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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)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2017 Sep 25

DOI: 10.23736/S1973-9087.17.04773-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Dual-task mobility among individuals with chronic stroke: changes in cognitive-motor interference patterns and relationship to difficulty level of mobility and cognitive tasks

Lei YANG 1, 2, 3, Freddy M. LAM 3, Meizhen HUANG 3, Chengqi HE 4, Marco Y. Pang 3

1 Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China; 2 Institute for Disaster Management and Reconstruction, Sichuan University, Hong Kong Polytechnic University, Sichuan, China; 3 Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China; 4 Department of Rehabilitation Medicine, West China Hospital, Chengdu, China


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BACKGROUND: Dual-task mobility performance is compromised after stroke.
AIM: This study evaluated how the difficulty level of mobility and cognitive tasks influenced the cognitive-motor interference pattern among individuals with chronic stroke and whether it differed from age-matched control participants.
DESIGN: A cross-sectional study.
SETTING: University laboratory.
POPULATION: Individuals with chronic stroke and age-matched controls.
METHODS: Sixty-one individuals with chronic stroke (mean age: 62.9±7.8 years) and 32 controls (mean age: 61.0±7.3 years) performed three mobility tasks (forward walking, obstacle-crossing, backward walking) and two cognitive tasks (serial-3-subtractions, serial-7-subtractions) in single-task and dual-task conditions. time to complete the mobility tasks and correct response rates were recorded.
RESULTS: Serial subtractions significantly increased the walking time compared to single-task walking (p<0.001) without decreasing the correct response rate (p>0.05) in both groups, indicating cognitive-related motor interference. As the difficulty of the walking task was increased (i.e., obstacle crossing), the dual-task effect on the walking time was similar to that observed during forward walking, but the correct response rate significantly decreased (p<0.05), indicating that more attentional resources were allocated to the mobility task. When the walking task difficulty level increased further (i.e., backward walking), an exaggerated increase in the walking time (p<0.001) was observed in both groups, but the stroke group also had a decreased correct response rate (p<0.001), indicative of a mutual interference pattern. The control group, however, maintained the correct response rate (p>0.05) despite the slowed walking speed in this condition (p<0.001).
CONCLUSIONS: The degree of dual-task interference and task prioritization strategies are highly specific to the combinations of the walking and cognitive tasks used and are affected by the presence of stroke.
CLINICAL REHABILITATION IMPACT: The study results may provide the basis for establishing assessment tools and creating intervention programs that address dual-task mobility function post-stroke.


KEY WORDS: Gait - Cognition - Cerebrovascular accident - Cognitive neuroscience

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Publication History

Article first published online: September 25, 2017
Manuscript accepted: September 22, 2017
Manuscript revised: August 31, 2017
Manuscript received: April 6, 2017

Per citare questo articolo

Yang L, Lam FM, Huang M, He C, Pang MY. Dual-task mobility among individuals with chronic stroke: changes in cognitive-motor interference patterns and relationship to difficulty level of mobility and cognitive tasks. Eur J Phys Rehabil Med 2017 Sep 25. DOI: 10.23736/S1973-9087.17.04773-6

Corresponding author e-mail

Marco.Pang@polyu.edu.hk