Effect of Dual-task Walking on Cognitive-motor Interference in Stroke Patients

doi:10.3969/j.issn.1673-5765.2021.03.003

Abstract

Abstract:

Objective To explore the effects of different cognitive tasks on gait and cognitive-motor interference (CMI) in ischemic stroke patients and healthy adults during dual-task walking (DTW). Methods 24 patients with acute ischemic stroke were selected as stroke group, and 16 healthy controls were matched for age and gender. They all received two cognitive tasks, including serial subtraction (SS) and word list generation (WLG) in sitting. Then, they received single-task walking (STW), serial subtraction in dual task walking (SS-DTW) and word list generation in dual task walking (WLG-DTW). The Codamotion 3D motion capture system was used to collect gait parameters, including gait speed, cadence, stride length and stride time. The number of correct response to cognitive tasks was recorded. The dual task cost of walking task and cognitive task in DTW between the two groups were compared. Results (1) In STW and both DTW, stroke group showed slower stride speed, shorter stride length, slower cadence and longer stride time than control group (P <0.05). Compared with STW, stroke group showed slower gait speed, slower cadence and longer stride time in different DTW, and shorter stride length in SS-DTW (P <0.05). The control group showed slower gait speed, slower cadence, shorter stride length and longer stride time in different DTW (P <0.05). (2) Compared with cognitive ST, the correct number of cognitive tasks in both DTW reduced in stroke group (P <0.05), while the correct number of cognitive tasks reduced in only SS-DTW in control group (P <0.05). Conclusions Gait performance reduced in performing dual task (DT) in stroke patients and healthy adults, and stroke patients were more prone to have gait disorders during DTW. Working memory tasks and semantic memory tasks had similar interference effect on gait. DTW can better reflect the ability of daily living activities. The exploration of CMI mode in DTW provides a theoretical basis for evaluating actual walking function and DT training effect.

Key words: Dual task; Ischemic stroke; Cognitive-motor interference; Gait; Cognition

摘要：

目的探讨缺血性卒中患者和健康人在进行双任务步行（dual-task wal ki ng，DTW）时，不同认知任务对步态和认知-运动干扰（cogni ti ve-motor interference，CMI）的影响。方法选取24例急性缺血性卒中患者为卒中组，并选取与卒中组性别、年龄、受教育程度相匹配的 16例健康志愿者为对照组。所有被试者依次完成坐姿下两项认知单任务（single-tas k，ST），包括连续减法任务（serial subtraction，SS）和单词生成任务（word list generation，WLG）。然后完成单任务步行（single-task walking，STW）、连续减法时双重任务步行（SS-DTW）和单词生成时双重任务步行（WLGDTW）。使用Codamotion三维动作捕捉系统采集步态参数，包括步速、步频、跨步长和跨步时间，记录认知任务正确反应数量。比较两组在DTW时步行和认知任务的双重任务成本差异。结果 ①在STW和两种DTW时，卒中组步速、跨步长和步频明显低于对照组，跨步时间长于对照组，差异有统计学意义（P <0.05）。与STW相比，卒中组在不同DTW时步速降低、步频减慢且跨步时间延长，在SS-DTW时跨步长变短，差异有统计学意义（P <0.05）；对照组在不同DTW时步速降低、步频减慢、跨步长变短和跨步时间延长，差异有统计学意义（P <0.05）。②与认知ST相比，卒中组在两种DTW中，认知任务正确次数均减少（P <0.05）；对照组仅在SS-DTW时，认知任务正确次数减少，差异有统计学意义（P <0.05）。结论执行双重任务（dual -task，DT）会导致缺血性卒中患者和健康者步态表现下降，卒中患者在 DTW时更易出现步态障碍。工作记忆任务和语义记忆任务对步态的干扰程度是相似的。DTW更能反映日常生活活动能力，关于DTW时CMI模式的探索可为评估实际步行功能和DT训练效果提供理论依据。

关键词: 双重任务; 缺血性卒中; 认知-运动干扰; 步态; 认知

ZHAO Yi-Shuang, ZHOU Ya-Nan,GONG Wei-Jun, ZHANG Yu-Mei. Effect of Dual-task Walking on Cognitive-motor Interference in Stroke Patients[J]. Chinese Journal of Stroke, 2021, 16(03): 230-235.

赵依双，周亚楠，公维军，张玉梅. 双任务步行对缺血性卒中患者认知－运动干扰的影响研究[J]. 中国卒中杂志, 2021, 16(03): 230-235.

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