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Visually directed head turning with a cognitive task alters spatiotemporal walking metrics in both healthy and
JooHyun Lee1, Prabhakar Chalise2, Carl W Luchies3
1University of Kansas Medical Center. Department of Physical Therapy, Rehabilitation Science, and Athletic Training, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
Background:
Community walking frequently requires individuals to turn their heads while simultaneously processing visual information. These combined motor, sensory, and cognitive demands may alter spatiotemporal gait metrics, particularly in older adults and those at increased risk of falls. However, it remains unclear whether adults at high risk of falls are disproportionately affected by a combined head-turning and visual-identification task.
Methods:
Forty community-dwelling adults participated (11 middle-aged (MA); mean age 56.3 ± 4.7 years, 12 older adults at low risk for falls (LFO); mean age 71.6 ± 3.8 years, 17 older adults with high risk for falls (HFO); mean age 74.7 ± 2.9 years). Participants wore seven inertial measurement units (IMUs), while performing two walking tasks on a 60-foot walkway: straight walking while looking ahead (STW) and walking with visually directed head turns (WWHT) to identify four letters and their colors. Spatiotemporal gait metrics and head rotation kinematics were calculated from the sensor data.
Results:
WWHT resulted in lower cadence (p = 0.007), slower gait speed (p < 0.001), higher double support duration (p < 0.001), and greater lateral step variability (p < 0.001) compared to STW. No significant group-by-condition interactions were seen. The HFO group walked more slowly than the MA and LFO groups across walking conditions (p < 0.05). Visual identification accuracy remained high, with two participants making one color-identification error each, whereas no letter-identification errors were noted. No differences in head rotation kinematics were noted between the three groups during WWHT (p > 0.05).
Significance:
The combined head-turning and visual-identification task altered spatiotemporal gait changes across all groups; however, the magnitude of change did not differ between groups. Although older adults at higher risk for falls walked more slowly than the MA and LFO groups, their gait was not disproportionately affected by WWHT. Participants preserved accurate performance of the visual identification task while modifying their gait.
