Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome.
Down syndrome teens’ balance crumbles when they talk and stand at the same time, so probe with verbal fluency to spot true fall risk.
01Research in Context
What this study did
Borji et al. (2023) watched adolescents with Down syndrome stand still on a force plate.
While standing, each teen named as many animals as possible for 30 seconds.
The team compared sway area and speed to same-age peers without disabilities.
What they found
The Down syndrome group wobbled far more when they had to talk and think at the same time.
Their postural sway doubled during the verbal task, while typical teens barely changed.
Verbal fluency, not just any mental load, was the hardest hit to balance.
How this fits with other research
Dudley et al. (2019) saw the opposite pattern: adding a hand task during sit-to-stand made kids with Down syndrome sway less, not more.
The difference is task type: manual jobs seem to trigger a stiffening strategy, but talking while standing does not.
Villarroya et al. (2012) already showed teens with Down syndrome have shaky static balance; Rihab proves the shakiness spikes when you stack a word game on top.
Perry et al. (2024) gives hope: adults with Down syndrome who dance have tighter sway, hinting that motor practice might blunt the dual-task drop seen here.
Why it matters
If you test balance in silence, you may miss real-life risk. Add a quick naming or counting task during your next standing assessment. A sudden sway jump flags clients who need dual-task balance drills, not just strength work.
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Join Free →During quiet standing baseline, ask the teen to name fruits for 15 seconds; note any big sway increase and log it as a dual-task balance goal.
02At a glance
03Original abstract
BACKGROUND: Individuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AIMS: This study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). METHODS AND PROCEDURES: Fifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. OUTCOMES AND RESULTS: In the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. CONCLUSION: Adolescents with DS are more prone to DT effects on postural balance than those with TD.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2023.104562