Gait in attention deficit hyperactivity disorder
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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.
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.
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.
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.
- Gait in attention deficit hyperactivity disorder
Journal of Neurology
Volume 254, Issue 10 , pp 1330-1338
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- dual task
- cognitive function
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- Author Affiliations
- 1. Paediatric Neurology Unit & Child Development Center, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- 2. Dept. of Pediatrics, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- 3. Dept. of Neurology, Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- 4. Dept. of Physical Therapy and Neurology, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
- 6. Laboratory for Gait & Neurodynamics, Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv, 64239, Israel
- 5. Division on Aging, Harvard Medical School, Boston, MA, USA