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      Gait parameters are differently affected by concurrent smartphone-based activities with scaled levels of cognitive effort

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          Abstract

          The widespread and pervasive use of smartphones for sending messages, calling, and entertainment purposes, mainly among young adults, is often accompanied by the concurrent execution of other tasks. Recent studies have analyzed how texting, reading or calling while walking–in some specific conditions–might significantly influence gait parameters. The aim of this study is to examine the effect of different smartphone activities on walking, evaluating the variations of several gait parameters. 10 young healthy students (all smartphone proficient users) were instructed to text chat (with two different levels of cognitive load), call, surf on a social network or play with a math game while walking in a real-life outdoor setting. Each of these activities is characterized by a different cognitive load. Using an inertial measurement unit on the lower trunk, spatio-temporal gait parameters, together with regularity, symmetry and smoothness parameters, were extracted and grouped for comparison among normal walking and different dual task demands. An overall significant effect of task type on the aforementioned parameters group was observed. The alterations in gait parameters vary as a function of cognitive effort. In particular, stride frequency, step length and gait speed show a decrement, while step time increases as a function of cognitive effort. Smoothness, regularity and symmetry parameters are significantly altered for specific dual task conditions, mainly along the mediolateral direction. These results may lead to a better understanding of the possible risks related to walking and concurrent smartphone use.

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          The role of executive function and attention in gait.

          Until recently, gait was generally viewed as a largely automated motor task, requiring minimal higher-level cognitive input. Increasing evidence, however, links alterations in executive function and attention to gait disturbances. This review discusses the role of executive function and attention in healthy walking and gait disorders while summarizing the relevant, recent literature. We describe the variety of gait disorders that may be associated with different aspects of executive function, and discuss the changes occurring in executive function as a result of aging and disease as well the potential impact of these changes on gait. The attentional demands of gait are often tested using dual tasking methodologies. Relevant studies in healthy adults and patients are presented, as are the possible mechanisms responsible for the deterioration of gait during dual tasking. Lastly, we suggest how assessments of executive function and attention could be applied in the clinical setting as part of the process of identifying and understanding gait disorders and fall risk. 2007 Movement Disorder Society
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            Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.

            The use of a simple, safe, and easy to perform assessment tool, like gait speed, to evaluate vulnerability to adverse outcomes in community-dwelling older people is appealing, but its predictive capacity is still questioned. The present manuscript summarises the conclusions of an expert panel in the domain of physical performance measures and frailty in older people, who reviewed and discussed the existing literature in a 2-day meeting held in Toulouse, France on March 12-13, 2009. The aim of the IANA Task Force was to state if, in the light of actual scientific evidence, gait speed assessed at usual pace had the capacity to identify community-dwelling older people at risk of adverse outcomes, and if gait speed could be used as a single-item tool instead of more comprehensive but more time-consuming assessment instruments. A systematic review of literature was performed prior to the meeting (Medline search and additional pearling of reference lists and key-articles supplied by Task Force members). Manuscripts were retained for the present revision only when a high level of evidence was present following 4 pre-selected criteria: a) gait speed, at usual pace, had to be specifically assessed as a single-item tool, b) gait speed should be measured over a short distance, c) at baseline, participants had to be autonomous, community-dwelling older people, and d) the evaluation of onset of adverse outcomes (i.e. disability, cognitive impairment, institutionalisation, falls, and/or mortality) had to be assessed longitudinally over time. Based on the prior criteria, a final selection of 27 articles was used for the present manuscript. Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive impairment, institutionalisation, falls, and/or mortality. In predicting these adverse outcomes over time, gait speed was at least as sensible as composite tools. Although more specific surveys needs to be performed, there is sufficient evidence to state that gait speed identifies autonomous community-dwelling older people at risk of adverse outcomes and can be used as a single-item assessment tool. The assessment at usual pace over 4 meters was the most often used method in literature and might represent a quick, safe, inexpensive and highly reliable instrument to be implemented.
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              Walking is more like catching than tapping: gait in the elderly as a complex cognitive task.

              Walking is generally viewed as an automated, over-learned, rhythmic motor task and may even be considered the lower-limb analog of rhythmic finger tapping, another automated motor task. Thus, one might hypothesize that walking would be associated with a simple rhythmic task like tapping rather than with a complex motor task like catching. Surprisingly, however, we find that among older adults, routine walking has more in common with complex motor tasks, like catching a moving object, than it does with tapping. Tapping performance, including both the average tapping interval and the variability of tapping interval, was not significantly associated with any gait parameter (gait speed, average stride time and stride time variability). In contrast, catch game performance was significantly associated with measures of walking, suggesting that walking is more like catching than it is like tapping. For example, participants with a higher gait speed tended to have lower times to first move when catching, better catching accuracy, and less catching errors. Stride time variability was significantly associated with each of the measures of catching. Participants with a lower stride time variability (a more steady gait) had better catching accuracy, lower time to first move, fewer direction changes when moving the cursor to catch the falling object, and less catching errors. To understand this association, we compared walking performance to performance on the Stroop test, a classic measure of executive function, and tests of memory. Walking was associated with higher-level cognitive resources, specifically, executive function, but not with memory or cognitive function in general. For example, a lower (better) stride time variability was significantly associated with higher (better) scores on the Stroop test, but not with tests of memory. Similarly, when participants were stratified based on their performance on the Stroop test and tests of memory, stride time variability was dependent on the former, but not the latter. These findings underscore the interconnectedness of gait and cognitive function, indicate that even routine walking is a complex cognitive task that is associated with higher-level cognitive function, and suggest an alternative approach to the treatment of gait and fall risk in the elderly.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 October 2017
                2017
                : 12
                : 10
                : e0185825
                Affiliations
                [001]Department of Engineering, Roma Tre University, Rome, Italy
                University of Western Ontario, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-5356-6986
                Article
                PONE-D-17-13544
                10.1371/journal.pone.0185825
                5638288
                29023456
                98c14fc5-8d43-4e21-95b0-0e24f2c5b197
                © 2017 Caramia et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 April 2017
                : 20 September 2017
                Page count
                Figures: 3, Tables: 0, Pages: 13
                Funding
                The work was funded in part by University and Department funds comprehensively dedicated to research activities.
                Categories
                Research Article
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Gait Analysis
                Medicine and Health Sciences
                Physiology
                Biological Locomotion
                Gait Analysis
                Engineering and Technology
                Equipment
                Communication Equipment
                Cell Phones
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Medicine and Health Sciences
                Physiology
                Biological Locomotion
                Walking
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Social Sciences
                Psychology
                Cognitive Psychology
                Biology and Life Sciences
                Behavior
                Recreation
                Games
                People and Places
                Population Groupings
                Age Groups
                Young Adults
                Computer and Information Sciences
                Network Analysis
                Social Networks
                Social Sciences
                Sociology
                Social Networks
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Attention
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Attention
                Social Sciences
                Psychology
                Cognitive Psychology
                Attention
                Custom metadata
                All relevant data are available from figshare at: DOI: 10.6084/m9.figshare.5437048.

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                Uncategorized

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