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Mobility - Brain-Culture Co-Construction
Mobility - Brain-Culture Co-Construction
Brain
Aging
Sensitivity of Perceptual System increasing i.e.busy streets become intolerable
Brain degeneration (myelination, white matter lesions) require us to invest more cognitive resources into previous "automatic" processes
Compensation - how do we redistribute resources over time
Prioritization of Tasks
Posture First (in healthy elderly) vs. Posture Second in PD
Attention
Executive Function
Cognitive Demand
Dual tasking
5 Determinants
Cognitive
Psychosocial
Physical
Environmental
Financial
Environment
The Design of our environment - what "things" load our attention, what parameters determines this
Urban Vs. Rural
Community Mobility (Patler): defined with respect to critical environmental factors (dimensions) that operationally define the complexity of mobility i space and time
Walking (moving in a complex context): Shumway-Cook
Somatosensory and Visual Factors while standing -Yogev-Seligman
Brain, Body, Environment Interaction
Webber's Conical Model
Life-Space: Room, Home, Outdoors, Neighbourhood ... World
Gender, culture and Biographical Influences
5 Determinants of Mobility
Considers all modes of moving around i.e. wheelchairs
Schumway-Cook
Env: visual and somatosensory changes
Brain: It takes more cognition on a less stable or with less salient stimuli
Body: postural control/stability/postural sway
View is very simplistic - does mention that varying sensory situations must be taken into consideration as in our natural environment, they are NEVER constant
Conclusion: the addition of a secondary auditory task significantly affected postural stability in all sensory conditions for fallers
No change in stability found in young healthy adults and healthy elderly only had significant changes in stability when all somatosensory and visual cues were removed
Yogev-Seligman
Expanding Brain and Env Interaction because when you walk your environment constantly changes
The Frontal Lobes (exec function) are highly susceptible to aging (changes in white matter)
Dual tasking - when you are less cognitively firm, the more likely a second task i.e. talking can cause problems performing the original task (walking)
Missing: the different factors or dimensions of the environment are not explore, the home vs. outdoor environment is not distinguished between, connection between factors etc. not accounted for
Studies show that even young adults and adults walk more slowly when asked to i.e. talk (those that did not, used very easy cognitive tasks)
Prioritization: posture first vs. posture second (PD)
Gait uses attention even in healthy adults and the dual task costs generally increase as gait becomes less automatic
Patler
Breaking down Executive Function - it isn't just one task that can be localized to i.e. the frontal lobe
Theme of Mobility Disability - the framework identifies the critical environment factors that operationally define mobility within a given community i.e. ambient conditions (mobility + environment determine disability)
Concept of Adaptation- mobility in a wide range of environments requires individuals to adapt how they sense and how they move
Missing: the home environment, the interaction between factors and the psychological, cognitive, financial side of things
Higher Forms of Mental processes
(Narrow) Localization
Grandmother Cell Theory
Functional System /Network Level Function: we must look at 2 things
Social Historical Origin (the environment)
Complex, hierachial Structure
Inter-Functional Organization
Link to Mobility
Mobility requires cognitive input/attention
Dual Tasking and /or cognitive training can help with gait when multi-tasking (walking and talking)
Performance on a cognitive task declines with age as someone walks (Posture first strategy)
Walking is no longer JUST viewed as an automatic task - as our brain degenerates naturally with age i.e. loss of myelenation or white matter lesions , walking requires more cognitive resources
Body
Walking
Standing
Our body placement in space over time
Life-Spaces: magnitude of travel into the environment