Cognitive demand affects functional mobility in multiple sclerosis.

TitleCognitive demand affects functional mobility in multiple sclerosis.
Publication TypeJournal Article
AuthorsKhurana SR, Cline MJ, DiGiacomo A, Bowen JD, Wadhwani R, Kraft GH
JournalMultiple Sclerosis

Background: Multiple sclerosis (MS) is an unpredictable and disabling condition that has been associated with decreased mobility, balance problems, and cognitive dysfunction. It has been speculated that persons with MS also have more difficulty multi-tasking compared to age-matched adults. The objective of this study is to analyze the affects of cognitive distractions on ambulation in people with multiple sclerosis (MS). Research Design: A prospective case-control study conducted at The University of Washington, Seattle, Washington. Methods: Ninety ambulatory (EDSS5≤6.0) community-dwelling adults (50 with MS, 40 age- and sex-matched controls) are being enrolled. Two ambulation measures are being used: the Timed Up and Go Test (TUG) and a 100-foot walking test. These measures are performed under three conditions: no cognitive task; a simple cognitive task: reciting the alphabet; a more difficult cognitive task: counting backwards by three. In addition, subjects will count backwards by three while seated and complete the Paced Auditory Serial Addition Test. Results: In MS subjects (n=28) and controls (n=10) studied to date, both simple and complex cognitive tasks adversely affect motor performance. MS subjects showed trends towards greater differences in speed between the TUG alone and the TUG with a cognitive task. The control group was 5.1% slower when performing the TUG with a cognitive task; MS subjects were 15.7% slower. Similar results were seen in the 100-foot walking tests while performing the easier cognitive task. Conclusions: This study is relevant to multiple sclerosis as it addresses the interplay between two areas that are commonly affected by MS: cognition and motor function. The results allow us to better understand the impact of distraction on common motor functions. By better understanding the conditions under which falls occur, the treating physician will be able to employ rehabilitation strategies more effectively, thus minimizing morbidity in this population.

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