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The moderating roles of self-efficacy and depression in dual-task walking in multiple sclerosis: A test of self-awareness theory

Published online by Cambridge University Press:  25 April 2022

Charles Van Liew ,
Mark Gudesblatt ,
Thomas J. Covey ,
Jeffrey Wilken ,
Daniel Golan ,
Myassar Zarif ,
Barbara Bumstead ,
Marijean Buhse ,
Edward Ofori Open the ORCID record for Edward Ofori [Opens in a new window]  and
Daniel Peterson Open the ORCID record for Daniel Peterson [Opens in a new window]
Charles Van Liew
Affiliation:
College of Health Solutions, Arizona State University, Phoenix, USA
Mark Gudesblatt
Affiliation:
South Shore Neurologic Associates, Patchogue, NY 11772, USA
Thomas J. Covey
Affiliation:
Division of Cognitive and Behavioral Neurosciences, Department of Neurology, University at Buffalo, Buffalo, USA Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
Jeffrey Wilken
Affiliation:
Washington Neuropsychology Research Group, Fairfax, VA, USA Department of Neurology, Georgetown University, Washington, DC, USA
Daniel Golan
Affiliation:
Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
Myassar Zarif
Affiliation:
South Shore Neurologic Associates, Patchogue, NY 11772, USA
Barbara Bumstead
Affiliation:
South Shore Neurologic Associates, Patchogue, NY 11772, USA
Marijean Buhse
Affiliation:
South Shore Neurologic Associates, Patchogue, NY 11772, USA Stony Brook University, Stony Brook, NY, USA
Edward Ofori*
Affiliation:
College of Health Solutions, Arizona State University, Phoenix, USA
Daniel Peterson
Affiliation:
College of Health Solutions, Arizona State University, Phoenix, USA Phoenix Veterans Affairs Medical Center, Phoenix, AZ, USA
*
Corresponding author: Edward Ofori, email: edward.ofori@asu.edu
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Abstract

Objective:

Multiple sclerosis (MS) is a debilitating neurological disease associated with a variety of psychological, cognitive, and motoric symptoms. Walking is among the most important functions compromised by MS. Dual-task walking (DTW), an everyday activity in which people walk and engage in a concurrent, discrete task, has been assessed in MS, but little is known about how it relates to other MS symptoms. Self-awareness theory suggests that DTW may be a function of the interactions among psychological, cognitive, and motor processes.

Method:

Cognitive testing, self-report assessments for depression and falls self-efficacy (FSE), and walk evaluations [DTW and single-task walk (STW)] were assessed in seventy-three people with MS in a clinical care setting. Specifically, we assessed whether psychological factors (depression and FSE) that alter subjective evaluations regarding one’s abilities would moderate the relationships between physical and cognitive abilities and DTW performance.

Results:

DTW speed is related to diverse physical and cognitive predictors. In support of self-awareness theory, FSE moderated the relationship between STW and DTW speeds such that lower FSE attenuated the strength of the relationship between them. DTW costs – the change in speed normalized by STW speed – did not relate to cognitive and motor predictors. DTW costs did relate to depressive symptoms, and depressive symptoms moderated the effect of information processing on DTW costs.

Conclusions:

Findings indicate that an interplay of physical ability and psychological factors – like depression and FSE – may enhance understanding of walking performance under complex, real-world, DTW contexts.

Keywords

Multiple sclerosisDual-task walkingSelf-efficacyDepressionCognition
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 3 , March 2023 , pp. 274 - 282
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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