ORIGINAL COMMUNICATION

Journal of Neurology

, Volume 254, Issue 10, pp 1330-1338

Gait in attention deficit hyperactivity disorder

Effects of methylphenidate and dual tasking
  • Yael LeitnerAffiliated withPaediatric Neurology Unit & Child Development Center, Tel-Aviv Sourasky Medical CenterDept. of Pediatrics, Sackler School of Medicine, Tel-Aviv University
  • , Ran BarakAffiliated withPaediatric Neurology Unit & Child Development Center, Tel-Aviv Sourasky Medical Center
  • , Nir GiladiAffiliated withDept. of Neurology, Movement Disorders Unit, Tel-Aviv Sourasky Medical CenterDept. of Physical Therapy and Neurology, Sackler School of Medicine, Tel-Aviv University
  • , Chava PeretzAffiliated withDept. of Neurology, Movement Disorders Unit, Tel-Aviv Sourasky Medical CenterDept. of Physical Therapy and Neurology, Sackler School of Medicine, Tel-Aviv University
  • , Rena EshelAffiliated withPaediatric Neurology Unit & Child Development Center, Tel-Aviv Sourasky Medical Center
  • , Leor GruendlingerAffiliated withDept. of Neurology, Movement Disorders Unit, Tel-Aviv Sourasky Medical CenterLaboratory for Gait & Neurodynamics, Movement Disorders Unit, Tel-Aviv Sourasky Medical Center
  • , Jeffrey M. HausdorffAffiliated withDept. of Neurology, Movement Disorders Unit, Tel-Aviv Sourasky Medical CenterDept. of Physical Therapy and Neurology, Sackler School of Medicine, Tel-Aviv UniversityDivision on Aging, Harvard Medical SchoolLaboratory for Gait & Neurodynamics, Movement Disorders Unit, Tel-Aviv Sourasky Medical Center Email author 

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Abstract

Background

Cognitive function and the loading of attention presumably play an important role in gait as well as in fall risk, but previous work has not demonstrated this in any cause-and-effect way.

Objectives

To gain insight into the relationship between gait and cognitive function, we sought: (1) To compare the gait rhythmicity (stride time variability) of children with attention deficit hyperactivity disorder (ADHD) to controls, (2) To test the hypothesis that dual tasking leads to increased stride-to-stride variability in ADHD, and (3) To test whether pharmacological treatment that relieves ADHD symptoms reduces stride-to-stride variability.

Patients and Methods

Gait was quantified in children with ADHD and in age-matched healthy controls under single task and dual task conditions on three occasions: off medications (both groups) and, in the ADHD group, after double blinded, randomized administration of methylphenidate (MPH) or placebo.

Results

At baseline, children with ADHD tended to walk with increased stride-to-stride variability compared to the controls during the single task condition (p = 0.09). During dual task walking, stride time variability was significantly reduced in the children with ADHD (p < 0.004), but not in the controls. In the children with ADHD, the placebo did not significantly affect stride-to-stride variability or the dual tasking response. In contrast, stride time variability was significantly reduced on MPH (p < 0.001) such that dual tasking no longer affected variability.

Conclusions

The present findings demonstrate alterations in the gait of children with ADHD, support a cause and effect link between cognitive function and gait, and suggest that enhancement of attention abilities may, in certain populations, improve gait rhythmicity.

Key words

gait attention dual task cognitive function ADHD