Analysis of the dual-task paradigm: attention x maintenance of posture in 7 years-old children and young adults

Cristina dos Santos Cardoso de S
Physiotherapy Department of IMES University

Renato Teodoro Ramos
Department and Institute of Psychiatry of Clinical Hospital of FMUSP

Catarina Costa Boffino
Department and Institute of Psychiatry of Clinical Hospital of FMUSP

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     Last modified: February 24, 2007

Abstract
PURPOSE: The maintenance of posture and balance depends on musculoskeletal and neural mechanisms and mainly from their interaction. The visual, vestibular and somatossensory systems are responsible for the muscular adjustments that lead to balance. The dual-task paradigm has been used to demonstrate that the attentional demand can compete with cognitive functions. Based on this paradigm our study investigates if attentional demand can also compete with posture and balance control. RELEVANCE: In rehabilitation routine we frequently expose patients to double activities involving the division of attentional resources and postural control (dual-task paradigms). We also expect our patients to develop the ability to perform dual-task activities without decreased performance. Although, we don?t know precisely how normal individuals respond to attentional sharing during dual-tasks activities, also it is not clear if attentional division can be learned or improved. It is necessary to clarify what is involved in this paradigm and the compensations or adaptations of the motor system related to it. METHODS: Nineteen 7 years-old non-pathological children and thirty-eight normal young adults (mean age = 23.42  2.66) were submitted to the Modified Sensory-Organization Test of Posturography (NeuroCom?). Their performance was measured in two different equilibrium conditions: 1 - eyes open/stable platform, 4 - eyes open/unstable platform, each one with and without performing an attentional visual tracking task (COGNITIVO?). The tracking task consisted in maintaining a circle, controlled with a joystick, inside a rectangle that was continuously and randomly moving horizontally on the computer screen, demanding attention, motor control and smooth pursuit eye movements. ANALYSIS: Student?s t was used to compare their balance performance under the different conditions. A significance level of p<0.05 was used in this study. RESULTS: All variable?s tests showed a significant difference with poorest performance for the 7 years-old children, including the time on target tax and equilibrium score in conditions 1 and 2 (p<0.001 in all conditions test, with and without the second task). CONCLUSION: Our study showed children achieved lower equilibrium and attentional scores than young adults during all test activities. Balance and attention functions need maturating process of musculoskeletal and neural mechanisms and it probably happen during all growing stage. Physiotherapists and other professionals may understand children are still developing motor and attentional functions.