The Interaction Between Executive Attention and Postural Control in Dual-Task Conditions: Children With Cerebral Palsy

Abstract Reilly DS, Woollacott MH, van Donkelaar P, Saavedra S. The interaction between executive attention and postural control in dual-task conditions: children with cerebral palsy. Objective To investigate the interference between a secondary task and a postural task in children with cerebral palsy (CP). Design In this exploratory study, a dual-task paradigm was used in which children stood in either a wide or a narrow stance position while simultaneously performing a visual working memory task calibrated to be of equitable attentional demand between groups. Setting Study data were gathered in a university motor control laboratory. Participants Children with CP (n=8; age range, 10−14y) were compared with typically developing older children (n=6; age range, 7−12y), and typically developing young children (n=5; age range, 4−6y). Interventions Not applicable. Main Outcome Measures Proficiency in postural control was measured by the range and root mean square of the velocity of center of pressure displacement in the mediolateral and anteroposterior directions, calculated from forceplate data. Accuracy of response was used as a measure of cognitive task performance. Capacity of the executive attention system was determined by assessing visual working memory capacity. Results Children with CP, like the typically developing young children, were more unstable and had less executive attention capacity compared with older children, and like the typically developing young children, experienced dual-task interference in postural control in both stance positions. Children with ataxic CP also experienced decreased cognitive task performance in narrow stance. Conclusions In designing therapeutic interventions for children with CP, it would be beneficial for clinicians to assess postural control in both single- and dual-task environments.