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      Changes in Standing and Walking Performance Under Dual-Task Conditions Across the Lifespan

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          Abstract

          Simultaneous performance of a postural and a concurrent task is rather unproblematic as long as the postural task is executed in an automatic way. However, in situations where postural control requires more central processing, cognitive resources may be exceeded by the addition of an attentionally demanding task. This may lead to interference between the two tasks, manifested in a decreased performance in one or both tasks (dual-task costs). Owing to changes in attentional demands of postural tasks as well as processing capacities across the lifespan, it might be assumed that dual-task costs are particularly pronounced in children and older adults probably leading to a U-shaped pattern for dual-task costs as a function of age. However, these changes in the ability of dual-tasking posture from childhood to old age have not yet been systematically reviewed. Therefore, Web of Science and PubMed databases were searched for studies comparing dual-task performance with one task being standing or walking in healthy groups of young adults and either children or older adults. Seventy-nine studies met inclusion criteria. For older adults, the expected increase in dual-task costs could be confirmed. In contrast, in children there was only feeble evidence for a trend towards enlarged dual-task costs. More good-quality studies comparing dual-task ability in children, young, and, ideally, also older adults within the same paradigm are needed to draw unambiguous conclusions about lifespan development of dual-task performance in postural tasks. There is evidence that, in older adults, dual-task performance can be improved by training. For the other age groups, these effects have yet to be investigated.

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          The automaticity of complex motor skill learning as a function of attentional focus.

          The present experiment was designed to test the predictions of the constrained-action hypothesis. This hypothesis proposes that when performers utilize an internal focus of attention (focus on their movements) they may actually constrain or interfere with automatic control processes that would normally regulate the movement, whereas an external focus of attention (focus on the movement effect) allows the motor system to more naturally self-organize. To test this hypothesis, a dynamic balance task (stabilometer) was used with participants instructed to adopt either an internal or external focus of attention. Consistent with earlier experiments, the external focus group produced generally smaller balance errors than did the internal focus group and responded at a higher frequency indicating higher confluence between voluntary and reflexive mechanisms. In addition, probe reaction times (RTs) were taken as a measure of the attention demands required under the two attentional focus conditions. Consistent with the hypothesis, the external focus participants demonstrated lower probe RTs than did the internal focus participants, indicating a higher degree of automaticity and less conscious interference in the control processes associated with the balance task.
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            "Stops walking when talking" as a predictor of falls in elderly people.

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              Components of postural dyscontrol in the elderly: a review.

              The concept of a generalized aging effect on a generalized balance mechanism is discussed, and an alternative, multicomponent approach to understanding the heterogeneity of postural dyscontrol in the elderly is presented. Neural sensorimotor components of normal postural control mechanisms are identified and discussed. The effects of Parkinson's disease, hemiplegia, cerebellar degeneration, peripheral vestibular loss, and other disorders on the components of postural control are summarized. Quantitative posturography is advocated to detect preclinical manifestation of multiple musculoskeletal and neuromuscular pathologies and reduced compensatory abilities in posturally unstable elderly adults.
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                Author and article information

                Contributors
                +41 26 300 72 62 , jan.ruffieux@unifr.ch
                Journal
                Sports Med
                Sports Med
                Sports Medicine (Auckland, N.z.)
                Springer International Publishing (Cham )
                0112-1642
                1179-2035
                8 August 2015
                8 August 2015
                2015
                : 45
                : 12
                : 1739-1758
                Affiliations
                [ ]Department of Medicine, Movement and Sport Sciences, University of Fribourg, Bd de Pérolles 95, 1700 Fribourg, Switzerland
                [ ]Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstr. 175, 79117 Freiburg, Germany
                Article
                369
                10.1007/s40279-015-0369-9
                4656695
                26253187
                51ed3675-84a5-4404-bddb-8293e941d10e
                © The Author(s) 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                © Springer International Publishing Switzerland 2015

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