Effect of dual task type on gait and dynamic stability during stair negotiation at different inclinations

Stair gait is a common daily activity with great potential risk for falls. Stairs have varying inclinations and people may perform other tasks concurrently with stair gait. This study investigated dual-task interference in the context of complex gait tasks, such as stair gait at different inclinations, a topic about which little is understood. We examined how secondary cognitive and manual tasks interfere with stair gait when a person concurrently performed tasks at different levels of complexity. Gait kinematic data and secondary task performance measures were obtained from fifteen healthy young males while ascending and descending a four-step staircase at three inclinations (17.7 degrees, 29.4 degrees, and 41.5 degrees) as well as level walking. They performed a cognitive task, 'backward digit recall', a manual task, 'carrying a cup of water' and a combination of the two tasks. Gait performance and dynamic stability were assessed by gait speed and whole body center of mass (COM) range of motion in the medial-lateral direction, respectively. No significant effect of the gait task on the cognitive task performance was observed. In contrast, stair walking adversely affected the performance of the manual task compared to level walking. Overall, more difficult postural and secondary tasks resulted in a decrease in gait speed and variation in COM displacement within normal range. Results suggest that COM displacement and gait alterations might be adopted to enhance the stability, and optimize the secondary task performance while walking under challenging circumstances. Our findings are useful for balance and gait evaluation, and for future falls prediction. (C) 2015 Elsevier B.V. All rights reserved.