The dual-task methodology and assessing the attentional demands of ambulation with walkers

Abstract

The Purpose Of this study was threefold: (1) to provide an examination Of the attentional demands of ambulating with two commonly prescribed walking aids (a standard Walker and a rolling walker) in a non-patient Population,, (2) to replicate Experiment one using a patient population, and (3) to identify factors that contribute to increased attention demand when using different ambulatory devices. In the first study, five healthy subjects familiar with the appropriate use of walkers and five subjects. uninformed as to the correct use of the walkers were used. Each subject completed three phases of the experiment: (1) performing the reaction time (RT) task only; (2) performing each of the walking tasks alone; and (3) performing each of the walking tasks in conjunction with the RT task, which constituted the dual-task condition. The second study replicated the above design using six patients with low back/lower extremity pain that increased with weight bearing. The final study involved 12 healthy subjects, three of which were familiar with the use of the ambulatory devices. The two phases of the third study consisted of: (1) performing the RT task only and (2) performing a combination of two speeds and two walking patterns in conjunction with the RT task. The findings of Experiment 1 indicate that walking, aided by either the standard or the rolling walker was highly attention demanding. In addition, ambulation assisted by a standard walker was shown to require relatively greater attention than a similar activity aided by a rolling walker. Experiment 2 demonstrated similar findings in a patient population with regard to the use of assistive devices. Ambulation without a device was also shown to be attention demanding, which was not the case in Experiment 1. This was most likely due to the presence of pain. Experiment 3 indicated that the increase in attention demands appears to be associated with speed as opposed to gait modifications when using the ambulatory devices.