An Italian auditory gender Stroop walking task: feasibility and preliminary cognitive-motor performance profiling in neurological populations

Introduction Stroop-based paradigms are widely used to probe inhibitory control during locomotion, although auditory Stroop walking tasks remain underexplored in neurological populations. This study introduced an Italian auditory adaptation of the Gender Stroop task and provided a preliminary methodological evaluation of its feasibility and of multidimensional gait, accuracy and verbal-timing information obtained during walking. Methods Forty participants were included: 24 individuals with neurological conditions (multiple sclerosis, n = 8; Parkinson’s disease, n = 8; stroke, n = 8) and 16 controls. Spatiotemporal gait parameters were recorded using a wearable inertial sensor, while Stroop accuracy, verbal response timing, feasibility and acceptability were also assessed. Results Hierarchical clustering of 15 standardized gait variables identified a higher-performance profile ( n = 22) and a low-performance profile ( n = 18), mainly characterized by differences in walking velocity, cadence, and gait cycle duration across walking conditions. In the primary age- and sex-adjusted analysis, clinical status was associated with lower-performance profile membership (OR = 11.15, 95% CI: 1.76–70.68, p = 0.008). The association was no longer statistically significant in the age-matched analysis (Fisher’s exact p = 0.106), while agreement with the full-sample profile assignments remained high. Repeated subsampling indicated moderate cluster stability. Condition-related gait effects and cognitive-verbal changes did not show robust clinical-control differences after FDR correction, indicating that the gait profiles primarily reflected general locomotor performance rather than Stroop-specific cognitive-motor interference. The paradigm was well tolerated, with no adverse events. Discussion Overall, the Italian auditory Gender Stroop walking task was feasible and allowed concurrent assessment of gait and cognitive-verbal performance during a structured cognitive-motor task. Larger, age-balanced and independent samples are required to establish the reproducibility of the gait-performance structure and determine the additional contribution of Stroop accuracy and verbal-timing measures beyond general locomotor performance.