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Dual Task of Fine Motor Skill and Problem Solving in Individuals With Multiple Sclerosis: A Pilot Study

  • Y. Goverover
    Correspondence
    Corresponding author Y. Goverover, PhD, OT, Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, 82 Washington Square East, 6th Floor, New York University, New York, NY 10003.
    Affiliations
    Department of Occupational Therapy, New York University, New York, NY

    Kessler Foundation, East Hanover, NJ
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  • B.M. Sandroff
    Affiliations
    Kessler Foundation, East Hanover, NJ

    Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL
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  • J. DeLuca
    Affiliations
    Kessler Foundation, East Hanover, NJ

    Department of Physical Medicine and Rehabilitation, Rutgers University–New Jersey Medical School, Newark, NJ
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Published:November 03, 2017DOI:https://doi.org/10.1016/j.apmr.2017.10.012

      Abstract

      Objectives

      To (1) examine and compare dual-task performance in patients with multiple sclerosis (MS) and healthy controls (HCs) using mathematical problem-solving questions that included an everyday competence component while performing an upper extremity fine motor task; and (2) examine whether difficulties in dual-task performance are associated with problems in performing an everyday internet task.

      Design

      Pilot study, mixed-design with both a within and between subjects' factor.

      Setting

      A nonprofit rehabilitation research institution and the community.

      Participants

      Participants (N=38) included persons with MS (n=19) and HCs (n=19) who were recruited from a nonprofit rehabilitation research institution and from the community.

      Interventions

      Not applicable.

      Main Outcome Measures

      Participant were presented with 2 testing conditions: (1) solving mathematical everyday problems or placing bolts into divots (single-task condition); and (2) solving problems while putting bolts into divots (dual-task condition). Additionally, participants were required to perform a test of everyday internet competence.

      Results

      As expected, dual-task performance was significantly worse than either of the single-task tasks (ie, number of bolts into divots or correct answers, and time to answer the questions). Cognitive but not motor dual-task cost was associated with worse performance in activities of everyday internet tasks.

      Conclusions

      Cognitive dual-task cost is significantly associated with worse performance of everyday technology. This was not observed in the motor dual-task cost. The implications of dual-task costs on everyday activity are discussed.

      Keywords

      List of abbreviations:

      ANOVA (analysis of variance), AR (Actual Reality), DT (dual task), DTC (dual-task cost), HC (healthy control), MS (multiple sclerosis), ST (single task)
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      References

        • Chiaravalloti N.D.
        • DeLuca J.
        Cognitive impairment in multiple sclerosis.
        Lancet Neurol. 2008; 7: 1139-1151
        • Jacobs J.V.
        • Kasser S.L.
        Effects of dual tasking on the postural performance of people with and without multiple sclerosis: a pilot study.
        J Neurol. 2012; 259: 1166-1176
        • Mehanna R.
        • Jankovic J.
        Movement disorders in multiple sclerosis and other demyelinating diseases.
        J Neurol Sci. 2013; 328: 1-8
        • Benedict R.H.
        • Holtzer R.
        • Motl R.W.
        • et al.
        Upper and lower extremity motor function and cognitive impairment in multiple sclerosis.
        J Int Neuropsychol Soc. 2011; 17: 643-653
        • Kelly V.E.
        • Eusterbrock A.J.
        • Shumway-Cook A.
        A review of dual-task walking deficits in people with Parkinson's disease: motor and cognitive contributions, mechanisms, and clinical implications.
        Parkinsons Dis. 2012; 2012: 918719
        • McFadyen B.J.
        • Gagné M.-È.
        • Cossette I.
        • Ouellet M.-C.
        Using dual task walking as an aid to assess executive dysfunction ecologically in neurological populations: a narrative review.
        Neuropsychol Rehabil. 2015; 2011: 1-22
        • Deprez S.
        • Vandenbulcke M.
        • Peeters R.
        • Emsell L.
        • Amant F.
        • Sunaert S.
        The functional neuroanatomy of multitasking: combining dual tasking with a short term memory task.
        Neuropsychologia. 2013; 51: 2251-2260
        • Kirkland M.C.
        • Wallack E.M.
        • Rancourt S.N.
        Comparing three dual-task methods and the relationship to physical and cognitive impairment in people with multiple sclerosis and controls.
        Mult Scler Int. 2015; 2015: 1-7
        • Leone C.
        • Patti F.
        • Feys P.
        Measuring the cost of cognitive-motor dual tasking during walking in multiple sclerosis.
        Mult Scler. 2015; 21: 123-131
        • Learmonth Y.C.
        • Ensari I.
        • Motl R.W.
        Cognitive motor interference in multiple sclerosis: insights from a systematic quantitative review.
        Arch Phys Med Rehabil. 2017; 98: 1229-1240
        • Learmonth Y.C.
        • Pilutti L.A.
        • Motl R.W.
        Generalised cognitive motor interference in multiple sclerosis.
        Gait Posture. 2015; 42: 96-100
        • Wajda D.A.
        • Sosnoff J.J.
        Cognitive-motor interference in multiple sclerosis: a systematic review of evidence, correlates, and consequences.
        Biomed Res Int. 2015; 2015: 720856
        • Wolkorte R.
        • Heersema D.J.
        • Zijdewind I.
        Reduced dual-task performance in MS patients is further decreased by muscle fatigue.
        Neurorehabil Neural Repair. 2015; 29: 424-435
        • Etemadi Y.
        Dual task cost of cognition is related to fall risk in patients with multiple sclerosis: a prospective study.
        Clin Rehabil. 2016; 31: 278-284
        • Goverover Y.
        • Kalmar J.
        • Gaudino-Goering E.
        • et al.
        The relation between subjective and objective measures of everyday life activities in persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2005; 86: 2303-2308
        • Goverover Y.
        • Haas S.
        • DeLuca J.
        Money management activities in persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2016; 97: 1901-1907
        • Goverover Y.
        • Chiaravalloti N.
        • DeLuca J.
        Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and performance of everyday life tasks: Actual Reality.
        Mult Scler. 2015; 22: 544-550
        • Goverover Y.
        • O'Brien A.R.
        • Moore N.B.
        • DeLuca J.
        Actual Reality: a new approach to functional assessment in persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2010; 91: 252-260
        • Polman C.H.
        • Reingold S.C.
        • Banwell B.
        • et al.
        Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.
        Ann Neurol. 2011; 69: 292-302
        • Diehl M.
        • Willis S.L.
        Chapter 6. Everyday competence and everyday problem solving in aging adults: the role of physical and social context.
        in: Annual review of gerontology and geriatrics: aging in context: socio-physical environments. Vol 23. Springer, New York City2003: 130-166
        • Grisso T.
        Evaluating competencies: forensic assessments and instruments. Vol 7. Plenum Press, New York1986
        • Law L.L.
        • Barnett F.
        • Yau M.K.
        • Gray M.A.
        Measures of everyday competence in older adults with cognitive impairment: a systematic review.
        Age Ageing. 2012; 41: 9-16
        • Kalmar J.H.
        • Gaudino E.A.
        • Moore N.B.
        • Halper J.
        • Deluca J.
        The relationship between cognitive deficits and everyday functional activities in multiple sclerosis.
        Neuropsychology. 2008; 22: 442-449
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        2nd ed. Erlbaum, Hillsdale, NJ1988
        • Allali G.
        • Laidet M.
        • Assal F.
        • Armand S.
        • Lalive P.H.
        Walking while talking in patients with multiple sclerosis: the impact of specific cognitive loads.
        Neurophysiol Clin. 2014; 44: 87-93
        • Hamilton F.
        • Rochester L.
        • Paul L.
        • Rafferty D.
        • O'Leary C.P.
        • Evans J.J.
        Walking and talking: an investigation of cognitive–motor dual tasking in multiple sclerosis.
        Mult Scler. 2009; 15: 1215-1227
        • Sandroff B.M.
        • Benedict R.H.
        • Motl R.W.
        Nonsignificant associations between measures of inhibitory control and walking while thinking in persons with multiple sclerosis.
        Arch Phys Med Rehabil. 2015; 96: 1518-1524
        • Nilsagård Y.
        • Denison E.
        • Gunnarsson L.
        • et al.
        Factors perceived as being related to accidental falls by persons with multiple sclerosis.
        Disabil Rehabil. 2009; 31: 1301-1310
        • Yozbatiran N.
        • Baskurt F.
        • Baskurt Z.
        • Ozakbas S.
        • Idiman E.
        Motor assessment of upper extremity function and its relation with fatigue, cognitive function and quality of life in multiple sclerosis patients.
        J Neurol Sci. 2006; 246: 117-122
        • Steene-Johannessen J.
        • Anderssen S.A.
        • Van Der Ploeg H.P.
        • et al.
        Are self-report measures able to define individuals as physically active or inactive?.
        Med Sci Sports Exerc. 2016; 48: 235-244
        • Goverover Y.
        • Chiaravalloti N.
        • Gaudino-Goering E.
        • Moore N.
        • DeLuca J.
        The relationship among performance of instrumental activities of daily living, self-report of quality of life, and self-awareness of functional status in individuals with multiple sclerosis.
        Rehabil Psychol. 2009; 54: 60-68