Τετάρτη 20 Ιουνίου 2018

O 030 - Learning effect of dynamic postural stability evaluation system

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): H. Keklicek, E. Kirdi, A. Yalcin, S. Topuz




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P 095 - Age-related differences in dynamic postural responses to soleus muscle vibration

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): D. Bzduskova, Z. Hirjaková, J. Kimijanová, F. Hlavačka




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P 098 - Preservation of motor flexibility in healthy aging: Old age and task constraints do not affect flexibility in joint coordination

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): C. Greve, T. Hortobágyi, R. Bongers




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O 049 - Post-stroke balance responses after lateral perturbations to pelvis during treadmill walking

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): M. Zadravec, A. Olenšek, M. Rudolf, N. Bizovičar, N. Goljar, Z. Matjačić




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O 021 - Does including EMG data in the estimation of muscle forces alter the evaluation of the effect of botulinum toxin injections?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): M. Wesseling, T. Hoekstra, H. Kainz, S. Van Rossom, K. Desloovere, F. De Groote, I. Jonkers




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Cognition and mobility show a global association in middle- and late-adulthood: Analyses from the Canadian Longitudinal Study on Aging

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): Naiara Demnitz, David B. Hogan, Helen Dawes, Heidi Johansen-Berg, Klaus P. Ebmeier, Marc J. Poulin, Claire E. Sexton
BACKGROUNDGiven our aging population, there’s great interest in identifying modifiable risk factors for cognitive decline. Studies have highlighted the relationship between aspects of mobility and cognitive processes. However, cognition and mobility are both multifaceted concepts and their interrelationships remain to be well defined.RESEARCH QUESTIONHere, we firstly aimed to replicate cross-sectional associations between objective measures of mobility and cognition. Second, we tested whether these associations remained after the consideration of multiple age-related confounders. Finally, to test the hypothesis that the association between mobility and cognition is stronger in older adults, we examined the moderating effect of age in the association between mobility and cognition.METHODSIn the Canadian Longitudinal Study on Aging, 28,808 community-dwelling adults (aged 45-87; 51% female) completed mobility (gait, balance and chair stands) and cognitive (memory, executive function and processing speed) assessments. General linear models were used to examine mobility-cognition relationships and the moderating effect of age.RESULTSCognitive measures were significantly associated with mobility measures (all p < 0.001). Further, age significantly moderated the mobility-cognition relationship, with the strength of the associations generally increasing with age.SIGNIFICANCEAll cognitive measures were related to indices of mobility, suggesting a global association. In our moderation analyses, the mobility-cognition relationship often increased with age. However, the small effect sizes observed suggest that mobility is, in isolation, not a strong correlate of cognitive performance in middle and late-adulthood.



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Carrying asymmetric loads during stair negotiation: Loaded limb stance vs. unloaded limb stance

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Publication date: July 2018
Source:Gait & Posture, Volume 64
Author(s): Junsig Wang, Jason C. Gillette
BackgroundIndividuals often carry items in one hand instead of both hands during activities of daily living. Research Question The purpose of this study was to investigate low back and lower extremity frontal plane moments for loaded limb stance and unloaded limb stance when carrying symmetric and asymmetric loads during stair negotiation.MethodsParticipants were instructed to ascend and descend a three-step staircase at preferred pace using a right leg lead and a left leg lead for each load condition: no load, 20% body weight (BW) bilateral load, and 20% BW unilateral load. L5/S1 contralateral bending, hip abduction, external knee varus, and ankle inversion moments were calculated using inverse dynamics.ResultsPeak L5/S1 contralateral bending moments were significantly higher when carrying a 20% BW unilateral load as compared to a 20% BW bilateral load for both stair ascent and stair descent. In addition, peak L5/S1 contralateral bending moments were significantly higher during step one than for step two. Peak external knee varus and hip abduction moments were significantly higher in unloaded limb stance as compared to loaded limb stance when carrying a 20% BW unilateral load.SignificanceGeneral load carriage recommendations include carrying less than 20% BW loads and splitting loads bilaterally when feasible. Assessment recommendations include analyzing the first stair step and analyzing both the loaded and unloaded limbs.



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Relationships between walking speed, T-score and age with gait parameters in older post-menopausal women with low bone mineral density

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Publication date: Available online 20 June 2018
Source:Gait & Posture
Author(s): Ali Dostanpor, Catherine A. Dobson, Natalie Vanicek
BackgroundThe gait patterns of women with low bone mineral density (BMD) or osteoporosis have not been thoroughly explored, and when examined, often studied in relation to falls and kyphosis.Research question: The aim of this study was to investigate the relationships between gait parameters and comfortable, self-selected walking speed and BMD in older post-menopausal women with a range of T-scores (healthy to osteoporotic).Methods3D kinematic and kinetic data were collected from forty-five women mean (SD) age 67.3 (1.4) years during level walking at their preferred speed. Multiple regression analysis explored the explained variance attributable to speed, femoral neck T-score, and age.ResultsThe mean (SD) walking speed 1.40 (0.19) m·s-1 explained the variance in most temporal-spatial, kinematic and joint powers (R2 = 12-68%, P≤0.001). T-score accounted for (R2 = 23%, P≤0.001) of the shared explained variance in stride width. It also increased the explanatory power for knee flexion (R2 = 7%, P≤0.05) and knee range of motion (R2 = 12%, P≤0.01). Power absorption by the knee flexors in terminal swing (K4) was the only power burst resulting in significant slope coefficients for all predictor variables (R2 = 52 and 54%) (P≤0.001) and (R2 = 68%, P≤0.05).SignificanceSpeed alone explained much of the variance of gait parameters, while speed and T-score combined increased the explained variance in some knee variables. Our findings demonstrate that older post-menopausal women with a broad range of T-scores can walk at comfortably fast speeds. The results also suggest that strengthening the hip abductor, knee extensor and flexor muscle groups may benefit the gait patterns of older postmenopausal women with low BMD.



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O 024 - Joint loading is normalized following single-event multilevel surgery and partly normalized following botulinum injections in cerebral palsy patients

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): S. Van Rossom, H. Kainz, M. Wesseling, E. Papageorgiou, F. De Groote, A. Van Campenhout, I. Jonkers




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O 057 - The intra-rater and inter-rater reliability of a method measuring the sagittal curvature of the spine using surface topography

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): E. Hannink, K. Barker, H. Dawes




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O 044 - Is there a relationship between trunk control, hand ability, communication and eating-drinking functions in children with spastic cerebral palsy?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): K. Seyhan, Ö. Çankaya, M.K. Günel




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O 037 – Estimating musculotendon forces in children with cerebral palsy: the importance of the use of electromyography in neuromusculoskeletal modelling

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): K. Veerkamp, W. Schallig, J. Harlaar, C. Pizzolato, C. Carty, D. Lloyd, M. van der Krogt




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O 019 - Do Botulinum Toxin-A and lower leg casting alter calf muscle and tendon lengths in children with spastic cerebral palsy?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): N. Peeters, B. Hanssen, F. Cenni, S.H. Schless, N. De Beukelaer, M. Degelaen, C. Van den Broeck, A. Van Campenhout, K. Desloovere, L. Bar-On




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The Relationships between Compensatory Stepping Thresholds and Measures of Gait, Standing Postural Control, Strength, and Balance Confidence in Older Women

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): Jeremy R. Crenshaw, Kathie A. Bernhardt, Elizabeth J. Atkinson, Sundeep Khosla, Kenton R. Kaufman, Shreyasee Amin
BackgroundCompensatory stepping thresholds evaluate the response to postural disturbances. Although such fall-recovery measures are a promising indicator of fall risk, the relationships between stepping thresholds and other measures used to predict falls are not well established.Research QuestionWe sought to quantify the relationships between stepping thresholds and other measurements used to assess fall risk in older women, a population at high risk for falls and related injuries, including fractures.MethodsWe studied 112 ambulatory, community-dwelling women, age 65 years or older. Using a treadmill to deliver standing postural disturbances, we determined anterior and posterior single-stepping and multiple-stepping thresholds. These thresholds represented the magnitude of the disturbance that elicited one step or more than one step, respectively. We also assessed balance confidence, functional reach, unipedal stance time, isometric strength, obstacle crossing, postural sway, and gait kinematics. Outcomes were normalized to body size.ResultsAfter accounting for age, stepping thresholds were, at most, moderately correlated (Pearson partial correlation coefficients r = 0.20 to 0.40 and r = -0.21 to -0.31) to several assessments of gait, postural control, and strength. Approximately 24-52% of the variance in stepping thresholds was explained by a combination of age and other fall risk assessments, which frequently consisted of balance confidence, unipedal stance time, obstacle crossing, the Romberg ratio of postural sway, and/or strength.SignificanceOur results suggest that anteroposterior fall-recovery ability, as assessed by stepping thresholds, can only be partially inferred from age and a combination of assessments of sway, strength, unipedal tasks, and balance confidence. Compensatory stepping thresholds may provide information on stability maintenance unique from other assessments of fall risk. Further investigation would be necessary to determine whether stepping thresholds are better predictors of falls in older women.



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O 030 - Learning effect of dynamic postural stability evaluation system

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): H. Keklicek, E. Kirdi, A. Yalcin, S. Topuz




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P 095 - Age-related differences in dynamic postural responses to soleus muscle vibration

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): D. Bzduskova, Z. Hirjaková, J. Kimijanová, F. Hlavačka




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P 098 - Preservation of motor flexibility in healthy aging: Old age and task constraints do not affect flexibility in joint coordination

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): C. Greve, T. Hortobágyi, R. Bongers




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O 049 - Post-stroke balance responses after lateral perturbations to pelvis during treadmill walking

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): M. Zadravec, A. Olenšek, M. Rudolf, N. Bizovičar, N. Goljar, Z. Matjačić




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O 021 - Does including EMG data in the estimation of muscle forces alter the evaluation of the effect of botulinum toxin injections?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): M. Wesseling, T. Hoekstra, H. Kainz, S. Van Rossom, K. Desloovere, F. De Groote, I. Jonkers




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Cognition and mobility show a global association in middle- and late-adulthood: Analyses from the Canadian Longitudinal Study on Aging

S09666362.gif

Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): Naiara Demnitz, David B. Hogan, Helen Dawes, Heidi Johansen-Berg, Klaus P. Ebmeier, Marc J. Poulin, Claire E. Sexton
BACKGROUNDGiven our aging population, there’s great interest in identifying modifiable risk factors for cognitive decline. Studies have highlighted the relationship between aspects of mobility and cognitive processes. However, cognition and mobility are both multifaceted concepts and their interrelationships remain to be well defined.RESEARCH QUESTIONHere, we firstly aimed to replicate cross-sectional associations between objective measures of mobility and cognition. Second, we tested whether these associations remained after the consideration of multiple age-related confounders. Finally, to test the hypothesis that the association between mobility and cognition is stronger in older adults, we examined the moderating effect of age in the association between mobility and cognition.METHODSIn the Canadian Longitudinal Study on Aging, 28,808 community-dwelling adults (aged 45-87; 51% female) completed mobility (gait, balance and chair stands) and cognitive (memory, executive function and processing speed) assessments. General linear models were used to examine mobility-cognition relationships and the moderating effect of age.RESULTSCognitive measures were significantly associated with mobility measures (all p < 0.001). Further, age significantly moderated the mobility-cognition relationship, with the strength of the associations generally increasing with age.SIGNIFICANCEAll cognitive measures were related to indices of mobility, suggesting a global association. In our moderation analyses, the mobility-cognition relationship often increased with age. However, the small effect sizes observed suggest that mobility is, in isolation, not a strong correlate of cognitive performance in middle and late-adulthood.



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Carrying asymmetric loads during stair negotiation: Loaded limb stance vs. unloaded limb stance

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Publication date: July 2018
Source:Gait & Posture, Volume 64
Author(s): Junsig Wang, Jason C. Gillette
BackgroundIndividuals often carry items in one hand instead of both hands during activities of daily living. Research Question The purpose of this study was to investigate low back and lower extremity frontal plane moments for loaded limb stance and unloaded limb stance when carrying symmetric and asymmetric loads during stair negotiation.MethodsParticipants were instructed to ascend and descend a three-step staircase at preferred pace using a right leg lead and a left leg lead for each load condition: no load, 20% body weight (BW) bilateral load, and 20% BW unilateral load. L5/S1 contralateral bending, hip abduction, external knee varus, and ankle inversion moments were calculated using inverse dynamics.ResultsPeak L5/S1 contralateral bending moments were significantly higher when carrying a 20% BW unilateral load as compared to a 20% BW bilateral load for both stair ascent and stair descent. In addition, peak L5/S1 contralateral bending moments were significantly higher during step one than for step two. Peak external knee varus and hip abduction moments were significantly higher in unloaded limb stance as compared to loaded limb stance when carrying a 20% BW unilateral load.SignificanceGeneral load carriage recommendations include carrying less than 20% BW loads and splitting loads bilaterally when feasible. Assessment recommendations include analyzing the first stair step and analyzing both the loaded and unloaded limbs.



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Relationships between walking speed, T-score and age with gait parameters in older post-menopausal women with low bone mineral density

S09666362.gif

Publication date: Available online 20 June 2018
Source:Gait & Posture
Author(s): Ali Dostanpor, Catherine A. Dobson, Natalie Vanicek
BackgroundThe gait patterns of women with low bone mineral density (BMD) or osteoporosis have not been thoroughly explored, and when examined, often studied in relation to falls and kyphosis.Research question: The aim of this study was to investigate the relationships between gait parameters and comfortable, self-selected walking speed and BMD in older post-menopausal women with a range of T-scores (healthy to osteoporotic).Methods3D kinematic and kinetic data were collected from forty-five women mean (SD) age 67.3 (1.4) years during level walking at their preferred speed. Multiple regression analysis explored the explained variance attributable to speed, femoral neck T-score, and age.ResultsThe mean (SD) walking speed 1.40 (0.19) m·s-1 explained the variance in most temporal-spatial, kinematic and joint powers (R2 = 12-68%, P≤0.001). T-score accounted for (R2 = 23%, P≤0.001) of the shared explained variance in stride width. It also increased the explanatory power for knee flexion (R2 = 7%, P≤0.05) and knee range of motion (R2 = 12%, P≤0.01). Power absorption by the knee flexors in terminal swing (K4) was the only power burst resulting in significant slope coefficients for all predictor variables (R2 = 52 and 54%) (P≤0.001) and (R2 = 68%, P≤0.05).SignificanceSpeed alone explained much of the variance of gait parameters, while speed and T-score combined increased the explained variance in some knee variables. Our findings demonstrate that older post-menopausal women with a broad range of T-scores can walk at comfortably fast speeds. The results also suggest that strengthening the hip abductor, knee extensor and flexor muscle groups may benefit the gait patterns of older postmenopausal women with low BMD.



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O 024 - Joint loading is normalized following single-event multilevel surgery and partly normalized following botulinum injections in cerebral palsy patients

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): S. Van Rossom, H. Kainz, M. Wesseling, E. Papageorgiou, F. De Groote, A. Van Campenhout, I. Jonkers




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O 057 - The intra-rater and inter-rater reliability of a method measuring the sagittal curvature of the spine using surface topography

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): E. Hannink, K. Barker, H. Dawes




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O 044 - Is there a relationship between trunk control, hand ability, communication and eating-drinking functions in children with spastic cerebral palsy?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): K. Seyhan, Ö. Çankaya, M.K. Günel




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O 037 – Estimating musculotendon forces in children with cerebral palsy: the importance of the use of electromyography in neuromusculoskeletal modelling

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): K. Veerkamp, W. Schallig, J. Harlaar, C. Pizzolato, C. Carty, D. Lloyd, M. van der Krogt




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O 019 - Do Botulinum Toxin-A and lower leg casting alter calf muscle and tendon lengths in children with spastic cerebral palsy?

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Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): N. Peeters, B. Hanssen, F. Cenni, S.H. Schless, N. De Beukelaer, M. Degelaen, C. Van den Broeck, A. Van Campenhout, K. Desloovere, L. Bar-On




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The Relationships between Compensatory Stepping Thresholds and Measures of Gait, Standing Postural Control, Strength, and Balance Confidence in Older Women

S09666362.gif

Publication date: Available online 19 June 2018
Source:Gait & Posture
Author(s): Jeremy R. Crenshaw, Kathie A. Bernhardt, Elizabeth J. Atkinson, Sundeep Khosla, Kenton R. Kaufman, Shreyasee Amin
BackgroundCompensatory stepping thresholds evaluate the response to postural disturbances. Although such fall-recovery measures are a promising indicator of fall risk, the relationships between stepping thresholds and other measures used to predict falls are not well established.Research QuestionWe sought to quantify the relationships between stepping thresholds and other measurements used to assess fall risk in older women, a population at high risk for falls and related injuries, including fractures.MethodsWe studied 112 ambulatory, community-dwelling women, age 65 years or older. Using a treadmill to deliver standing postural disturbances, we determined anterior and posterior single-stepping and multiple-stepping thresholds. These thresholds represented the magnitude of the disturbance that elicited one step or more than one step, respectively. We also assessed balance confidence, functional reach, unipedal stance time, isometric strength, obstacle crossing, postural sway, and gait kinematics. Outcomes were normalized to body size.ResultsAfter accounting for age, stepping thresholds were, at most, moderately correlated (Pearson partial correlation coefficients r = 0.20 to 0.40 and r = -0.21 to -0.31) to several assessments of gait, postural control, and strength. Approximately 24-52% of the variance in stepping thresholds was explained by a combination of age and other fall risk assessments, which frequently consisted of balance confidence, unipedal stance time, obstacle crossing, the Romberg ratio of postural sway, and/or strength.SignificanceOur results suggest that anteroposterior fall-recovery ability, as assessed by stepping thresholds, can only be partially inferred from age and a combination of assessments of sway, strength, unipedal tasks, and balance confidence. Compensatory stepping thresholds may provide information on stability maintenance unique from other assessments of fall risk. Further investigation would be necessary to determine whether stepping thresholds are better predictors of falls in older women.



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In a Concurrent Memory and Auditory Perception Task, the Pupil Dilation Response Is More Sensitive to Memory Load Than to Auditory Stimulus Characteristics

Objectives: Speech understanding may be cognitively demanding, but it can be enhanced when semantically related text cues precede auditory sentences. The present study aimed to determine whether (a) providing text cues reduces pupil dilation, a measure of cognitive load, during listening to sentences, (b) repeating the sentences aloud affects recall accuracy and pupil dilation during recall of cue words, and (c) semantic relatedness between cues and sentences affects recall accuracy and pupil dilation during recall of cue words. Design: Sentence repetition following text cues and recall of the text cues were tested. Twenty-six participants (mean age, 22 years) with normal hearing listened to masked sentences. On each trial, a set of four-word cues was presented visually as text preceding the auditory presentation of a sentence whose meaning was either related or unrelated to the cues. On each trial, participants first read the cue words, then listened to a sentence. Following this they spoke aloud either the cue words or the sentence, according to instruction, and finally on all trials orally recalled the cues. Peak pupil dilation was measured throughout listening and recall on each trial. Additionally, participants completed a test measuring the ability to perceive degraded verbal text information and three working memory tests (a reading span test, a size-comparison span test, and a test of memory updating). Results: Cue words that were semantically related to the sentence facilitated sentence repetition but did not reduce pupil dilation. Recall was poorer and there were more intrusion errors when the cue words were related to the sentences. Recall was also poorer when sentences were repeated aloud. Both behavioral effects were associated with greater pupil dilation. Larger reading span capacity and smaller size-comparison span were associated with larger peak pupil dilation during listening. Furthermore, larger reading span and greater memory updating ability were both associated with better cue recall overall. Conclusions: Although sentence-related word cues facilitate sentence repetition, our results indicate that they do not reduce cognitive load during listening in noise with a concurrent memory load. As expected, higher working memory capacity was associated with better recall of the cues. Unexpectedly, however, semantic relatedness with the sentence reduced word cue recall accuracy and increased intrusion errors, suggesting an effect of semantic confusion. Further, speaking the sentence aloud also reduced word cue recall accuracy, probably due to articulatory suppression. Importantly, imposing a memory load during listening to sentences resulted in the absence of formerly established strong effects of speech intelligibility on the pupil dilation response. This nullified intelligibility effect demonstrates that the pupil dilation response to a cognitive (memory) task can completely overshadow the effect of perceptual factors on the pupil dilation response. This highlights the importance of taking cognitive task load into account during auditory testing. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ACKNOWLEDGMENTS: This work is supported by grants from The Swedish Research Council. We thank Hans van Beek for his technical support in the data collection. The authors have no conflicts of interest to disclose. Received February 14, 2017; accepted April 10, 2018. Address for correspondence: Adriana A. Zekveld, Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery and Amsterdam Public Health research institute, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: aa.zekveld@vumc.nl Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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In a Concurrent Memory and Auditory Perception Task, the Pupil Dilation Response Is More Sensitive to Memory Load Than to Auditory Stimulus Characteristics

Objectives: Speech understanding may be cognitively demanding, but it can be enhanced when semantically related text cues precede auditory sentences. The present study aimed to determine whether (a) providing text cues reduces pupil dilation, a measure of cognitive load, during listening to sentences, (b) repeating the sentences aloud affects recall accuracy and pupil dilation during recall of cue words, and (c) semantic relatedness between cues and sentences affects recall accuracy and pupil dilation during recall of cue words. Design: Sentence repetition following text cues and recall of the text cues were tested. Twenty-six participants (mean age, 22 years) with normal hearing listened to masked sentences. On each trial, a set of four-word cues was presented visually as text preceding the auditory presentation of a sentence whose meaning was either related or unrelated to the cues. On each trial, participants first read the cue words, then listened to a sentence. Following this they spoke aloud either the cue words or the sentence, according to instruction, and finally on all trials orally recalled the cues. Peak pupil dilation was measured throughout listening and recall on each trial. Additionally, participants completed a test measuring the ability to perceive degraded verbal text information and three working memory tests (a reading span test, a size-comparison span test, and a test of memory updating). Results: Cue words that were semantically related to the sentence facilitated sentence repetition but did not reduce pupil dilation. Recall was poorer and there were more intrusion errors when the cue words were related to the sentences. Recall was also poorer when sentences were repeated aloud. Both behavioral effects were associated with greater pupil dilation. Larger reading span capacity and smaller size-comparison span were associated with larger peak pupil dilation during listening. Furthermore, larger reading span and greater memory updating ability were both associated with better cue recall overall. Conclusions: Although sentence-related word cues facilitate sentence repetition, our results indicate that they do not reduce cognitive load during listening in noise with a concurrent memory load. As expected, higher working memory capacity was associated with better recall of the cues. Unexpectedly, however, semantic relatedness with the sentence reduced word cue recall accuracy and increased intrusion errors, suggesting an effect of semantic confusion. Further, speaking the sentence aloud also reduced word cue recall accuracy, probably due to articulatory suppression. Importantly, imposing a memory load during listening to sentences resulted in the absence of formerly established strong effects of speech intelligibility on the pupil dilation response. This nullified intelligibility effect demonstrates that the pupil dilation response to a cognitive (memory) task can completely overshadow the effect of perceptual factors on the pupil dilation response. This highlights the importance of taking cognitive task load into account during auditory testing. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ACKNOWLEDGMENTS: This work is supported by grants from The Swedish Research Council. We thank Hans van Beek for his technical support in the data collection. The authors have no conflicts of interest to disclose. Received February 14, 2017; accepted April 10, 2018. Address for correspondence: Adriana A. Zekveld, Section Ear & Hearing, Department of Otolaryngology-Head and Neck Surgery and Amsterdam Public Health research institute, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: aa.zekveld@vumc.nl Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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