{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:51:57Z","timestamp":1790063517764,"version":"4.0.1"},"reference-count":58,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,4,5]],"date-time":"2018-04-05T00:00:00Z","timestamp":1522886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Gait is a complex process that involves coordinating motor and sensory systems through higher\u2010order cognitive processes. Walking with a prosthesis after lower extremity amputation challenges these processes. However, the factors that influence the cognitive\u2010motor interaction in gait among lower extremity amputees has not been evaluated. To assess the interaction of cognition and mobility, individuals must be evaluated using the dual\u2010task paradigm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the effect of etiology and time with prosthesis on dual\u2010task performance in those with lower extremity amputations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Outpatient and inpatient amputee clinics at an academic rehabilitation hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Sixty\u2010four individuals (aged 58.20\u00b112.27 years; 74.5% male) were stratified into 3 groups; 1 group of new prosthetic ambulators with transtibial amputations (NewPA) and 2 groups of established ambulators: transtibial amputations of vascular etiology (TTA\u2010vas), transtibial amputations of nonvascular etiology (TTA\u2010nonvas).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Time to complete the L Test measured functional mobility under single and dual\u2010task conditions. A serial arithmetic task (subtraction by 3s) was paired with the L Test to create the dual\u2010task test condition. Single\u2010task performance on the cognitive arithmetic task was also recorded. Dual\u2010task costs (DTCs) were calculated for performance on the cognitive and gait tasks. Analysis of variance determined differences between groups. A performance\u2010resource operating characteristic (POC) graph was used to graphically display DTCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Gait performance was worse under dual\u2010task conditions for all groups. Gait was significantly slower under dual\u2010task conditions for the TTA\u2010vas (<jats:italic>P<\/jats:italic> &lt; .001), TTA\u2010nonvas (<jats:italic>P<\/jats:italic> &lt; .001), and NewPA groups (<jats:italic>P<\/jats:italic> &lt; .001). However, there was no between\u2010group difference for gait DTC. The 3 groups tested did not differ in the amount of cognitive DTC (DTCcog). Dual\u2010task conditions also had a negative impact on cognitive task performance for the TTA\u2010nonvas (<jats:italic>P<\/jats:italic> = .02) and NewPA groups (<jats:italic>P<\/jats:italic>\u2009&lt; .001). The TTA\u2010vas group had a slight improvement during dual\u2010task conditions and has a positive DTCcog as a result (<jats:italic>P<\/jats:italic>\u2009= .04). However, no between\u2010group differences were seen for DTCcog. The POC graph demonstrated that many individuals had a decrease in performance on both tasks; however, the gait task was prioritized for the majority (56.2%) of participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cognitive distractions while walking pose challenges to individuals regardless of etiology, level of amputation, or time with the prosthesis. These findings highlight that individuals are at risk for adverse events when performing multiple tasks while walking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>II<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2018.03.018","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T00:35:23Z","timestamp":1522974923000},"page":"1012-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Comparing the Effects of Dual\u2010Task Gait Testing in New and Established Ambulators With Lower Extremity Amputations"],"prefix":"10.1002","volume":"10","author":[{"given":"Courtney","family":"Frengopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.C.","family":"Payne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey 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