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The Effects of Dual-Task Gait Training on Gait Performance under Cognitive Tasks in Chronic Stroke  

Yu, Kyung-hoon (Department of Physical Therapy, Division of Health Science, Baekseok University)
Jeon, Hye-seon (Department of Physical Therapy, College of Health Science, Yonsei University)
Publication Information
The Journal of Korean Physical Therapy / v.27, no.5, 2015 , pp. 364-368 More about this Journal
Abstract
Purpose: Walking in the dual-task condition is a critical skill for hemiplegic patients to live in real-life situations. The purpose of this study was to compare the effect of dual-task gait training and general gait training on gait parameters and cognitive function in patients with chronic stroke during dual-task walking. Methods: The study included 23 patients with chronic hemiparetic stroke who were randomly divided into experimental (dual-task gait training) and control (general walking training) groups. The 11 subjects in the experimental group and nine subjects in the control group received dual-task gait training (walking while handling a ball, crossing obstacles, picking up various objects, and problem solving simple cognitive tasks and general over-ground gait training, respectively, for 30 minutes per day 5 days per week for 4 weeks. Spatiotemporal parameters and cognitive tasks in the dual-task gait condition were measured. Statistical analysis of the changes between the pre- and post-intervention measurement variables was performed using ANCOVA. Results: In the gait condition under cognitive tasks, the changes pre- and post-intervention in gait velocity, stride length, double support limb, and step symmetry were significantly greater in the dual-task gait training group; however, the dual-task gait training group showed no significant improvement compared to the general gait training group in terms of the assessment of cognitive tasks. Conclusion: The findings suggest that dual-task gait training may be beneficial for walking ability in dual-task walking condition.
Keywords
Dual task; Gait; Training; Cognition; Stroke;
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Times Cited By KSCI : 8  (Citation Analysis)
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1 Mercier L, Audet T, Hebert R et al. Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke. Stroke. 2001;32:2602-8.   DOI
2 Ryan A, Dobrovolny CL, Silver KH et al. Cardiovascular fitness after stroke: Role of muscle mass and gait deficit severity. J Stroke Cardiovasc Dis. 2000;9:185-91.   DOI
3 Dettmann MA, Linder MT, Sepic SB. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med. 1987;66:77-90.
4 Weerdesteyn V, de Niet M, van Duijnhoven HJ et al. Falls in individuals with stroke. J Rehabil Res Dev. 2008;45:1195-214.   DOI
5 Nielsen JB. How we walk: Central control of muscle activity during human walking, Neuroscientist. 2003;9:195-204.   DOI
6 Mulder T, Zijlstra W, Geurts A. Assessment of motor recovery and decline. Gait Posture. 2002;16(2):198-210.   DOI
7 Yogev-Seligmann G, Hausdorff JM, Giladi N. The role of executive function and attention in gait. Mov Disord. 2008;23(3):329-42.   DOI
8 Hyndman D, Ashburn A, Yardley L et al. Interference between balance, gait and cognitive task performance among people with stroke living in the community. Disabil Rehabil. 2006;28:849-56.   DOI
9 Plummer-D'Amato P, Altmann LJ, Saracino D et al. Interactions between cognitive tasks and gait after stroke: a dual task study. Gait Posture. 2008;27(4):683-8.   DOI
10 Siu KC, Chou LS, Mayr U et al. Does inability to allocate attention contribute to balance constraints during gait in older adults? J Gerontol A Biol Sci Med Sci. 2008;63:1364-9.   DOI
11 Bowen A, Wenman R, Mickelborough J et al. Dual-task effects of talking while walking on velocity and balance following a stroke. Age Ageing. 2001;30:319-23.   DOI
12 Dault MC, Geurts ACH, Mulder TW et al. Postural control and cognitive task performance in healthy participants while balancing on different support-surface configurations. Gait Posture. 2001;14:248-55.   DOI
13 MacAulay RK. Allaire TD, Brouillette RM et al. Longitudinal assessment of neuropsychological and temporal/spatial gait characteristics of elderly fallers: Taking it all in stride. Front Aging Neurosci. 2015;7(34):1-8.
14 van de Port IG, Kwakkel G, van Wijk I et al. Susceptibility to deterioration of mobility long-term after stroke: A prospective cohort study. Stroke. 2006;37(1):167-71.   DOI
15 Choi JH, Park SH. The effect of dual-task training on a serial reaction time task for motor learning. J Kor Phys Ther. 2012;24(6):405-8.   DOI
16 Hwang S, Jeon HS, Yi CH et al. Locomotor imagery training improves gait performance in people with chronic hemiparetic stroke: A controlled clinical trial. Clin Rehabil. 2010;24(6):514-22.   DOI
17 Kim SH, Choi JD. The effect of gait training of progressive increasing in body weight support and gait speed on stroke patients. J Kor Phys Ther. 2013;5(5):252-9.
18 Lim CG. The Effects of proprioceptive neuromuscular facilitation (PNF) Pattern Exercise Using the Sprinter and the Skater on Balance and Gait Function in the Stroke Patients. J Kor Phys Ther.2014;26(4):249-56.
19 Hong SI, Bang DH, Shin WS. Effects of side walking training with elastic-band on gait and balance of stroke patients. J Kor Phys Ther. 2014;6(5):372-8.
20 Cho MK., Kim JH., Chung Y et al. Treadmill gait training combined with functional electrical stimulation on hip abductor and ankle dorsiflexor muscles for chronic hemiparesis. Gait and Posture. 2015;42(1):73-8.   DOI
21 Park SK, Park SH. The effect of water-based exercise on physiological cost index and balance in stroke patients. J Kor Phys Ther. 2014;6(6):411-7.
22 Llorens R, Gil-Gomez JA., Alcaniz M et al. Improvement in balance using a virtual reality-based stepping exercise: A randomized controlled trial involving individuals with chronic stroke. Clinical Rehabilitation. 2015;29(3):261-8.   DOI
23 Yang YR, Wang RY, Chen YC et al. Dual-task exercise improves walking ability in chronic stroke: A randomized controlled trial. Arch Phys Med Rehabil. 2007;88:1236-40.   DOI
24 Kim GY, Han MR, Lee HG. Effect of Dual-task Rehabilitative Training on Cognitive and Motor Function of Stroke Patients. J Phys Ther Sci. 2014;26(1):1-6.   DOI
25 Kim HA, Lee HM, Seo KC. The Effects of Dual-Motor Task Training on the Gait Ability of Chronic Stroke Patients J Phys Ther Sci. 2013;25:317-20.   DOI
26 Folstein M, Folstein SE, McHugh PR. "Mini-Mental State" a Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research. 1975;12(3):189-98.   DOI
27 Damian MF, Vigliocco G, Levelt WJ. Effects of semantic context in the naming of pictures and words. Cognition. 2001;81(3):77-86.   DOI
28 Menz HB, Latt MD, Tiedemann A et al. Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2004;20(1):20-5.   DOI
29 Stokic DS, Horn TS, Ramshur JM et al. Agreement between temporospatial gait parameters of an electronic walkway and a motion capture system in healthy and chronic stroke populations. Am J Phys Med Rehabil. 2009;88(6):437-44.   DOI
30 Patterson KK, Parafianowicz I, Danells CJ et al. Gait asymmetry in community-ambulating stroke survivors. Arch Phys Med Rehabil. 2008;89:304-10.   DOI
31 van de Port IG, Wevers L, Roelse H et al. Cost-effectiveness of a structured progressive task-oriented circuit class training programme to enhance walking competency after stroke: The protocol of the FIT-Stroke trial. BMC Neurol. 2009;13:9-43.
32 Choi W, Lee G, Lee S. Effect of the cognitive-motor dual-task using auditory cue on balance of surviviors with chronic stroke: A pilot study. Clin Rehabil. 2014;13:1-8.
33 Sim SM, Oh DW. Effect of Dual-task Training With Cognitive Motor Task on Walking and Balance Functions in Patients With Chronic Stroke: Randomized Controlled Pilot Study. Phys Ther Korea. 2015;22(2):11-20.   DOI
34 Plummer-D'Amato P, Altmann LJ, Behrman AL et al. Interference between cognition, double-limb support, and swing during gait in community-dwelling individuals poststroke. Neurorehabil Neural Repair. 2010;24(6):542-9.   DOI
35 Pellecchia GL. Dual-task training reduces impact of cognitive task on postural sway. J Mot Behav. 2005;37(3):239-46.   DOI
36 Kim JH. Relationship between gait symmetry and functional balance, walking performance in subjects with stroke. J Kor Phys Ther. 2014;26(1):1-8.   DOI
37 McEwen SE, Huijbregts MP, Ryan JD et al. Cognitive strategy use to enhance motor skill acquisition post-stroke: a critical review. Brain Inj. 2009;23(4):263-77.   DOI
38 Jung SR, Won JI. Effects of Dual-Task Training on Balance and Gait Performance in Patients With Stroke. Phys Ther Korea. 2014;21(2):18-27.   DOI
39 Plummer P, Villalobos RM, Vayda MS et al. Feasibility of dual-task gait training for community-dwelling adults after stroke: a case series. Stroke research and treatment. 2014;9:1-12.
40 Pashler H. Dual-task interference in simple tasks: Data and theory. Psychol Bull. 1994;116(2):220-44.   DOI