Gait in Very Preterm School-Aged Children in Dual-Task Paradigms

Arx, Priska Hagmann-von; Manicolo, Olivia; Perkinson‐Gloor, Nadine; Weber, Peter; Grob, Alexander; Lemola, Sakari · 2015 · OpenAlex-citations

DOI: 10.1371/journal.pone.0144363

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Summary

This study investigates gait performance in very preterm school-aged children compared to full-term peers, specifically examining how concurrent cognitive and motor tasks affect walking. The research was motivated by the known deficits in executive and attentional functions among preterm children and the scarcity of data regarding their gait development beyond early childhood. The authors hypothesized that dual-tasking would impair gait more severely in preterm children due to these cognitive limitations. The study included 44 very preterm children (born <32 weeks gestation) and 44 age- and sex-matched full-term children. The preterm group was further subdivided into those with very low birth weight (≤1500 g) and those with birth weight >1500 g. Gait was assessed using an electronic walkway system (GAITRite) under single-task (walking only), dual-task (walking plus one concurrent task), and triple-task (walking plus two concurrent tasks) conditions. Concurrent tasks included naming animals, memorizing digits, carrying a tray with balls, and manipulating a button. The analysis focused on spatio-temporal parameters (velocity, cadence, stride length, support times), normalized parameters, and gait variability (stride velocity and length variability). Statistical analyses employed repeated-measures MANOVAs to compare walking conditions and prematurity status. Results indicated that dual- and triple-task conditions significantly decreased gait velocity, cadence, and stride length, while increasing single and double support times and gait variability for all participants compared to single-task walking. This confirms that walking requires executive and attentional resources in both preterm and full-term children. Crucially, there were no significant interactions between walking conditions and prematurity status, meaning preterm children did not show disproportionately worse gait performance under cognitive load compared to full-term peers. However, a systematic linear trend was observed in stride velocity variability: it decreased from preterm children with very low birth weight to those with higher birth weights, and finally to full-term children. This suggests that poorer walking regularity is associated with lower maturity at birth, even in the absence of significant group differences in other gait parameters. The findings imply that while dual-tasking universally affects gait in school-aged children, the specific hypothesis that preterm children exhibit greater gait impairment under cognitive load was not supported. Instead, the birth-weight-dependent differences in stride velocity variability highlight subtle, persistent motor control differences linked to prematurity. These results contribute to the understanding of long-term motor outcomes in preterm children, suggesting that while gross gait mechanics may normalize, subtle variability in gait regularity remains associated with early developmental maturity.

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• child pedestrian