Cognitive-Motor Interference in Multiple Sclerosis: A Systematic Review of Evidence, Correlates, and Consequences

Individuals with multiple sclerosis (MS) regularly exhibit deficits in motor and cognitive function. Recent evidence suggests that these impairments are compounded when motor and cognitive task are performed simultaneously such as walking while talking. The changes incurred during simultaneous performance of motor and cognitive tasks are a result of cognitive-motor interference (CMI) and operationalized as dual task costs (DTC). Recently in MS, research has been conducted to understand and analyze the impact of CMI. The purpose of this paper was to review the current literature related to the evidence, correlates, and consequences of CMI in MS. Relevant literature was collected from the results of a PubMed search for terms including "Cognitive-motor interference" or "Cognitive-motor interaction" or "Dual task" and "multiple sclerosis. " Overall, 20 papers were included for review which focused on CMI during balance and walking tasks. The finding that there is a lack of evidence pertaining to changes in the cognitive domain as well as to the specific consequences of CMI in MS was noted. Future work should aim to fill these gaps and ultimately investigate the usefulness of targeted interventions in reducing the deleterious effects of CMI in individuals with MS

Cognitive-Motor Interference in Multiple Sclerosis: A Systematic Review of Evidence, Correlates, and Consequences

Individuals with multiple sclerosis (MS) regularly exhibit deficits in motor and cognitive function. Recent evidence suggests that these impairments are compounded when motor and cognitive task are performed simultaneously such as walking while talking. The changes incurred during simultaneous performance of motor and cognitive tasks are a result of cognitive-motor interference (CMI) and operationalized as dual task costs (DTC). Recently in MS, research has been conducted to understand and analyze the impact of CMI. The purpose of this paper was to review the current literature related to the evidence, correlates, and consequences of CMI in MS. Relevant literature was collected from the results of a PubMed search for terms including “Cognitive-motor interference” or “Cognitive-motor interaction” or “Dual task” and “multiple sclerosis.” Overall, 20 papers were included for review which focused on CMI during balance and walking tasks. The finding that there is a lack of evidence pertaining to changes in the cognitive domain as well as to the specific consequences of CMI in MS was noted. Future work should aim to fill these gaps and ultimately investigate the usefulness of targeted interventions in reducing the deleterious effects of CMI in individuals with MS

Human Factors Assessment of a Novel Pediatric Lower-Limb Exoskeleton

While several lower-limb exoskeletons have been designed for adult patients, there remains a lack of pediatric-oriented devices. This paper presented a human factor assessment of an adjustable pediatric lower-limb exoskeleton for childhood gait assistance. The hip and knee exoskeleton uses an adjustable frame for compatibility with children 6–11 years old. This assessment evaluates the device’s comfort and ease of use through timed donning, doffing, and reconfiguration tasks. The able-bodied study participants donned the device in 6 min and 8 s, doffed it in 2 min and 29 s, and reconfigured it in 8 min and 23 s. The results of the timed trials suggest that the exoskeleton can be easily donned, doffed, and reconfigured to match the anthropometrics of pediatric users. A 6-min unpowered walking experiment was conducted while the child participant wore the exoskeletal device. Inspection of both the device and participant yielded no evidence of damage to either the device or wearer. Participant feedback on the device was positive with a system usability scale rating of 80/100. While minor improvements can be made to the adjustability indicators and padding placement, the results indicate the exoskeleton is suitable for further experimental evaluation through assistive control assessments

Human Factors Assessment of a Novel Pediatric Lower-Limb Exoskeleton

While several lower-limb exoskeletons have been designed for adult patients, there remains a lack of pediatric-oriented devices. This paper presented a human factor assessment of an adjustable pediatric lower-limb exoskeleton for childhood gait assistance. The hip and knee exoskeleton uses an adjustable frame for compatibility with children 6–11 years old. This assessment evaluates the device’s comfort and ease of use through timed donning, doffing, and reconfiguration tasks. The able-bodied study participants donned the device in 6 min and 8 s, doffed it in 2 min and 29 s, and reconfigured it in 8 min and 23 s. The results of the timed trials suggest that the exoskeleton can be easily donned, doffed, and reconfigured to match the anthropometrics of pediatric users. A 6-min unpowered walking experiment was conducted while the child participant wore the exoskeletal device. Inspection of both the device and participant yielded no evidence of damage to either the device or wearer. Participant feedback on the device was positive with a system usability scale rating of 80/100. While minor improvements can be made to the adjustability indicators and padding placement, the results indicate the exoskeleton is suitable for further experimental evaluation through assistive control assessments

Effects of Walking Direction and Cognitive Challenges on Gait in Persons with Multiple Sclerosis

Declines in walking performance are commonly seen when undergoing a concurrent cognitive task in persons with multiple sclerosis (MS). The purpose of this study was to determine the effect of walking direction and simultaneous cognitive task on the spatiotemporal gait parameters in persons with MS compared to healthy controls. Ten persons with MS (Median EDSS, 3.0) and ten healthy controls took part in this pilot study. Participants performed 4 walking trials at their self-selected comfortable pace. These trials included forward walking, forward walking with a cognitive task, backward walking, and backward walking with a cognitive task. Walking performance was indexed with measures of velocity, cadence, and stride length for each testing condition. The MS group walked slower with significantly reduced stride length compared to the control group. The novel observation of this investigation was that walking differences between persons with MS and healthy controls were greater during backward walking, and this effect was further highlighted during backward walking with added cognitive test. This raises the possibility that backward walking tests could be an effective way to examine walking difficulties in individuals with MS with relatively minimal walking impairment