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A Comparison of Mental Workload in Individuals with Transtibial and Transfemoral Lower Limb Loss during Dual-Task Walking under Varying Demand

Published online by Cambridge University Press:  29 August 2019

Emma P. Shaw ,
Jeremy C. Rietschel ,
Brad D. Hendershot ,
Alison L. Pruziner ,
Erik J. Wolf ,
Christopher L. Dearth ,
Matthew W. Miller ,
Bradley D. Hatfield  and
Rodolphe J. Gentili
Emma P. Shaw
Affiliation:
Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, 20742, USA Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA
Jeremy C. Rietschel
Affiliation:
Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA Baltimore Veterans Affairs Medical Center, Baltimore, MD, 21201, USA
Brad D. Hendershot
Affiliation:
Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, 20889, USA Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
Alison L. Pruziner
Affiliation:
Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, 20889, USA Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
Erik J. Wolf
Affiliation:
Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, 20889, USA Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
Christopher L. Dearth
Affiliation:
Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, 20889, USA Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
Matthew W. Miller
Affiliation:
School of Kinesiology, Auburn University, Auburn, AL, 36849, USA Center for Neuroscience, Auburn University, Auburn, AL, 36849, USA
Bradley D. Hatfield
Affiliation:
Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, 20742, USA Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA
Rodolphe J. Gentili*
Affiliation:
Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, 20742, USA Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA Maryland Robotics Center, University of Maryland, College Park, MD, 20742, USA
*
Correspondence and reprint requests to: Rodolphe J. Gentili, Department of Kinesiology, School of Public Health (Bldg #255), University of Maryland, Room #2138, College Park, MD 20742, USA. E-mail: rodolphe@umd.edu
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Abstract

Objectives: This study aimed to evaluate the influence of lower limb loss (LL) on mental workload by assessing neurocognitive measures in individuals with unilateral transtibial (TT) versus those with transfemoral (TF) LL while dual-task walking under varying cognitive demand. Methods: Electroencephalography (EEG) was recorded as participants performed a task of varying cognitive demand while being seated or walking (i.e., varying physical demand). Results: The findings revealed both groups of participants (TT LL vs. TF LL) exhibited a similar EEG theta synchrony response as either the cognitive or the physical demand increased. Also, while individuals with TT LL maintained similar performance on the cognitive task during seated and walking conditions, those with TF LL exhibited performance decrements (slower response times) on the cognitive task during the walking in comparison to the seated conditions. Furthermore, those with TF LL neither exhibited regional differences in EEG low-alpha power while walking, nor EEG high-alpha desynchrony as a function of cognitive task difficulty while walking. This lack of alpha modulation coincided with no elevation of theta/alpha ratio power as a function of cognitive task difficulty in the TF LL group. Conclusions: This work suggests that both groups share some common but also different neurocognitive features during dual-task walking. Although all participants were able to recruit neural mechanisms critical for the maintenance of cognitive-motor performance under elevated cognitive or physical demands, the observed differences indicate that walking with a prosthesis, while concurrently performing a cognitive task, imposes additional cognitive demand in individuals with more proximal levels of amputation.

Keywords

Mental loadEEG dynamicsSpectral powerAmputation levelsAlpha and theta bandsProsthesisConcurrent secondary taskLocomotion
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 9 , October 2019 , pp. 985 - 997
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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