Interférence cognitivo-motrice chez les personnes atteintes de sclérose en plaques
A thesis presented to the Faculty of Medicine and Health Sciences in partial fulfillment of the requirements of the degree of Master of Science in Health sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada, J1H 5N4 Background: Multiple sclerosis (MS) is a neurodegenerative disease which is associated with cognition and balance disorders. It is established that postural control requires congnitive resources and it’s possible to evaluate this interaction by using the dual-task paradigm (DT). Few studies have examined the effect of DT through the dual task cost (DTC) in people with MS. Specifically, the objectives of this thesis were to 1) determine the DTC of two tasks under different postural conditions in people with MS and in healthy individuals, and 2) explore different parameters of postural control performance and cognition by means of different clinical tests and questionnaires. Methods: One group of MS (n = 22) and healthy controls (n = 22) were matched according to age, gender and level of education for this cross-sectional study. Each participant had to perform a static balance task in three different positions (seated, standing and tandem) and a choice reaction time in single task (ST) and DT. The mean sway velocity, medio-lateral sway, antero-posterior sway and reaction time were calculated for each condition. In addition, both groups underwent the Montreal Cognitive Assessment, Fullerton Advanced Balance Scale, Falls Efficacy Scale-International and Fatigue Scale for Motor and Cognitive Functions. Results: A repeated measures ANOVA showed there were no effect or interaction for the DTC variables between the two groups (p < 0.05). However, the MS group showed a motor task prioritization, while the healthy group demonstrated mutual facilitation in both tasks in a DTC model. The healthy group had faster reaction times than the MS group. A Group*Posture*Vision interaction was detected, but no effect of task was noted. MS subjects had better balance than healthy participants in tandem stance only (F(1,40) = 15.95, p < 0.05). The MS group was also moderately fatigued (p < 0.01) and concerned about the risk of falling (p < 0.01) compared to healthy group. Conclusion: DTC was not significantly different between the two groups. However, it is possible to distinguish different patterns of attentional demands between both groups. Furthermore, the results suggest a difference of performance between both groups.
Sclérose en plaques, Multiple sclerosis, Double tâche, Dual-Task, Coût de la double tâche, Dual-task cost, Posture, Cognition
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