A DIFFERENT APPROACH TO DUAL TASK TESTING

Laessoe U1,2, Larsen CB1, Schunck LN1, Lehmann LJ1, Iversen H11University College of Northern Denmark, Physiotherapy, Aalborg, Denmark, 2University College of Northern Denmark, Research and Development, Aalborg, DenmarkBackground: Good postural control may require minimal attention in normal daily living situations. A well learned sensory-motor control is considered to be automatic and will allow the individual residual attentional capacity for other concurrent tasks. The assessment of a patient's postural control may be of relevance in the clinic. A given test on motor control may be misguiding, however, as the participant may use his/her residual attentional capacity to perform well in the test. Therefore, emphasis has been made on the importance of assessing postural control using dual-task tests. These tests may combine a motor task and a cognitive task. Different attentional requirements may exist, depending on the task, the environment and the balance abilities of the individual. In a clinical setting it remains a challenge to control the individual's prioritization between the tasks and it is difficult to monitor the performance in a secondary task. To overcome these challenges, we evaluate a new approach to dual-task testing.Purpose: Validation of a new version of a dual-task test.Methods: Fifty-four community-dwelling elderly (age 65+) and a reference group of 20 young participants performed a test in which they could utilize cues to improve their base line performance. In the construct validation of the test, it was assumed that the postural control was poorer in the elderly group. In most dual task tests the outcome measure is the decrement in primary task performance with a concurrent secondary task. In this new test the participants may improve the performance with the secondary task. The primary task requires 15 locomotion to touch three lights placed in different zones. In the secondary task, specific colour codes may guide the participant's anticipatory postural control strategies toward these zones. A better performance time can be obtained, provided the level of postural control of the individual is leaving residual attention capacity for this cognitive task and allows the individual to use these cues.Results: The young group improved their performance time by 23.9% (10.7) and 7.1% (14.2) with a cue and a reverse cue respectively. The elderly did not improve their performance time and the difference between groups was highly significant. The test did not distinguish between the individuals within the elderly group with respect to fall history. This was ascribed to a floor effect.Conclusion(s): The test reveals the capacity to use cues for anticipatory postural control strategies in a dual task setting and thereby estimates the automatization of the postural control. With respect to differentiation between the levels of postural control within the elderly group, the dual task aspects of the test add no value.Implications: With a further technical development of the setup, the test may be useful in a clinical setting where a dual-task testing approach is required.Keywords: Postural control, Dual task, TestFunding acknowledgements: No fundingTopic: Outcome measurement; Human movement analysisEthics approval required: NoInstitution: N/AEthics committee: Regional Ethics Committee of Northern DenmarkReason not required: The respond respond received from the ethics committee was: that study was not regarded as a clinical trial and was not covered by the danish national research ethics lawAll authors, affiliations and abstracts have been published as submitted.