complex movements.
- Assessing postural sway during functional tasks like sit-to-stand is crucial for understanding motor control in children.
- Cognitive-motor dual-task costs (DTCs) provide insights into the attentional demands and control strategies during simultaneous tasks.
Purpose of the Study:
- To investigate and compare the cognitive-motor dual-task costs (DTCs) on postural sway in children with typical development (TD) and children with cerebral palsy (CP).
- To analyze these DTCs during the sit-to-stand movement across different phases (preparation, rising, stabilization).
- To examine how varying cognitive task complexity influences postural sway in both groups.
Main Methods:
- Twenty children with TD and 17 children with CP performed sit-to-stand under simple motor, low-complexity dual-task, and high-complexity dual-task conditions.
- Postural sway was quantified by center of pressure area, velocity, and duration during three movement phases.
- DTCs were calculated as the percentage change in sway variables between simple and dual-task conditions.
Main Results:
- Children with CP exhibited lower DTCs in sway area (P1, P2) and velocity (P1, P2, P3) compared to TD children.
- TD children showed significantly higher DTCs with increased cognitive task complexity (high vs. low).
- Children with CP did not demonstrate significant differences in DTCs between low and high cognitive task complexities, indicating a lack of adaptation.
Conclusions:
- The impact of cognitive-motor dual-tasking on postural sway differs between children with CP and TD, contingent on task demands.
- Rehabilitation strategies should incorporate varied postural sway challenges to enhance motor control in these populations.
- Understanding group-specific DTCs is vital for tailoring effective assessment and intervention approaches.
Objective:
The purpose of this study was to investigate the cognitive-motor dual-task costs (DTCs) on postural sway of children with typical development (TD) and children with cerebral palsy (CP) during the sit-to-stand movement.
Methods:
Twenty children with TD (mean age = 9.35 years) and 17 children with CP (mean age = 8.29 years) randomly performed 3 test conditions: simple motor task, low-complexity cognitive-motor dual-task, and high-complexity cognitive-motor dual-task. The sit-to-stand movement was divided into 3 phases for data analysis: preparation (P1), rising (P2), and stabilization (P3). For each of these phases, the DTCs were calculated by the percentage change in the center of pressure area of sway, velocity of sway, and duration variables between the simple and dual-task conditions. Analysis of variance was applied to test the group, task conditions, and interaction effects.
Results:
Children with CP had lower DTC than children with TD in area of sway in P1 and P2 variables; anteroposterior velocity of sway in P1, P2, and P3; and duration in P3. Children with TD had higher DTC in the high-complexity cognitive-motor dual-task than in the low complexity one. Children with CP did not show adaptations between the dual-task conditions, showing no differences in DTCs.
Conclusion:
The simultaneous performance of a motor task and a cognitive task seems to affect children with CP and children with TD differently, but the effects depend on the specific demands of each task. These results demonstrate the importance of rehabilitation actions to place demands involving a variety of postural sway strategies.
Impact:
DTCs are different for children with TD and children with CP. Assessment and rehabilitation strategies must take into account the postural sway behavior of these children.
