TY - JOUR
T1 - Exploring the Roles of Central and Peripheral Nervous System Function in Gait Stability
T2 - Preliminary Insights from Cancer Survivors
AU - Monfort, Scott M.
AU - Pan, Xueliang
AU - Loprinzi, Charles L.
AU - Lustberg, Maryam B.
AU - Chaudhari, Ajit M.W.
N1 - Funding Information:
This research was supported by the National Cancer Institute (Grant No. R03 CA182165) and the National Science Foundation Graduate Research Fellowship Program (Grant No. DGE-1343012). Additional financial support for this work was provided by Ohio State University's Center for Clinical and Translational Science (partial support for Xueliang Pan) and Graduate School (partial research support for Scott Monfort). The authors would like to thank Nelson Glover for his contributions in preparing the gait data for analysis, and Lynette Mesi for her contributions to patient recruitment.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/6
Y1 - 2019/6
N2 - Background: Impairments in central and/or peripheral nervous systems are known to be associated with altered gait; however, the interplay between cognitive function, peripheral sensation, and orbital gait stability remains largely unclear. Elucidating these relationships is expected to provide a clearer understanding of potential fall risk factors across various populations and targets for novel interventions. Many patients diagnosed with cancer are treated with chemotherapy agents known to be neurotoxic to the central and/or peripheral nervous systems that can contribute to movement deficiencies, making this population a novel model to investigate these relationships. Research Question: The purpose of this exploratory study was to investigate how central and peripheral nervous system impairments associate with orbital stability during single- and dual-task gait. Methods: Twenty cancer survivors were enrolled and separated into three groups: no prior chemotherapy exposure (CON, n = 6), and prior treatment with chemotherapy and having no/mild chemotherapy-induced peripheral neuropathy (CIPN) symptoms (-CIPN, n = 8) or moderate/severe CIPN symptoms (+CIPN, n = 6). Testing included single- and dual-task (i.e., serial sevens) treadmill walking as well as a computerized test of executive function. Maximum Floquet multipliers were calculated to assess orbital stability during gait. Results: Worse executive function was associated with decreased orbital stability during the dual-task condition in the +CIPN group (Spearman's ρ = 0.94, P = 0.017). Additionally, decreased orbital stability during dual-task gait was observed for the -CIPN group compared to the CON group (ES = 1.96, P = 0.019). Significance: Executive dysfunction was associated with decreased gait stability during challenging dual-task gait in survivors with sensory symptoms of CIPN. The association between combined central and peripheral nervous system impairments and decreased gait stability in cancer survivors provides a novel demonstration of potential compensatory strategies that accompany deficiencies in these functions. Future work is needed to confirm these relationships and whether they hold in other populations.
AB - Background: Impairments in central and/or peripheral nervous systems are known to be associated with altered gait; however, the interplay between cognitive function, peripheral sensation, and orbital gait stability remains largely unclear. Elucidating these relationships is expected to provide a clearer understanding of potential fall risk factors across various populations and targets for novel interventions. Many patients diagnosed with cancer are treated with chemotherapy agents known to be neurotoxic to the central and/or peripheral nervous systems that can contribute to movement deficiencies, making this population a novel model to investigate these relationships. Research Question: The purpose of this exploratory study was to investigate how central and peripheral nervous system impairments associate with orbital stability during single- and dual-task gait. Methods: Twenty cancer survivors were enrolled and separated into three groups: no prior chemotherapy exposure (CON, n = 6), and prior treatment with chemotherapy and having no/mild chemotherapy-induced peripheral neuropathy (CIPN) symptoms (-CIPN, n = 8) or moderate/severe CIPN symptoms (+CIPN, n = 6). Testing included single- and dual-task (i.e., serial sevens) treadmill walking as well as a computerized test of executive function. Maximum Floquet multipliers were calculated to assess orbital stability during gait. Results: Worse executive function was associated with decreased orbital stability during the dual-task condition in the +CIPN group (Spearman's ρ = 0.94, P = 0.017). Additionally, decreased orbital stability during dual-task gait was observed for the -CIPN group compared to the CON group (ES = 1.96, P = 0.019). Significance: Executive dysfunction was associated with decreased gait stability during challenging dual-task gait in survivors with sensory symptoms of CIPN. The association between combined central and peripheral nervous system impairments and decreased gait stability in cancer survivors provides a novel demonstration of potential compensatory strategies that accompany deficiencies in these functions. Future work is needed to confirm these relationships and whether they hold in other populations.
KW - Dual-task gait
KW - Executive function
KW - Neuropathy
KW - Orbital stability
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U2 - 10.1016/j.gaitpost.2019.04.002
DO - 10.1016/j.gaitpost.2019.04.002
M3 - Article
C2 - 31009918
AN - SCOPUS:85064426487
SN - 0966-6362
VL - 71
SP - 62
EP - 68
JO - Gait and Posture
JF - Gait and Posture
ER -