Influence of Different Arm Movement Strategies on Subjective Task-Related Perceptions and Walking Outcomes Under Single- and Dual-Task Conditions in Healthy Children Compared to Young Adults

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Abstract
Background/Objectives: Emerging evidence shows that dual tasking as well as the restriction of arm movements independently lead to detrimental effects on walking performance. However, it is unclear whether the deteriorations are more pronounced when applied together and if children (i.e., due to ongoing maturation processes) perform differently compared to young adults. This study investigated the influence of different arm movement strategies on subjective and objective markers related to beam walking under single-task (ST) and dual-task (DT) conditions in children and young adults. Methods: Twenty-six children (age: 11.3 ± 0.6 years) and 30 young adults (age: 23.2 ± 2.8 years) walked three meters on a balance beam with free and restricted (i.e., arms crossed over the chest) arm movements in a random order while concurrently performing a cognitive task (i.e., serial subtractions) or not. Walking outcomes (i.e., gait speed, cadence) were measured and used as objective markers. Self-reported task-related perceptions (i.e., balance confidence, fear of falling, perceived instability, conscious balance processing) were assessed and used as subjective indicators. Results: Walking under DT conditions (i.e., main effects of task) detrimentally influenced subjective task-related perceptions and walking outcomes, but using free arm movements (i.e., task × arm interactions) mitigated these deteriorations. Further, children exhibited largely stable levels of conscious balance processing, whereas young adults demonstrated overall higher levels along with pronounced differences between ST and DT walking when arm movements were unrestricted (i.e., group × task × arm interaction). Conclusions: These findings indicate that free arm movements seem to constitute a simple yet effective complementary ‘upper-body strategy’ that enhances postural control during a cognitively demanding walking task. Further, age differences imply that young adults compensate demanding walking conditions (i.e., DT walking with restricted arms) by elevated conscious processing of balance (i.e., a shift from automated to more conscious attention towards postural control).

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