title: A cognitive dual task affects gait variability in patients suffering from chronic low back pain.
abstract: Chronic pain and gait variability in a dual-task situation are both associated with higher risk of falling. Executive functions regulate (dual-task) gait variability. A possible cause explaining why chronic pain increases risk of falling in an everyday dual-task situation might be that pain interferes with executive functions and results in a diminished dual-task capability with performance decrements on the secondary task. The main goal of this experiment was to evaluate the specific effects of a cognitive dual task on gait variability in chronic low back pain (CLBP) patients. Twelve healthy participants and twelve patients suffering from CLBP were included. The subjects were asked to perform a cognitive single task, a walking single task and a motor-cognitive dual task. Stride variability of trunk movements was calculated. A two-way ANOVA was performed to compare single-task walking with dual-task walking and the single cognitive task performance with the motor-cognitive dual-task performance. We did not find any differences in both of the single-task performances between groups. However, regarding single-task walking and dual-task walking, we observed an interaction effect indicating that low back pain patients show significantly higher gait variability in the dual-task condition as compared to controls. Our data suggest that chronic pain reduces motor-cognitive dual-task performance capability. We postulate that the detrimental effects are caused by central mechanisms where pain interferes with executive functions which, in turn, might contribute to increased risk of falling.
authors: Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104, Magdeburg, Germany, dennis.hamacher@ovgu.de.
authors: Dennis
authors: D
authors: Hamacher
authors: Daniel
authors: D
authors: Hamacher
authors: Lutz
authors: L
authors: Schega
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D059350:Chronic Pain / Q000150:complications*; D015331:Cohort Studies; D056344:Executive Function / Q000502:physiology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D017116:Low Back Pain / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D016138:Walking