Age impairs sit-to-walk motor performance

Sit-to-walk (STW) is a common functional and transitional task which challenges an individual's postural control systems. As aging is associated with an increased risk of falls during transitional movements, we biomechanically investigated the STW movement task in 12 healthy young and 12 healthy elderly individuals. Performance was evaluated utilizing motion analysis and two force plates. The principal finding of this study was the impaired performance of the healthy older adults. The older adults generated significantly less momentum prior to rising (p=0.011) and further delayed (p<0.001) the initiation of gait until standing more upright (p=0.036). The young adults successfully merged the component tasks shortly after seat-off and displayed significantly greater step length (p<0.001), step velocity (p<0.001), and tolerated greater separation of the center of pressure and center of mass at the end single support phase of the initial step (p=0.001). While the young adults fluidly merged the standing and walking task components, the older adults displayed a conservative movement performance during the STW task thereby limiting threats to their postural stability.     

Unexpected Dual Task Benefits on Cycling in Parkinson Disease and Healthy Adults: A Neuro-Behavioral Model

BackgroundWhen performing two tasks at once, a dual task, performance on one or both tasks typically suffers. People with Parkinson’s disease (PD) usually experience larger dual task decrements on motor tasks than healthy older adults (HOA). Our objective was to investigate the decrements in cycling caused by performing cognitive tasks with a range of difficulty in people with PD and HOAs.MethodsTwenty-eight participants with Parkinson’s disease and 20 healthy older adults completed a baseline cycling task with no secondary tasks and then completed dual task cycling while performing 12 tasks from six cognitive domains representing a wide range of difficulty.ResultsCycling was faster during dual task conditions than at baseline, and was significantly faster for six tasks (all p<.02) across both groups. Cycling speed improved the most during the easiest cognitive tasks, and cognitive performance was largely unaffected. Cycling improvement was predicted by task difficulty (p<.001). People with Parkinson’s disease cycled slower (p<.03) and showed reduced dual task benefits (p<.01) than healthy older adults.ConclusionsUnexpectedly, participants’ motor performance improved during cognitive dual tasks, which cannot be explained in current models of dual task performance. To account for these findings, we propose a model integrating dual task and acute exercise approaches which posits that cognitive arousal during dual tasks increases resources to facilitate motor and cognitive performance, which is subsequently modulated by motor and cognitive task difficulty. This model can explain both the improvement observed on dual tasks in the current study and more typical dual task findings in other studies.     

Gait in Very Preterm School-Aged Children in Dual-Task Paradigms

Objective

The control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms.

Study design

Twenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed.

Results

In dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status.

Conclusions

Dual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity variability indicate poorer walking performance in preterm children who were less mature at birth.     

Effects of Aging on Arm Swing during Gait: The Role of Gait Speed and Dual Tasking

Healthy walking is characterized by pronounced arm swing and axial rotation. Aging effects on gait speed, stride length and stride time variability have been previously reported, however, less is known about aging effects on arm swing and axial rotation and their relationship to age-associated gait changes during usual walking and during more challenging conditions like dual tasking. Sixty healthy adults between the ages of 30–77 were included in this study designed to address this gap. Lightweight body fixed sensors were placed on each wrist and lower back. Participants walked under 3 walking conditions each of 1 minute: 1) comfortable speed, 2) walking while serially subtracting 3’s (Dual Task), 3) walking at fast speed. Aging effects on arm swing amplitude, range, symmetry, jerk and axial rotation amplitude and jerk were compared between decades of age (30–40; 41–50; 51–60; 61–77 years). As expected, older adults walked slower (p = 0.03) and with increased stride variability (p = 0.02). Arm swing amplitude decreased with age under all conditions (p = 0.04). In the oldest group, arm swing decreased during dual task and increased during the fast walking condition (p<0.0001). Similarly, arm swing asymmetry increased during the dual task in the older groups (p<0.004), but not in the younger groups (p = 0.67). Significant differences between groups and within conditions were observed in arm swing jerk (p<0.02), axial rotation amplitude (p<0.02) and axial jerk (p<0.001). Gait speed, arm swing amplitude of the dominant arm, arm swing asymmetry and axial rotation jerk were all independent predictors of age in a multivariate model. These findings suggest that the effects of gait speed and dual tasking on arm swing and axial rotation during walking are altered among healthy older adults. Follow-up work is needed to examine if these effects contribute to reduced stability in aging.     

Fatiguing Exercise Intensity Influences the Relationship between Parameters Reflecting Neuromuscular Function and Postural Control Variables

The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique) and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R²≤0.82) of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R²≤0.73) for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.     

Age-Related Modifications to the Magnitude and Periodicity of Neuromuscular Noise

Background

Evaluation of task related outcomes within geriatric and fall-prone populations is essential not only for identification of neuromuscular deficits, but also for effective implementation of fall prevention strategies. As most tasks and activities of daily living are performed at submaximal force levels, restoration of muscle strength often does not produce the expected benefit in functional capacity. However, it is known that muscular control plays a key role in the performance of functional tasks, but it remains unclear to what degree muscular control and the associated neuromuscular noise (NmN) is age-related, particularly in the lower-extremities.

Objectives

The aim of this study was to determine the effects of age and fall-pathology on the magnitude as well as the frequency of NmN during lower extremity force production.

Methods

Sixteen young healthy adults, as well as seventy elderly women (36 healthy, 34 elderly fallers), performed force production tests at moderate levels (15% of maximum voluntary isometric contractions).

Results

Elderly fallers exhibited the highest magnitude of NmN, while the highest frequency components of NmN tended to occur in the healthy elderly. Young subjects exhibited significantly more power in the low frequency ranges than either of the elderly groups, and had the lowest levels of NmN.

Conclusion

These data suggest increased degeneration of muscular control through greater NmN in elderly fallers compared to healthy elderly or young subjects. This could possibly be associated with muscle atrophy and lower levels of motor unit synchronisation.     

Reading from a Head-Fixed Display during Walking: Adverse Effects of Gaze Stabilization Mechanisms

Reading performance during standing and walking was assessed for information presented on earth-fixed and head-fixed displays by determining the minimal duration during which a numerical time stimulus needed to be presented for 50% correct naming answers. Reading from the earth-fixed display was comparable during standing and walking, with optimal performance being attained for visual character sizes in the range of 0.2° to 1°. Reading from the head-fixed display was impaired for small (0.2-0.3°) and large (5°) visual character sizes, especially during walking. Analysis of head and eye movements demonstrated that retinal slip was larger during walking than during standing, but remained within the functional acuity range when reading from the earth-fixed display. The detrimental effects on performance of reading from the head-fixed display during walking could be attributed to loss of acuity resulting from large retinal slip. Because walking activated the angular vestibulo-ocular reflex, the resulting compensatory eye movements acted to stabilize gaze on the information presented on the earth-fixed display but destabilized gaze from the information presented on the head-fixed display. We conclude that the gaze stabilization mechanisms that normally allow visual performance to be maintained during physical activity adversely affect reading performance when the information is presented on a display attached to the head.     

Inhibition of Propofol Anesthesia on Functional Connectivity between LFPs in PFC during Rat Working Memory Task

Working memory (WM) refers to the temporary storage and manipulation of information necessary for performance of complex cognitive tasks. There is a growing interest in whether and how propofol anesthesia inhibits WM function. The aim of this study is to investigate the possible inhibition mechanism of propofol anesthesia based on the functional connections of multi-local field potentials (LFPs) and behavior during WM tasks. Adult SD rats were randomly divided into 3 groups: pro group (0.5 mg·kg⁻¹·min⁻¹,2 h), PRO group (0.9 mg·kg⁻¹·min⁻¹, 2 h) and control group. The experimental data were 16-channel LFPs obtained at prefrontal cortex with implanted microelectrode array in SD rats during WM tasks in Y-maze at 24, 48, 72, 96, 120 hours (day 1-day 5) after propofol anesthesia, and the behavior results of WM were recoded at the same time. Directed transfer function (DTF) method was applied to analyze the connections among LFPs directly. Furthermore, the causal networks were identified by DTF. The clustering coefficient (C), network density (D) and global efficiency (E_global) were selected to describe the functional connectivity quantitatively. The results show that: comparing with the control group, the LFPs functional connectivity in pro group were no significantly difference (p>0.05); the connectivity in PRO group were significantly decreased (p<0.05 at 24 hours, p<0.05 at 48 hours), while no significant difference at 72, 96 and 120 hours for rats (p>0.05), which were consistent with the behavior results. These findings could lead to improved understanding the mechanism of inhibition of anesthesia on WM functions from the view of connections among LFPs.     

D1 and D2 Inhibitions of the Soleus H-Reflex Are Differentially Modulated during Plantarflexion Force and Position Tasks

Presynaptic inhibition (PSI) has been shown to modulate several neuronal pathways of functional relevance by selectively gating the connections between sensory inputs and spinal motoneurons, thereby regulating the contribution of the stretch reflex circuitry to the ongoing motor activity. In this study, we investigated whether a differential regulation of Ia afferent inflow by PSI may be associated with the performance of two types of plantarflexion sensoriomotor tasks. The subjects (in a seated position) controlled either: 1) the force level exerted by the foot against a rigid restraint (force task, FT); or 2) the angular position of the ankle when sustaining inertial loads (position task, PT) that required the same level of muscle activation observed in FT. Subjects were instructed to maintain their force/position at target levels set at ~10% of maximum isometric voluntary contraction for FT and 90° for PT, while visual feedback of the corresponding force/position signals were provided. Unconditioned H-reflexes (i.e. control reflexes) and H-reflexes conditioned by electrical pulses applied to the common peroneal nerve with conditioning-to-test intervals of 21 ms and 100 ms (corresponding to D1 and D2 inhibitions, respectively) were evoked in a random fashion. A significant main effect for the type of the motor task (FT vs PT) (p = 0.005, η² _p = 0.603) indicated that PTs were undertaken with lower levels of Ia PSI converging onto the soleus motoneuron pool. Additionally, a significant interaction between the type of inhibition (D1 vs D2) and the type of motor task (FT vs PT) (p = 0.038, η² _p = 0.395) indicated that D1 inhibition was associated with a significant reduction in PSI levels from TF to TP (p = 0.001, η² _p = 0.731), whereas no significant difference between the tasks was observed for D2 inhibition (p = 0.078, η² _p = 0.305). These results suggest that D1 and D2 inhibitions of the soleus H-reflex are differentially modulated during the performance of plantarflexion FT and PT. The reduced level of ongoing PSI during PT suggests that, in comparison to FT, there is a larger reliance on inputs from muscle spindles primary afferents when the neuromuscular system is required to maintain position-controlled plantarflexion contractions.     

Association between Cytomegalovirus Antibody Levels and Cognitive Functioning in Non-Elderly Adults

Background

Elevated levels of antibodies to Cytomegalovirus (CMV) have been associated with cognitive impairment, but the quantitative relationship between CMV antibody levels and domains of cognitive functioning in younger adults has not been established.

Methods

We measured IgG class antibodies to Cytomegalovirus in 521 individuals, mean age 32.8 years. Participants were selected for the absence of psychiatric disorder and of a serious medical condition that could affect brain functioning. Cognitive functioning was measured with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Wisconsin Card Sorting Test, Trail Making Test part A, and the WAIS III Letter Number Sequencing subtest. Linear regression analyses were used to measure the quantitative association between cognitive scores and Cytomegalovirus IgG antibody level. Logistic regression analyses were used to measure the odds of low cognitive scores and elevated antibody levels defined as an antibody level > = 50^th, 75^th, and 90^th percentile of the group.

Results

Higher levels of CMV antibodies were associated with lower performance on RBANS Total (coefficient −1.03, p<.0002), Delayed Memory (coefficient −0.94, p<.001), Visuospatial/Constructional (coefficient −1.77, p<5×10⁻⁷), and Letter Number Sequencing (coefficient −0.15, p<.03). There was an incremental relationship between the level of CMV antibody elevation and the odds of a low RBANS Total score. The odds of a low total cognitive score were 1.63 (95^th % CI 1.01, 2.64; p<.045), 2.22 (95^th % CI 1.33, 3.70; p<.002), and 2.46 (95^th % CI 1.24, 4.86; p<.010) with a CMV antibody level greater than or equal to the 50^th, 75^th, and 90^th percentile respectively.

Conclusions

Higher levels of Cytomegalovirus antibodies are associated with lower levels of cognitive functioning in non-elderly adults. Methods for the prevention and treatment of CMV infection should be evaluated to determine if they result in an improvement in cognitive functioning in otherwise healthy adults.     

Climate Exposure of US National Parks in a New Era of Change

US national parks are challenged by climate and other forms of broad-scale environmental change that operate beyond administrative boundaries and in some instances are occurring at especially rapid rates. Here, we evaluate the climate change exposure of 289 natural resource parks administered by the US National Park Service (NPS), and ask which are presently (past 10 to 30 years) experiencing extreme (<5^th percentile or >95^th percentile) climates relative to their 1901–2012 historical range of variability (HRV). We consider parks in a landscape context (including surrounding 30 km) and evaluate both mean and inter-annual variation in 25 biologically relevant climate variables related to temperature, precipitation, frost and wet day frequencies, vapor pressure, cloud cover, and seasonality. We also consider sensitivity of findings to the moving time window of analysis (10, 20, and 30 year windows). Results show that parks are overwhelmingly at the extreme warm end of historical temperature distributions and this is true for several variables (e.g., annual mean temperature, minimum temperature of the coldest month, mean temperature of the warmest quarter). Precipitation and other moisture patterns are geographically more heterogeneous across parks and show greater variation among variables. Across climate variables, recent inter-annual variation is generally well within the range of variability observed since 1901. Moving window size has a measureable effect on these estimates, but parks with extreme climates also tend to exhibit low sensitivity to the time window of analysis. We highlight particular parks that illustrate different extremes and may facilitate understanding responses of park resources to ongoing climate change. We conclude with discussion of how results relate to anticipated future changes in climate, as well as how they can inform NPS and neighboring land management and planning in a new era of change.     

Field Tests for Evaluating the Aerobic Work Capacity of Firefighters

Working as a firefighter is physically strenuous, and a high level of physical fitness increases a firefighter’s ability to cope with the physical stress of their profession. Direct measurements of aerobic capacity, however, are often complicated, time consuming, and expensive. The first aim of the present study was to evaluate the correlations between direct (laboratory) and indirect (field) aerobic capacity tests with common and physically demanding firefighting tasks. The second aim was to give recommendations as to which field tests may be the most useful for evaluating firefighters’ aerobic work capacity. A total of 38 subjects (26 men and 12 women) were included. Two aerobic capacity tests, six field tests, and seven firefighting tasks were performed. Lactate threshold and onset of blood lactate accumulation were found to be correlated to the performance of one work task (r_s = −0.65 and −0.63, p<0.01, respectively). Absolute (mL·min⁻¹) and relative (mL·kg⁻¹·min⁻¹) maximal aerobic capacity was correlated to all but one of the work tasks (r_s = −0.79 to 0.55 and −0.74 to 0.47, p<0.01, respectively). Aerobic capacity is important for firefighters’ work performance, and we have concluded that the time to row 500 m, the time to run 3000 m relative to body weight (s·kg⁻¹), and the percent of maximal heart rate achieved during treadmill walking are the most valid field tests for evaluating a firefighter’s aerobic work capacity.     

Maintaining Gait Performance by Cortical Activation during Dual-Task Interference: A Functional Near-Infrared Spectroscopy Study

In daily life, mobility requires walking while performing a cognitive or upper-extremity motor task. Although previous studies have evaluated the effects of dual tasks on gait performance, few studies have evaluated cortical activation and its association with gait disturbance during dual tasks. In this study, we simultaneously assessed gait performance and cerebral oxygenation in the bilateral prefrontal cortices (PFC), premotor cortices (PMC), and supplemental motor areas (SMA), using functional near-infrared spectroscopy, in 17 young adults performing dual tasks. Each participant was evaluated while performing normal-pace walking (NW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT). Our results indicated that the left PFC exhibited the strongest and most sustained activation during WCT, and that NW and WMT were associated with minor increases in oxygenation levels during their initial phases. We observed increased activation in channels in the SMA and PMC during WCT and WMT. Gait data indicated that WCT and WMT both caused reductions in walking speed, but these reductions resulted from differing alterations in gait properties. WCT was associated with significant changes in cadence, stride time, and stride length, whereas WMT was associated with reductions in stride length only. During dual-task activities, increased activation of the PMC and SMA correlated with declines in gait performance, indicating a control mechanism for maintaining gait performance during dual tasks. Thus, the regulatory effects of cortical activation on gait behavior enable a second task to be performed while walking.     

Neural Effects of Auditory Distraction on Visual Attention in Schizophrenia

Sensory flooding, particularly during auditory stimulation, is a common problem for patients with schizophrenia. The functional consequences of this impairment during cross-modal attention tasks, however, are unclear. The purpose of this study was to examine how auditory distraction differentially affects task-associated response during visual attention in patients and healthy controls. To that end, 21 outpatients with schizophrenia and 23 healthy comparison subjects performed a visual attention task in the presence or absence of distracting, environmentally relevant “urban” noise while undergoing functional magnetic resonance imaging at 3T. The task had two conditions (difficult and easy); task-related neural activity was defined as difficult – easy. During task performance, a significant distraction (noise or silence) by group (patient or control) interaction was observed in the left dorsolateral prefrontal cortex, right hippocampus, left temporoparietal junction, and right fusiform gyrus, with patients showing relative hypoactivation during noise compared to controls. In patients, the ability to recruit the dorsolateral prefrontal cortex during the task in noise was negatively correlated with the effect of noise on reaction time. Clinically, the ability to recruit the fusiform gyrus during the task in noise was negatively correlated with SANS affective flattening score, and hippocampal recruitment during the task in noise was positively correlated with global functioning. In conclusion, schizophrenia may be associated with abnormalities in neural response during visual attention tasks in the presence of cross-modal noise distraction. These response differences may predict global functioning in the illness, and may serve as a biomarker for therapeutic development.     

Influence of simulated neuromuscular noise on movement variability and fall risk in a 3D dynamic walking model

People at risk of falling exhibit increased gait variability, which may predict future falls. However, the causal mechanisms underlying these correlations are not well known. Increased neuronal noise associated with aging likely leads to increased gait variability, which could in turn lead to increased fall risk. This paper presents a model of how changes in neuromuscular noise independently affect gait variability and probability of falling, and aims to determine the extent to which changes in gait variability directly predict fall risk. We used a dynamic walking model that incorporates a lateral step controller to maintain lateral stability. Noise was applied to this controller to approximate neuromuscular noise in humans. Noise amplitude was varied between low amplitudes that did not induce falls and high amplitudes for which the model always fell. With increases in noise amplitude, the model fell more often and after fewer steps. Gait variability increased with noise amplitude and predicted increased probability of falling. Importantly, these relationships were not linear. At either low gait variability or very high gait variability, small increases in noise and variability affected probability of falling very little. Conversely, at intermediate noise and/or variability levels, the same small increases resulted in large increases in probability of falling. Our results validate the idea that age-related increases in neuromuscular noise likely play a direct contributing role in increasing fall risk. However, neuromuscular noise remains only one of many important factors that need to be considered. These findings have important implications for fall prevention research and practice.     

Nordic Walking improves daily physical activities in COPD: a randomised controlled trial

Background

In patients with COPD progressive dyspnoea leads to a sedentary lifestyle. To date, no studies exist investigating the effects of Nordic Walking in patients with COPD. Therefore, the aim was to determine the feasibility of Nordic Walking in COPD patients at different disease stages. Furthermore we aimed to determine the short- and long-term effects of Nordic Walking on COPD patients'' daily physical activity pattern as well as on patients exercise capacity.

Methods

Sixty COPD patients were randomised to either Nordic Walking or to a control group. Patients of the Nordic Walking group (n = 30; age: 62 ± 9 years; FEV₁: 48 ± 19% predicted) underwent a three-month outdoor Nordic Walking exercise program consisting of one hour walking at 75% of their initial maximum heart rate three times per week, whereas controls had no exercise intervention. Primary endpoint: daily physical activities (measured by a validated tri-axial accelerometer); secondary endpoint: functional exercise capacity (measured by the six-minute walking distance; 6MWD). Assessment time points in both groups: baseline, after three, six and nine months.

Results

After three month training period, in the Nordic Walking group time spent walking and standing as well as intensity of walking increased (Δ walking time: +14.9 ± 1.9 min/day; Δ standing time: +129 ± 26 min/day; Δ movement intensity: +0.40 ± 0.14 m/s²) while time spent sitting decreased (Δ sitting time: -128 ± 15 min/day) compared to baseline (all: p < 0.01) as well as compared to controls (all: p < 0.01). Furthermore, 6MWD significantly increased compared to baseline (Δ 6MWD: +79 ± 28 meters) as well as compared to controls (both: p < 0.01). These significant improvements were sustained six and nine months after baseline. In contrast, controls showed unchanged daily physical activities and 6MWD compared to baseline for all time points.

Conclusions

Nordic Walking is a feasible, simple and effective physical training modality in COPD. In addition, Nordic Walking has proven to positively impact the daily physical activity pattern of COPD patients under short- and long-term observation.

Clinical trial registration

Nordic Walking improves daily physical activities in COPD: a randomised controlled trial - ISRCTN31525632     

Visuospatial Tasks Affect Locomotor Control More than Nonspatial Tasks in Older People

Background

Previous research has shown that visuospatial processing requiring working memory is particularly important for balance control during standing and stepping, and that limited spatial encoding contributes to increased interference in postural control dual tasks. However, visuospatial involvement during locomotion has not been directly determined. This study examined the effects of a visuospatial cognitive task versus a nonspatial cognitive task on gait speed, smoothness and variability in older people, while controlling for task difficulty.

Methods

Thirty-six people aged ≥75 years performed three walking trials along a 20 m walkway under the following conditions: (i) an easy nonspatial task; (ii) a difficult nonspatial task; (iii) an easy visuospatial task; and (iv) a difficult visuospatial task. Gait parameters were computed from a tri-axial accelerometer attached to the sacrum. The cognitive task response times and percentage of correct answers during walking and seated trials were also computed.

Results

No significant differences in either cognitive task type error rates or response times were evident in the seated conditions, indicating equivalent task difficulty. In the walking trials, participants responded faster to the visuospatial tasks than the nonspatial tasks but at the cost of making significantly more cognitive task errors. Participants also walked slower, took shorter steps, had greater step time variability and less smooth pelvis accelerations when concurrently performing the visuospatial tasks compared with the nonspatial tasks and when performing the difficult compared with the easy cognitive tasks.

Conclusions

Compared with nonspatial cognitive tasks, visuospatial cognitive tasks led to a slower, more variable and less smooth gait pattern. These findings suggest that visuospatial processing might share common networks with locomotor control, further supporting the hypothesis that gait changes during dual task paradigms are not simply due to limited attentional resources but to competition for common networks for spatial information encoding.     

Carriers of Loss-of-Function Mutations in EXT Display Impaired Pancreatic Beta-Cell Reserve Due to Smaller Pancreas Volume

Exotosin (EXT) proteins are involved in the chain elongation step of heparan sulfate (HS) biosynthesis, which is intricately involved in organ development. Loss of function mutations (LOF) in EXT1 and EXT2 result in hereditary exostoses (HME). Interestingly, HS plays a role in pancreas development and beta-cell function, and genetic variations in EXT2 are associated with an increased risk for type 2 diabetes mellitus. We hypothesized that loss of function of EXT1 or EXT2 in subjects with hereditary multiple exostoses (HME) affects pancreatic insulin secretion capacity and development. We performed an oral glucose tolerance test (OGTT) followed by hyperglycemic clamps to investigate first-phase glucose-stimulated insulin secretion (GSIS) in HME patients and age and gender matched non-affected relatives. Pancreas volume was assessed with magnetic resonance imaging (MRI). OGTT did not reveal significant differences in glucose disposal, but there was a markedly lower GSIS in HME subjects during hyperglycemic clamp (iAUC HME: 0.72 [0.46–1.16] vs. controls 1.53 [0.69–3.36] nmol·l⁻¹·min⁻¹, p<0.05). Maximal insulin response following arginine challenge was also significantly attenuated (iAUC HME: 7.14 [4.22–10.5] vs. controls 10.2 [7.91–12.70] nmol·l⁻¹·min⁻¹ p<0.05), indicative of an impaired beta-cell reserve. MRI revealed a significantly smaller pancreatic volume in HME subjects (HME: 72.0±15.8 vs. controls 96.5±26.0 cm³ p = 0.04). In conclusion, loss of function of EXT proteins may affect beta-cell mass and insulin secretion capacity in humans, and render subjects at a higher risk of developing type 2 diabetes when exposed to environmental risk factors.     

Perfectionism in Anorexia Nervosa: Novel Performance Based Evidence

Existing research into perfectionism in Anorexia Nervosa (AN) is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study – 81 with a diagnosis of AN and 72 healthy controls (HCs). Participants completed two performance based tasks assessing perfectionism – a text replication task and a bead sorting task – along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36) and produced significantly higher quality copies (p = <0.01, d = 0.45). In the bead sorting task, there was a trend towards more participants in the AN group choosing to check their work compared with the HC group (p = 0.07, d = 0.30) and the AN group took significantly longer checking than those in the HC group (p = <0.01, d = 0.45). Only copy quality uniquely predicted scores on self report measures of perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.     

The Role of Textured Material in Supporting Perceptual-Motor Functions

Simple deformation of the skin surface with textured materials can improve human perceptual-motor performance. The implications of these findings are inexpensive, adaptable and easily integrated clothing, equipment and tools for improving perceptual-motor functionality. However, some clarification is needed because mixed results have been reported in the literature, highlighting positive, absent and/or negative effects of added texture on measures of perceptual-motor performance. Therefore the aim of this study was to evaluate the efficacy of textured materials for enhancing perceptual-motor functionality. The systematic review uncovered two variables suitable for sub-group analysis within and between studies: participant age (groupings were 18–51 years and 64.7–79.4 years) and experimental task (upright balance and walking). Evaluation of studies that observed texture effects during upright balance tasks, uncovered two additional candidate sub-groups for future work: vision (eyes open and eyes closed) and stability (stable and unstable). Meta-analysis (random effects) revealed that young participants improve performance by a small to moderate amount in upright balance tasks with added texture (SMD = 0.28, 95%CI = 0.46–0.09, Z = 2.99, P = 0.001; Tau² = 0.02; Chi² = 9.87, df = 6, P = 0.13; I² = 39.22). Significant heterogeneity was found in, the overall effect of texture: Tau² = 0.13; Chi² = 130.71, df = 26, P<0.0001; I² = 85.98%, pooled samples in upright balance tasks: Tau² = 0.09; Chi² = 101.57, df = 13, P<0.001; I² = 72.67%, and in elderly in upright balance tasks: Tau² = 0.16; Chi² = 39.42, df = 5, P<0.001; I² = 83.05%. No effect was shown for walking tasks: Tau² = 0.00; Chi² = 3.45, df = 4, P = 0.27, I² = 22.99%. Data provides unequivocal support for utilizing textured materials in young healthy populations for improving perceptual-motor performance. Future research is needed in young healthy populations under conditions where visual and proprioceptive information is challenged, as in high-speed movements, or where use of equipment mediates the performer-environment interaction or where dysfunctional information sources ‘compete’ for attention. In elderly and ailing populations data suggests further research is required to better understand contexts where texture can facilitate improved perceptual-motor performance.