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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 May 12

DOI: 10.23736/S1973-9087.17.04598-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Effects of dual- and complex-task on walking ability of ambulatory individuals with spinal cord injury

Kitiyawadee SRISIM 1, 2, Thiwabhorn THAWEEWANNAKIJ 1, 2, Preeda ARRAYAWICHANON 2, 3, Pipatana AMATACHAYA 2, 4, Lugkana MATO 1, 2, Sugalya AMATACHAYA 1, 2

1 School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand; 2 Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand; 3 Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4 Department of Mechanical Engineering, Faculty of Engineering and Architecture, Rajamangala University of Technology Isan, Nakhon Ratchasima, Thailand


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BACKGROUND: Attempting to perform dual- and complex-tasks obviously reduces the walking ability of individuals with impaired cognitive functions. However, there is no clear evidence describing the effects of dual- and complex-tasks on the walking ability of ambulatory individuals with a spinal cord injury (SCI) who have intact cognitive functions, but suffer from various degrees of sensorimotor deterioration.
AIM: To primarily investigate the effects of dual- and complex-task on the walking ability of ambulatory subjects with SCI as compared to healthy individuals. In addition, the study secondarily compared the effects in subgroups of subjects with SCI, including different age groups, lesion severity and level of ability.
DESIGN: Cross-sectional design.
SETTING: A major tertiary referral and community hospitals in Thailand.
POPULATION: Thirty-seven ambulatory individuals with SCI and 13 healthy subjects.
METHODS: All subjects were evaluated for outcomes while they walked under four conditions, including single-task overground walking (ST-OG), dual-task overground walking (DT-OG) using a colour word Stroop task, single-task obstacle crossing (ST-OC) and dual-task obstacle crossing (DTOC). The outcomes were compared among the conditions and between the groups of subjects in terms of walking time, obstacle crossing ability and percent of Stroop task errors.
RESULTS: With the increasing complexity of the tasks, both SCI and healthy subjects walked significantly slower (p < 0.001 for those with SCI and p <0.05 for healthy subjects), but not when compared between the ST-OC and DT-OG conditions (p > 0.05). Subjects also showed a greater percentage of cognitive task errors when they encountered a dual- and complex-task, particularly those with SCI who were over 50 years old, had mild lesion severity or walked with a walking device (p < 0.001).
CONCLUSION: The incorporation of dual- and complex-task challenged cognitive-motor interference of ambulatory individuals with SCI.
CLINICAL REHABILITATION IMPACT: The application of such tasks may benefit rehabilitation outcomes in a real-world situation for patients, especially for those who are older than 50, have mild lesion severity or use a walking
device.


KEY WORDS: Cognition - Walking ability - Assistive device - Obstacle crossing - Rehabilitation

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Srisim K, Thaweewannakij T, Arrayawichanon P, Amatachaya P, Mato L, Amatachaya S. Effects of dual- and complex-task on walking ability of ambulatory individuals with spinal cord injury. Eur J Phys Rehabil Med 2017 May 12. DOI: 10.23736/S1973-9087.17.04598-1 

Corresponding author e-mail

samata@kku.ac.th