Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-02T18:58:43.232Z Has data issue: false hasContentIssue false
  • English
  • Français

Walking and talking therapy: Improving cognitive–motor dual-tasking in neurological illness

Published online by Cambridge University Press:  01 January 2009

JONATHAN J. EVANS ,
EVE GREENFIELD ,
BARBARA A. WILSON  and
ANDREW BATEMAN
JONATHAN J. EVANS*
Affiliation:
Section of Psychological Medicine, Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom
EVE GREENFIELD
Affiliation:
Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom
BARBARA A. WILSON
Affiliation:
Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
ANDREW BATEMAN
Affiliation:
Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, United Kingdom
*
*Correspondence and reprint requests to: Jonathan Evans, University of Glasgow, Faculty of Medicine, Section of Psychological Medicine, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Using randomized control trial methodology, we evaluated the effectiveness of a 5-week cognitive–motor dual-tasking training program developed to improve performance of a group of people with dual-tasking difficulties arising from acquired brain injury. Training involved twice-daily practice on exercises involving walking being combined with tasks which increased in cognitive demand over the course of the intervention. A treatment group (n = 10) was compared with a control group (n = 9). The primary outcome measure was a task requiring participants to walk and carry out a spoken sentence verification task simultaneously. Secondary outcome measures were measures of dual-tasking involving either two motor tasks or two cognitive tasks. A questionnaire measure relating to activities of daily living requiring dual-tasking was also completed. Compliance with the training program was good. We found evidence of improvement in performance on the primary outcome measure, but little evidence of generalization to other measures. There was some evidence that participants believed that their dual-tasking performance in everyday life was improved after the intervention. The study was limited in terms of sample size, was not blinded and did not control fully for therapist contact time, but has produced valuable data relating to effect sizes associated with this form of intervention. (JINS, 2009, 15, 112–120.)

Keywords

AttentionBrain injuryRehabilitationCognitionWalkingRandomized controlled trial
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 1 , January 2009 , pp. 112 - 120
Copyright
Copyright © INS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Baddeley, A.D., Della Sala, S., Gray, C., Papagno, C., & Spinnler, H. (1997). Testing central executive functioning with a pencil and paper test. In Rabbitt, P. (Ed.), Methodology of Frontal and Executive Function. Hove: Psychology Press.Google Scholar
Baddeley, A.D., Emslie, H., & Nimmo-Smith, I. (1992). The Speed and Capacity of Language Processing (SCOLP) Test. Bury St Edmunds: Thames Valley Test Company.Google Scholar
Brooks, D.N. & McKinlay, W. (1987). Return to work within the first seven years of severe head injury. Brain Injury, 1, 5–15.CrossRefGoogle ScholarPubMed
Camicioli, R., Bouchard, T., & Licis, L. (2006). Dual-tasks and walking fast: Relationship to extra-pyramidal signs in advanced Alzheimer’s disease. Journal of the Neurological Sciences, 248, 205–209.CrossRefGoogle Scholar
Camicioli, R., Howieson, D., Lehman, S., & Kaye, J. (1997). Talking while walking: The effect of a dual task in aging and Alzheimer’s disease. Neurology, 48, 955–958.CrossRefGoogle ScholarPubMed
Cocchini, G., Della Sala, S., Logie, R.H., Pagani, L., & Spinnier, H. (2004). Dual task effects of walking when talking in Alzheimer’s disease. La Revue Neurologique, 160, 1, 74–80.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences (2nd Ed). Hillsdale, NJ: Erlbaum.Google Scholar
Evans, J.J., Greenfield, E., & Wilson, B.A. (2004). The development of an ecologically valid test of divided attention [Abstract]. Brain Impairment, 5(Suppl.), 51–52.Google Scholar
Greenfield, E., Evans, J.J., Emslie, H., Manly, T., Wilson, B.A., & Hodges, J.R. (2006). Cognitive-motor dual tasking in Alzheimer’s disease [Abstract]. Journal of the International Neuropsychological Society; JINS, 12(Suppl. 2), 49.Google Scholar
Greenfield, E., Evans, J.J., and Wilson, B.A. (2004). Use of a divided attention test to assess emergence from post traumatic amnesia [Abstract]. Brain Impairment, 5(Suppl.), 53.Google Scholar
Haggard, P. & Cockburn, J. (1998). Dividing attention between cognitive and motor tasks in neurological rehabilitation. Neuropsychological Rehabilitation, 8, 155–170.Google Scholar
Haggard, P., Cockburn, J., Cock, J., Fordham, C., & Wade, D. (2000). Interference between gait and cognitive tasks in a rehabilitating neurological population. Journal of Neurology, Neurosurgery, and Psychiatry, 69, 479–486.CrossRefGoogle Scholar
Logie, R.H., Della Sala, S., Cocchini, G., & Baddeley, A.D. (2004). Is there a specific executive capacity for dual task coordination? Evidence from Alzheimer’s disease. Neuropsychology, 18, 504–513.CrossRefGoogle Scholar
Lundin-Olsson, L., Nyberg, L., & Gustafson, Y. (1997). “Stops walking when talking” as a predictor of falls in elderly people. The Lancet, 349, 617.CrossRefGoogle ScholarPubMed
Mahoney, F.I. & Barthel, D. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 56–61.Google ScholarPubMed
Manly, T. & Mattingly, J. (2004). Visuospatial and attentional disorders. In Goldstein, L. & McNeil, J. (Eds.), Clinical Neuropsychology: A Practical Guide to Assessment and Management for Clinicians. Chichester: Wiley.Google Scholar
Posner, M.I. & Peterson, S.E. (1990). The attention system of the human brain. Annual Review of Neuroscience, 13, 25–42.CrossRefGoogle ScholarPubMed
Robertson, I.H., Ward, A., Ridgeway, V., & Nimmo-Smith, I. (1994). Test of Everyday Attention. London: Pearson.Google Scholar
Robertson, I.H., Ridgeway, V., Greenfield, E., & Parr, A. (1997). Motor recovery after stroke depends upon intact sustained attention: A two year follow-up study. Neuropsychology, 11, 290–295.CrossRefGoogle Scholar
Rochester, L., Hetherington, V., Jones, D., Nieuwboer, A., Willems, A.M., Kwakkel, G., & Van Wegen, E. (2004). Attending to the task: Interference effects of functional tasks on walking in Parkinson’s disease and the roles of cognition, depression, fatigue, and balance. Archives of Physical Medicine and Rehabilitation, 85, 1578–1585.CrossRefGoogle Scholar
Sohlberg, M.M. & Mateer, C.A. (2001). Cognitive Rehabilitation: An Integrative Neuropsychological Approach. New York: Guilford Press.Google Scholar
Streiner, D. & Norman, G. (1995). Health Measurement Scales: A Practical Guide to their Development and Use. Oxford: Oxford University Press.Google Scholar
Sturm, W., Finn, B., Cantagallo, A., Cremel, N., North, P., Passadori, A., Pizzamiglio, L., Rousseaux, P., Zimmerman, P., Deloche, G., & Leclercq, M. (2002). Computerised training of specific attention deficits in stroke and traumatic brain injured patients: A multicentre efficacy study. In Leclerk, M., & Zimmerman, P. (Eds.), Applied Neuropsychology of Attention. Hove: Psychology Press.Google Scholar
Wilkins, A.J., Shallice, T., & McCarthy, R. (1987). Frontal lesions and sustained attention. Neuropsychologia, 25, 359–365.CrossRefGoogle ScholarPubMed
Wilson, B.A., Evans, J.J., Greenfield, E., Emslie, H., Manly, T., & Bateman, A. (2006). Identifying and Understanding Divided Attention Deficits in People with Brain Injury. London: Department of Health, National Research Register.Google Scholar
Yogev, G., Peretz, C., Springer, S., Simon, E.S., & Hausdorff, J.M. (2005). Dual tasking, gait rhythmicity, and Parkinson’s disease: Which aspects of gait are attention demanding? European Journal of Neuroscience, 22, 1248–1256.CrossRefGoogle ScholarPubMed
Zakzanis, K.K. (2001). Statistics to tell the truth, the whole truth, and nothing but the truth: Formulae, illustrative numerical examples, and heuristic interpretation of effect size analyses for neuropsychological researchers. Archives of Clinical Neuropsychology, 16, 653–667.CrossRefGoogle ScholarPubMed