The influence of cognitive tasks on sensory organization test performance

We investigated the influence of dual-tasks on sensory integration for postural control and cognitive performance during the sensory organization test and examined the relationship between cognitive function and dual-task cost during the sensory organization test.

Methods:

Twenty adults completed single and dual-task versions of the six conditions of the sensory organization test were completed during two visits separated by one week. A subset of 13 participants completed three National Institute of Health (NIH)-toolbox cognitive tests including the Flanker inhibitory control and attention test, dimensional change card sort test and pattern comparison processing speed test. Wilcoxon signed rank tests were used to compare postural sway during single and dual-task sensory organization test. Friedman’s test, with pairwise comparison post-hoc tests, was used to compare single task serial subtraction performance to the 6 dual-task sensory organization test conditions. Spearman’s correlation coefficients were used to assess the relationship between cognitive performance on NIH-toolbox test and postural and cognitive dual-task cost during the sensory organization test.

Results:

Performing a cognitive dual-task during the sensory organization test resulted in a significant increase in postural sway during condition 1 (Z = −3.26, p = 0.001, ES = 0.73), condition 3 (Z = −2.53, p = 0.012, ES = 0.56), and condition 6 (Z = −2.02, p = 0.044, ES = 0.45). Subtraction performance significantly decreased in during condition 6 (Z = −2.479, p = 0.011, ES = 0.55) compared to single-task. The dimensional change card sort test demonstrated moderate correlations with dual-task cost of serial subtraction performance in condition 5 (dimensional change card sort test: r = −0.62, p = 0.02) and condition 6 (dimensional change card sort test: r= −0.56, p = 0.04). Pattern comparison processing speed test scores were significantly correlated with dual-task cost of postural control during condition 2.

Conclusion:

Performing a cognitive task during the sensory organization test resulted in significantly increased postural sway during three conditions, particularly during visual environment manipulation oppose to vestibular and somatosensory manipulation. Cognitive performance decreased during the most complex sensory organization test condition. Additionally, we found participants with poorer executive function had greater dual-task cost during more complex sensory integration demands.

Keywords
Sensory integration; Postural control; Dual task

Test	Cognitive domain(s) assessed	Description
Flanker Inhibitory Control and Attention Test (FICA)	Executive function; inhibitory control and attention	A central arrow facing left or right is surrounded by arrows on either side. The surrounding arrows are pointing the same or opposite direction as the central arrow. Individuals must identify the direction the central arrow is pointing as quickly as possible.
Dimensional Change Card Sort Test (DCCS)	Executive function; cognitive flexibility	Two different objects, different in shape and color, are presented side-by-side. A third object is presented in the center of the screen. Individuals must to match either the shape or color of the two objects to a third object as quickly as possible.
Pattern Comparison Processing Speed Test (PCPS)	Cognitive processing speed	This assessment requires individuals to indicate if two objects are the same or different as quickly as possible.

SOT condition	Single-task	Dual-task	p-value	Effect size
C1	92.7 (2.2)	89.8 (6.2)	0.001	0.73
C2	90.7 (4.2)	89.8 (8.2)	0.064	0.41
C3	91.3 (4.9)	88.3 (7.42)	0.012	0.56
C4	76.0 (13.3)	76.8 (17.8)	0.322	0.22
C5	63.0 (10.3)	64.2 (17.13)	0.467	0.16
C6	65.3 (15.5)	60.0 (21.7)	0.044	0.45
Somatosensory	98.5 (3.72)	100.0 (6.5)	0.407	0.19
Visual	82.0 (9.75)	83.0 (21.75)	0.602	0.12
Vestibular	67.5 (11.5)	74.0 (29)	0.421	0.18
Composite score	75.6 (11.2)	75 (14.0)	0.286	0.24

	Serial subtraction performance	p-value	Effect size
Single task	7.5 (5.75)
Dual-task SOT condition
C1	5.83 (5.00)	0.167	0.31
C2	5.67 (5.77)	0.126	0.34
C3	5.67 (6.17)	0.13	0.34
C4	6.00 (4.25)	0.083	0.38
C5	5.67 (4.83)	0.145	0.33
C6	5.33 (2.83)	0.013	0.55

SOT condition	Dimensional change card sort test	Flanker inhibitory control and attention test	Pattern comparison processing speed test	Composite NIHTB
C1	0.05	−0.01	−0.32	−0.10
C2	−0.14	−0.20	0.01	−0.15
C3	−0.03	−0.10	−0.13	0.01
C4	−0.30	−0.36	−0.51	−0.35
C5	−0.62^a a p <0.05.	−0.25	−0.40	−0.59^a a p <0.05.
C6	−0.56^a a p <0.05.	−0.50	−0.50	−0.66^a a p <0.05.

SOT condition	Dimensional change card sort test	Flanker inhibitory control and attention test	Pattern comparison processing speed test	Composite NIHTB
C1	0.04	0.43	0.08	0.10
C2	0.10	0.31	0.55^a	0.33
C3	0.22	0.16	0.31	0.28
C4	−0.46	−0.35	−0.04	−0.30
C5	−0.46	−0.25	−0.11	−0.37
C6	−0.13	−0.15	−0.08	−0.24

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail: nathan.morelli@uky.edu (N. Morelli).