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Postural control among children with and without attention deficit hyperactivity disorder in single and dual conditions

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Abstract

Given the known deficits in attention in attention deficit hyperactivity disorder (ADHD) and the evidence suggesting that postural control requires attention, this study aimed to investigate the mechanisms of postural control of children with and without ADHD in single-(ST) and dual-task (DT) conditions. Postural sway and stabilogram diffusion analysis (SDA) were performed on the Center of Pressure trajectories on 24 ADHD children and 17 age–gender-matched healthy controls. The subjects were instructed to stand as stable as possible on a force platform in two task conditions: (1) single task (ST) and (2) dual task (DT)—an auditory-memory attention-demanding cognitive task. During ST and DT conditions, the ADHD children showed significantly greater ML-sway, short- and long-term effective diffusion coefficients, and critical displacement of SDA compared with controls. The effects of DT were somewhat unexpected; the control group indicated a significant decrease in ML-sway, AP-sway, sway area, and critical displacement of SDA; the ADHD group showed a significant decrease in ML-sway range and critical displacement. It is concluded that a greater sway displacement before closed-loop mechanisms is called into play in ADHD children. The DT enhanced balance control by reinforcing balance automaticity and minimizing sway in both healthy and ADHD children.

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References

  1. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). American Psychiatric Association, Washington, DC

    Google Scholar 

  2. Anand V, Buckley JG, Scally A et al (2003) Postural stability in the elderly during sensory perturbations and dual tasking: the influence of refractive blur. Invest Ophthalmol Vis Sci 44(7):2885–2891

    Article  PubMed  Google Scholar 

  3. Bradley JD, Golden CJ (2001) Biological contributions to the presentation and understanding of attention-deficit/ hyperactivity disorder: a review. Clin Psychol Rev 21:907–929

    Article  PubMed  CAS  Google Scholar 

  4. Cheng J, Wang YF (2007) Comparison of postural control between normal and attention deficit hyperactivity disorder boys. Beijing Da Xue Xue Bao 39:531–534, Abstract in Chinese

    PubMed  Google Scholar 

  5. Christiansen A (2000) Persisting motor control problems in 11- to 12-year-old boys previously diagnosed with deficits in attention, motor control and perception (DAMP). Dev Med Child Neurol 42:4–7

    Article  PubMed  CAS  Google Scholar 

  6. Collins JJ, De Luca CJ (1993) Open-loop and closed-loop control of posture: a random walk analysis of center-of-pressure trajectories. Exp Brain Res 95:308–318

    Article  PubMed  CAS  Google Scholar 

  7. Collins JJ, De Luca CJ, Burrows A et al (1995) Age-related-changes in open-loop and closed-loop postural control mechanisms. Exp Brain Res 104:480–492

    Article  PubMed  CAS  Google Scholar 

  8. Conners CK, Sitarenios G, Parker JD et al (1998) The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol 26:257–268

    Article  PubMed  CAS  Google Scholar 

  9. Feng L, Wang YF, Cao QJ (2007) A pilot study on effect of methylphenidate on balance function of children with attention deficit hyperactivity disorder. Beijing Da Xue Xue Bao 39:304–309, Abstract in Chinese

    PubMed  Google Scholar 

  10. Huxhold O, Li S-C, Schmiedek F et al (2006) Dual tasking postural control: aging and the effects of cognitive demand in conjunction with focus of attention. Brain Res Bull 69:294–305

    Article  PubMed  Google Scholar 

  11. Jacobi-Polishook T, Shorer Z, Melzer I (2009) The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder—a double blind randomized control trial. J Neurol Sci 280(1–2):15–21

    Article  PubMed  CAS  Google Scholar 

  12. Jucaite A, Fernell E, Forssberg H et al (2003) Deficient coordination of associated postural adjustments during a lifting task in children with neurodevelopmental disorders. Dev Med Child Neurol 45:731–742

    Article  PubMed  Google Scholar 

  13. Kadesjö B, Gillberg C (1998) Attention deficit and clumsiness in Swedish 7-year-olds. Dev Med Child Neurol 40:796–804

    Article  PubMed  Google Scholar 

  14. Kadesjö B, Gillberg C (1999) Developmental coordination disorder in Swedish 7-year-old children. J Am Acad Child Ps 38:820–828

    Article  Google Scholar 

  15. Lajoie Y, Teasdale N, Bard C et al (1993) Attentional demands for static and dynamic equilibrium. Exp Brain Res 97:139–144

    Article  PubMed  CAS  Google Scholar 

  16. Landgren M, Kjellman B, Gillberg C (2000) Deficits in attention, motor control and perception (DAMP): a simplified school entry examination. Acta Paediatr 89(3):302–309

    Article  PubMed  CAS  Google Scholar 

  17. Landgren M, Pettersson R, Kjellman B et al (1996) ADHD, DAMP and other neurodevelopmental/psychiatric disorders in 6-year-old children: epidemiology and comorbidity. Dev Med Child Neurol 38:891–906

    Article  PubMed  CAS  Google Scholar 

  18. Leitner Y, Barak R, Giladi N et al (2007) Gait in attention deficit hyperactivity disorder: effects of methylphenidate and dual tasking. J Neurol 254:1330–1338

    Article  PubMed  Google Scholar 

  19. Levy F (1991) The dopamine theory of attention deficit hyperactivity disorder (ADHD). Aust NZ J Psychiat 25:277–283

    Article  CAS  Google Scholar 

  20. Melzer I, Benjuya N, Kaplanski J (2001) Age-related changes of postural control: effect of cognitive tasks. Gerontology 47:189–194

    Article  PubMed  CAS  Google Scholar 

  21. Mulas F, Mattos L, de la Osa-Langreo A et al (2007) Attention deficit hyperactivity disorder: in favour of the organic origin. Rev Neurol 44(3):S47–S49, Review. [Spanish]

    PubMed  Google Scholar 

  22. Neumann O (1984) Automatic processing: a review of recent findings and a plea for an old theory. In: Prinz W, Sanders AF (eds) Cognition and motor processes. Springer, Berlin, pp 255–293

    Chapter  Google Scholar 

  23. Pellecchia GL (2003) Postural sway increases with attentional demands of concurrent cognitive task. Gait Posture 18:29–34

    Article  PubMed  Google Scholar 

  24. Piek JP, Pitcher TM, Hay DA (1999) Motor coordination and kinaesthesis in boys with attention deficit-hyperactivity disorder. Dev Med Child Neurol 41:159–165

    Article  PubMed  CAS  Google Scholar 

  25. Rankin JK, Woollacott MH, Shumway-Cook A et al (2000) Cognitive influence on postural stability: a neuromuscular analysis in young and older adults. J Gerontol A Biol Sci Med Sci 55(3):M112–M119

    Article  PubMed  CAS  Google Scholar 

  26. Rasmussen P, Gillberg C (2000) Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Psy 39:1424–1431

    Article  CAS  Google Scholar 

  27. Riley MA, Baker AA, Schmit JM (2003) Inverse relation between postural variability and difficulty of a concurrent short-term memory task. Brain Res Bull 62(3):191–195

    Article  PubMed  Google Scholar 

  28. Schaefer S, Krampe RT, Lindenberger U et al (2008) Age differences between children and young adults in the dynamics of dual-task prioritization: body (balance) versus mind (memory). Dev Psychol 44(3):747–757

    Article  PubMed  Google Scholar 

  29. Scherder EJ, Rommelse NN, Bröring T et al (2008) Somatosensory functioning and experienced pain in ADHD-families: a pilot study. Eur J Paediatr Neurol 12(6):461–469, Epub 2008 Feb 8

    Article  PubMed  Google Scholar 

  30. Schmid M, Conforto S, Lopez L et al (2007) Cognitive load affects postural control in children. Exp Brain Res 179:375–385

    Article  PubMed  Google Scholar 

  31. Schoemaker MM, Ketelaars CE, van Zonneveld M, Minderaa RB, Mulder T (2005) Deficits in motor control processes involved in production of graphic movements of children with attention-deficit-hyperactivity disorder. Dev Med Child Neurol 47:390–395

    Article  PubMed  Google Scholar 

  32. Sergeant JA, Piek JP, Oosterlaan J (2006) ADHD and DCD: a relationship in need of research. Hum Mov Sci 25:76–89

    Article  PubMed  Google Scholar 

  33. Shumway-Cook A, Woollacott M, Baldwin M et al (1997) The effects of cognitive demands on postural sway in elderly fallers and non fallers. J Gerontol 52:M232–M240

    CAS  Google Scholar 

  34. Shumway-Cook A, Woollacott M, Kerns KA et al (1997) The effect of two types of cognitive tasks on postural stability in older adults with and without a history of falls. J Gerontol 52A:232–240

    Google Scholar 

  35. Silk T, Vance A, Rinehart N et al (2005) Fronto-parietal activation in attention-deficit hyperactivity disorder, combined type: functional magnetic resonance imaging study. Brit J Psychiat 187:282–283

    Article  PubMed  CAS  Google Scholar 

  36. Swan L, Otani H, Loubert P et al (2004) Improving balance by performing a secondary cognitive task. Brit J Psychol 95:31–40

    Article  PubMed  Google Scholar 

  37. Taketomo CK (2005) Pediatric dosage handbook with international index, 12th edn. Lexi-Comp, Inc, Hudson, OH

    Google Scholar 

  38. Teicher MH, Ito Y, Glod CA et al (1996) Objective measurement of hyperactivity and attentional problems in ADHD. J Am Acad Child Psy 35:334–342

    Article  CAS  Google Scholar 

  39. Tervo RC, Azuma S, Fogas B et al (2002) Children with ADHD and motor dysfunction compared with children with ADHD only. Dev Med Child Neurol 44:383–390

    Article  PubMed  Google Scholar 

  40. Whitmont S, Clark C (1996) Kinaesthetic acuity and fine motor skills in children with attention deficit hyperactivity disorder: a preliminary report. Dev Med Child Neurol 38:1091–1098

    Article  PubMed  CAS  Google Scholar 

  41. Wickens CD (1989) Attention and skilled performance. In: Holding DH (ed) Human skills. J Wiley & Sons, New York, pp 71–105

    Google Scholar 

  42. Woollacott M, Shumway-Cook A (2002) Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 16:1–14

    Article  PubMed  Google Scholar 

  43. Wulf G, McNevin N, Shea CH (2001) The automaticity of complex motor skill learning as a function of attentional focus. Q J Exp Psychol A 54:1143–1154

    Article  PubMed  CAS  Google Scholar 

  44. Yardley L, Gardner M, Leadbetter A et al (1999) Effect of articulatory and mental tasks on postural control. Neuroreport 10:215–219

    Article  PubMed  CAS  Google Scholar 

  45. Zametkin AJ, Liotta W (1998) The neurobiology of attention-deficit/hyperactivity disorder. J Clin Psychiat 59(Suppl 7):17–2

    Google Scholar 

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Conflict of interest

The authors declare that they have no competing interests and no financial relationship with the organization that sponsored the research.

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Authors and Affiliations

  1. Pediatric Neurology Unit, Soroka Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Zamir Shorer & Talia Jacobi-Polishook

  2. Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences Ben-Gurion University of the Negev, P.O.B. 653, Beer-Sheva, Israel

    Boaz Becker, Talia Jacobi-Polishook & Itshak Melzer

  3. Sister Kenny Rehabilitation Institute, Sister Kenny Research Center, Minneapolis, MN, USA

    Lars Oddsson

Authors
  1. Zamir Shorer
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  2. Boaz Becker
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  3. Talia Jacobi-Polishook
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  4. Lars Oddsson
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  5. Itshak Melzer
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Correspondence to Itshak Melzer.

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Shorer, Z., Becker, B., Jacobi-Polishook, T. et al. Postural control among children with and without attention deficit hyperactivity disorder in single and dual conditions. Eur J Pediatr 171, 1087–1094 (2012). https://doi.org/10.1007/s00431-012-1695-7

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  • DOI: https://doi.org/10.1007/s00431-012-1695-7

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