21 research outputs found
Relevance of walking characteristics in simple and dual task as biomarkers of asymptomatic phase in cognitive decline ?
On admet aujourd'hui que les tests psychomĂ©triques traditionnels paraissent insuffisants pour dĂ©tecter prĂ©cocement des troubles cognitifs. ParallĂšlement, des cliniciens observent une perte de l'automaticitĂ© de la marche lors du vieillissement normal ou de pathologies neurodĂ©gĂ©nĂ©ratives qui peut ĂȘtre directement imputĂ©e au dĂ©clin des fonctions exĂ©cutives (FE) et aggravĂ© lors des situations de double-tĂąche (DT). Plusieurs auteurs ont montrĂ© que la prĂ©sence prĂ©maturĂ©e d'une atteinte motrice pouvait prĂ©dire une Ă©volution dĂ©favorable vers une dĂ©mence de type Alzheimer. Dans ce contexte, il devient Ă©vident que l'Ă©valuation de la marche doit faire l'objet d'une investigation spĂ©cifique lors d'un bilan cognitif. Les travaux de cette thĂšse s'articulent autour du concept de troubles cognitifs lĂ©gers, des FE et de l'Ă©valuation motrice lors de diverses situations de marche.L'objectif principal est de dĂ©terminer si l'Ă©valuation de la marche spontanĂ©e et/ou en DT constitue un outil de dĂ©tection prĂ©coce des troubles cognitifs. Un objectif secondaire est de prĂ©ciser les FE qui affectent la performance motrice dans les situations de DT. L'originalitĂ© de ce travail de thĂšse rĂ©side dans le dĂ©veloppement de nouveaux exercices de DT de navigation spatiale basĂ©s sur l'adaptation de tests neuropsychologiques (test de Corsi, de Stroop et Trail Making Test) Ă la marche. Finalement, nous avons aussi proposĂ© un « stroop Ă©cologique » qui s'intĂ©resse Ă la prise de dĂ©cision de traverser de rue au feu piĂ©ton.Les rĂ©sultats rĂ©vĂšlent que les interfĂ©rences provoquĂ©es par les situations de DT entrainent une modification spĂ©cifique du schĂ©ma de marche du sujet ĂągĂ© ayant des troubles cognitifs mĂȘme lorsqu'ils sont infracliniques. De plus, la rĂ©solution des tests de DT nĂ©cessite la participation commune de plusieurs FE.En conclusion, la batterie de test que nous proposons prĂ©sente un intĂ©rĂȘt potentiel dans la dĂ©tection prĂ©coce des troubles cognitifs chez les sujets ĂągĂ©s, mais aussi dans la comprĂ©hension des mĂ©canismes rĂ©gulant les FE.Traditional psychometric and/or neuropsychologic tests alone, are not powerful enough to detect cognitive disturbances in aging subjects and therefore new criteria and tests should be developed to get relevant screening tools. Since walking is not anymore considered as a pure automatic motor task but as a task depending both on cognitive and executive functions (EF), clinicians became interested in studying walking disturbances in the course of neurodegenerative pathology development. Walking tasks can be complex and could be assimilated as a double-task (DT) when individuals have to simultaneously proceed with cognitive and motor tasks. Several authors have suggested that disturbances in walking abilities could predict cognitive disorders (e.g. Alzheimer Disease, Mild Cognitive Impairment (MCI)). Therefore, walking abilities should specifically be evaluated during cognitive clinical investigation.The main goal of our work is to evaluate whether a walking task alone and/or walking tasks in the context of DT could be of interest in detecting early stages of cognitive disorders in the elderly. A secondary goal is to investigate what are the executive functions that can influence walking during a DT. The originality of our approach also stems from the new motor ability tests we have developed. They are based on validated neuropsychological tests (Corsi, Stroop and Trail Making Tests) and are adapted to the context of walking. Moreover, we also present an adaptation of the Stroop test in the situation of a pedestrian at the cross light intending to cross a street ("ecological Stroop test").Our results show that DT situations induce specific changes in walking scheme in the elderly with established cognitive disorders and also -and this is one of our most important result- with borderline patients. We also show that the DT we tested required the involment of several EF.In conclusion, the new tests we present could be of interest in detecting early stages of cognitive disorders in elderly subjects and moreover can give clues to the mechanisms involved in the regulation of executive functions
The Walking Trail-Making Test is an early detection tool for mild cognitive impairment.
International audienceExecutive function impairment (in particular, mental flexibility) in the elderly, and in patients with mild cognitive impairment (MCI), is strongly correlated with difficulties in performing complex walking tasks. The aim of this study was to determine if the adaptation of a neuropsychological test (the Trail-Making Test), to evaluate executive functions during walking, can be an early detection tool for cognitive impairment. Fifty subjects (15 young, 20 older, presumably healthy, and 15 MCI) were first evaluated for cognitive functions (Mini-Mental State Examination, Frontal Assessment Battery, and Trail-Making Test) and motor functions (10-meter walking test). All subjects then performed a spatial navigation, or a complex walking test (the Walking Trail-Making Test: [WTMT]), and their spatiotemporal walking variables were analyzed using cluster analysis. Following evaluation of WTMT locomotor performance, cluster analysis revealed three groups that were distinctly different in age and cognitive abiliTIES: a group of young subjects, a group of healthy older subjects, MCI subjects with amnestic impairment, and a group of MCI subjects with executive function impairment. The WTMT enabled early detection, (ie, borderline MCI) of dysexecutive impairment, with 78% sensitivity and 90% specificity. The WTMT is of interest in that it can help provide early detection of dysexecutive cognitive impairment
Should the concept of MCI be revised in order to improve detection of dementia?
International audienc
Utilisation de la rĂ©alitĂ© virtuelle pour lâapprentissage de la lecture critique dâarticle en santĂ©
Contexte: La rĂ©alitĂ© virtuelle est utilisĂ©e dans de nombreux enseignements et de diffĂ©rentes maniĂšres en pĂ©dagogie mĂ©dicale mais jusquâĂ prĂ©sent jamais pour lâapprentissage de la lecture critique dâarticle. But : Ăvaluer lâutilisabilitĂ© et lâintĂ©rĂȘt de la rĂ©alitĂ© virtuelle, en complĂ©ment de lâanalyse de la version textuelle dâun article, lors dâun enseignement de lecture critique dâarticle. MĂ©thodes : Seize Ă©tudiants en troisiĂšme annĂ©e de masso-kinĂ©sithĂ©rapie Ă lâUniversitĂ© de Limoges ont bĂ©nĂ©ficiĂ© dâun enseignement de lecture critique dâarticle Ă distance dans le cadre dâun dispositif recourant Ă la rĂ©alitĂ© virtuelle. Des questionnaires les interrogeaient sur leur ressenti, sur les effets secondaires (VRSQ), sur lâutilisabilitĂ© du systĂšme (SUS) et sur lâexpĂ©rience perçue dâutilisateur (AttrackDiff 2). Une grille de lecture critique dâarticle a Ă©tĂ© remplie par les Ă©tudiants aprĂšs lecture dâun article scientifique, puis complĂ©tĂ©e aprĂšs le module en rĂ©alitĂ© virtuelle, donnant deux scores de performance. Le parcours dâapprentissage des Ă©tudiants dans lâexpĂ©rience virtuelle a Ă©galement Ă©tĂ© analysĂ©. RĂ©sultats : Les apprenants ont obtenu des scores significativement supĂ©rieurs aprĂšs la visualisation du module en rĂ©alitĂ© virtuelle (respectivement 13,1 ± 3,0 et 14,3 ± 3,1, p < 0,05). Les Ă©tudiants ont estimĂ© que lâoutil facilitait la comprĂ©hension dâune Ă©tude scientifique et quâil augmentait la motivation et la concentration. LâutilisabilitĂ© et lâattractivitĂ© du module en rĂ©alitĂ© virtuelle Ă©tait satisfaisantes, malgrĂ© la prĂ©sence de quelques effets indĂ©sirables. Conclusion : La rĂ©alitĂ© virtuelle semble ĂȘtre un outil intĂ©ressant Ă utiliser dans le cadre du dĂ©veloppement de la capacitĂ© dâanalyse critique, notamment dans un enseignement Ă distance en ligne
Walking Stroop carpet: an innovative dual-task concept for detecting cognitive impairment
International audienceBackground: Several studies have reported the potential value of the dual-task concept dur- ing locomotion in clinical evaluation because cognitive decline is strongly associated with gait abnormalities. However, current dual-task tests appear to be insufficient for early diagnosis of cognitive impairment.Methods: Forty-nine subjects (young, old, with or without mild cognitive impairment) underwent cognitive evaluation (Mini-Mental State Examination, Frontal Assessment Battery, five-word test, Stroop, clock-drawing) and single-task locomotor evaluation on an electronic walkway. They were then dual-task-tested on the Walking Stroop carpet, which is an adaptation of the Stroop colorâword task for locomotion. A cluster analysis, followed by an analysis of variance, was performed to assess gait parameters.Results: Cluster analysis of gait parameters on the Walking Stroop carpet revealed an inter- action between cognitive and functional abilities because it made it possible to distinguish dysexecutive cognitive fragility or decline with a sensitivity of 89% and a specificity of 94%. Locomotor abilities differed according to the group and dual-task conditions. Healthy subjects performed less well on dual-tasking under reading conditions than when they were asked to distinguish colors, whereas dysexecutive subjects had worse motor performances when they were required to dual task.Conclusion: The Walking Stroop carpet is a dual-task test that enables early detection of cognitive fragility that has not been revealed by traditional neuropsychological tests or single- task walking analysis
Cognitive Impairment Assessment through Visuospatial Memory Can Be Performed with a Modified Walking Corsi Test Using the âMagic Carpet'
Background: Subjects with mild cognitive impairment (MCI) have disturbances in their spatial navigation abilities and exhibit early deficits in visuospatial short-term memory. The purpose of the present study was to determine whether a quantitative (span score) and qualitative (evaluating navigation strategies used) analysis of the Corsi test (usual condition and complex navigation task) would be useful to reveal cognitive decline. Methods: We evaluated the performance of 15 young adults, 21 healthy elderly subjects and 15 subjects with MCI using the electronic version of the Corsi test (the Modified Corsi Block-Tapping Test, MCBT) and the complex navigation task (the Modified Walking Corsi Test, MWCT). The MWCT, which is an adaptation of the Corsi test, assesses spatial memory when the subject walks in a complex environment. We used Richard et al.'s model [Cogn Sci 1993;17:497-529] to investigate problem-solving strategies during the Corsi tests. Results: The span scores obtained on the MCBT and the MWCT were significantly lower in the healthy elderly subjects (MCBT = 5.0 ± 0.7; MWCT = 4.0 ± 0.7) and the subjects with MCI (MCBT = 4.7 ± 0.8; MWCT = 4.1 ± 0.9) than in the younger adults (MCBT = 6.2 ± 0.6; MWCT = 5.3 ± 1.0). The visuospatial working memory was more impaired in the complex navigation task (MWCT = 4.3 ± 0.9) than in the modified Corsi test (MCBT = 5.3 ± 0.8). Finally, the subjects with greater cognitive impairment were more likely to have inadequate or absence of problem-solving strategies. Conclusions: Investigating the problem-solving strategies used during the MWCT appears to be a promising way to differentiate between the subjects with MCI and the healthy elderly subjects
Ăvaluation par les pairs Ă distance lors dâun enseignement de lecture critique dâarticles pour des Ă©tudiants paramĂ©dicaux
International audienceIntroduction : Lâobjectif de cette Ă©tude Ă©tait de dĂ©terminer la faisabilitĂ© et le niveau de satisfaction dâun atelier dâĂ©valuation par les pairs lors dâun enseignement hybride de lecture critique dâarticles chez des Ă©tudiants en masso-kinĂ©sithĂ©rapie. MatĂ©riel et MĂ©thode : 70 Ă©tudiants en deuxiĂšme annĂ©e (43 femmes et 27 hommes, 21.8 + 3.3 ans) de trois promotions diffĂ©rentes ont participĂ© Ă un dispositif de formation hybride qui associe des cours prĂ©sentiels sur la lecture critique dâarticles et une Ă©valuation sommative par un atelier dâĂ©valuation par les pairs Ă distance via une plateforme numĂ©rique. Nous avons estimĂ© lâacquisition des compĂ©tences par la note obtenue Ă lâexamen et nous avons Ă©valuĂ© le niveau de satisfaction des Ă©tudiants par un questionnaire. RĂ©sultats : Tous les Ă©tudiants ont validĂ© cet enseignement et les notes ne varient pas entre les diffĂ©rentes promotions (p>0.05). Les Ă©tudiants semblent satisfaits de cette Ă©valuation par les pairs Ă distance (6.75/10 ± 1.39) et ils perçoivent bien les compĂ©tences acquises par cet atelier. Ils souhaiteraient globalement avoir plus dâateliers de ce type et ils voient un intĂ©rĂȘt dây avoir recours lors dâune crise sanitaire. Discussion/Conclusion : Cette Ă©tude montre que lâĂ©valuation par les pairs dans le cadre dâune Ă©valuation sommative dâun enseignement de lecture critique dâarticles est applicable et pertinente. LâĂ©valuation par les pairs rĂ©alisĂ©e Ă distance pourrait prĂ©senter un intĂ©rĂȘt majeur pour former et Ă©valuer les Ă©tudiants en formation Ă distance lors de situations exceptionnelles telles quâune pandĂ©mie ou des catastrophes naturelles
The "Stroop Walking Task" : An innovative dual-task for the early detection of executive function impairment
International audienceTo evaluate a dual-task named the "Stroop Walking Task", which is similar to the task of making a decision of whether to cross a street based on a pedestrian traffic light. Fifty-one subjects (15 young adults, 21 subjectively healthy old subjects and 15 old subjects with mild cognitive impairment) had to respond to a visual signal (pictogram) with an appropriate motor response (walk or stop). We used an electronic walkway system to record the gait parameters and performed a cluster analysis on the obtained data. This dual-task enables the early detection of executive function impairment with 89% sensitivity and 87% specificity. The use of a dual-task that is inspired by an everyday event as an evaluation tool seems to facilitate the detection of ageing subjects' cognitive impairment, which is not detectable with traditional psychometric tests
Cardiorespiratory fitness and prefrontal cortex oxygenation during Stroop task in older males
International audienceThe aim of the current study was to assess whether executive function and prefrontal oxygenation are dependent on fitness level and age in older adults
Exercise-based games interventions at home in individuals with a neurological disease: A systematic review and meta-analysis
International audienceThe objective of this review was to summarize the current best evidence for the effectiveness, feasibility, user compliance and safety of exercise-based games (EBGs), including virtual reality and interactive video game interventions, for the rehabilitation of individuals with neurological disorders at home