• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.121-129
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• 2017

PURPOSE: This study was conducted to determine the effect of dual-task training (based on the International Classification of Functioning, Disability, and Health; ICF) on walking ability and self-efficacy in individuals with chronic stroke. METHODS: 22 chronic stroke patients participated in this study. Participants were randomly allocated into either the single-task group (n=11) or the dual-task group (n=11). Both groups had physical training three a week for 4 weeks, and at a three-week follow-up. Outcome measures included the 10m walking test (10MWT), figure of 8 walk test (F8WT), dynamic gait index (DGI), and Self-efficacy scale. All data were analyzed using SPSS 18.0 for Windows. Between-group and within-group comparison were analyzed by using the Mann-Whitney U test and Wilcoxon singed-rank test respectively. RESULTS: In the dual-task group, the 10MWT, time and steps of F8WT, DGI, and self-efficacy showed significant differences between pre- and post-test (p<.05). The Changes between the pre- and post-test values of 10MWT (p<.05), DGI (p<.05), and self-efficacy scale (p<.05) showed significant differences between the dual-task group and single-task group. CONCLUSION: Participants reported improved walking ability and self-efficacy, suggesting that dual-task training holds promise in the rehabilitation of walking in chronic stroke patients. This study showed that ICF-based on a dual-task protocol contiributes to motor learning after chronic stroke.

• Journal of Convergence for Information Technology
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• v.10 no.6
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• pp.217-227
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• 2020

This study investigated the effects of dual task training on balance, upper extremity motor function and activities of daily living in patients with chronic stroke. The study subjects were 14 chronic stroke patients. dual task training groups(n=7), and single task training groups(n=7). The intervention period was conducted for 3 times a week, 30 minutes per session, and 4 weeks for all groups. To measure the BT4, JTT, K-MBI were used before and after the intervention. Dual task training groups showed a significant increase in BT 4 and JTT scores(p<.05). The difference between the two groups was significant in the BT4 and JJT scores(p<.05). There was a score improvement in K-MBI, but there was no statistically significant difference(p>.05) Dual task training was effective in facilitating balance, upper extremity function and activities of daily living in patients with chronic stroke.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.571-578
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• 2022

Objective: Cognitive-motor trainings had a positive impact on cognitive function and dual-task trainings led to improvements of global cognitive function. The brain activity of the prefrontal cortex (PFC) is another indicator that can infer cognitive function. This study aims to confirm the usability of the interactive system cognitive-motor training program and the changes in the prefrontal cortex through training. Design: Cross-sectional study Methods: In this study, two cognitive tasks were randomly applied to 20 adults as cognitive-motor training using an interactive system, and the same task was performed using the original method. During all tasks, the brain activity of the prefrontal cortex was measured by the change in oxyhemoglobin (HbO) in real-time using Functional Near-Infrastructure. After performing the tasks, the usability of the developed interactive system was evaluated by a usability questionnaire which consists of five items, and each item consists of a 7-point Likert scale that responds from 1 point to 7 points. Results: The HbO levels were increased during cognitive task performance than at the resting phase. And evaluating the usefulness of the interactive system, a questionnaire result showed that it would be useful for cognitive-motor programs. Conclusions: The cognitive-motor training using the interactive system increased the activity of the prefrontal cortex, and the developed wearable sensor-based interactive system confirmed its usefulness.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.7-25
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• 2020

Objective : The purpose of this study was to analyze the effects of dual-task training on stroke patients. Methods : We searched the databases such as NDSL, RISS, PubMed, CoChrane and EMBASE for publications in the past decade. Finally, 10 papers were selected. Qualitative assessment was performed according to the traditional single-layer evidence model, and meta-analysis was performed using the Comprehensive Meta Analysis 3.0 program. Results : The quality level of each of the 10 selected papers all correspond to I and II in the traditional single-layer evidence model. The motor tasks that constitute dual-task training comprised walking or balancing tasks in 7 articles and the motor tasks related to upper extremity were selected in 3 studies. The effect sizes for ADL function and Cognitive function were 0.65 and 0.64 (medium size effect) respectively. Moreover, the effect sizes of Lower extremity and Upper extremity motor function were 0.34 and 0.22 (small size effect) respectively. The effect size of ADL function and Cognitive function were statistically significant p<0.05). Conclusion : This study confirmed that dual-ask training can be a useful intervention technique for recovering a stroke patient's ability to perform daily activities and cognitive functions. This could be used as a helpful data when selecting appropriate intervention for stroke patients in the clinical setting.

• Therapeutic Science for Rehabilitation
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• v.5 no.1
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• pp.23-32
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• 2016

Objective : To investigate the current international researches which identify the effect of stroke with hemiplegia after dual-task training Methods : We systematically examined journals published from 2007 to 2015, searching PubMed. Total 5 researches were selected for the analyses. Results : Selected studies were all in international journal and they used two group experimental design. In addition, all the paper got PEDro scores above 6. They conducted gait task for motor task, at the same time used various domain of cognitive task such as from sustain attention to working memory. The outcome measure tools used for evaluation by the standardized assessment tool and operational definition, further also included the assessment tool designed for the dual-task training such as a variety of tools make possible to assess various aspects of effect. Discussion : Dual-task training in this study was found to give a positive effect on the dual-task performance, as well as improving the motor and cognitive function in patients with stroke. However there were also limitation to the studies conducted so far. In order to apply the occupational therapy, this results can consider as the preliminary data which suggest supplement point and can be a evidence for effective treatment for stroke with hemiplegia.

• PNF and Movement
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• v.10 no.1
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• pp.25-33
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• 2012

Purpose : The purpose of this study was to compare the effect of treadmill training and cognitive task with in the course of treadmill training at the same time with chronic stroke patients. Methods : Fourteen chronic stroke patients participated. Participants were randomly assigned to the control and experimental group(7 experimental, 7 control). All of participants were in-patients at local hospital and had been receiving a traditional rehabilitation program, five days a week. The both groups have undergone 4weeks. The experimental group trained in treadmill and cognitive task at the same time, but control group trained only treadmill. 10m walking test, Timed Up & Go (TUG) test and 6 Minutes walking(6M walking) test to measure the walking speed, dynamic balance and waling endurance ability were carried out before and after the training. Results : The result of the study were as follow:10m walking test were significantly increased both groups(p<.01), but not significant between groups(p>.05). TUG test were significantly increased both groups(p<.001) and between groups(p<.01). 6M walking test were significantly increased both groups(p<.001), but not significant between groups(p>.05). Conclusion : Ahead of return to the community to patients with stroke, cognitive task with in the course of treadmill training at the same time was effective in improving the dynamic balance ability.

• PNF and Movement
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• v.7 no.4
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• pp.31-36
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• 2009

Many daily activities require people to complete a motor task while walking. Substantial gait decrements during simultaneous attention to a variety of cognitive tasks have been shown by a group of severely injured neurological patients of mixed etiology. And previous studies have shown that the attentional load of a walking-associated task increased with its level of difficulty. The purpose of this study was to analyze subjects' gait changes are affected by the effects of arithmetic task difficulty and performance level. Participants performed a walking task alone, three different Arithmetic tasks while seated, and among them, two kinds of the simillar Arithmetic tasks in combination with walking. Reaction time and accuracy were recorded for two of the Arithmetic tasks. The mean values of the gait were measured using a Timed Up and Go test among 11 with post-stroke patients while walking with and without forward counting (WFC) and backward counting(WBC).There was significant Arithmetic Task Difficulty level between the 10-forward counting task condition(FC) and the 10-backward counting task condition(BC)(p=0.008). The mean values of T.U.G time were significantly higher under backward counting dual-task condition than during a simple walking task(p=0.009) and WFC(p=0.009). The change in T.U.G time during WFC was higher when compared with the change during a simple walking, but there was no significant difference (p=0.246). This study suggesting that a high interference could be linked with a high level of difficulty, whereas adaptive task enabled participants to perfectly share their attention between two concurrent tasks. Future research should determine whether dual task training can reduce gait decrements in dual task situations in people after stroke. And the dual-task-based exercise program is feasible and beneficial for improving walking ability in subjects with stroke.

• Physical Therapy Korea
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• v.21 no.4
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• pp.34-39
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• 2014

The purpose of this study was to examine the effect of three cognitive tasks on gait at a preferred walking speed, and at a fast speed, using dual-task methodology. A total of 29 stroke patients participated in the study. All 29 subjects performed 2 motor tasks (10-meter walk task and timed up and go task each at a preferred and a fast speed) and three cognitive tasks [Stroop, word list generation (WLG), serial subtraction (SS)] under dual-task conditions [cognitive-motor interference (CMI)] in a randomized order. Gait speeds were measured in six different conditions. A repeated-measure analysis of variance was employed to compare the results of the Stroop training, WLG, and SS tasks during preferred and fast walking. A Bonferroni adjustment use for post hoc analysis. The level of statistical significance was set at ${\alpha}=.05$. A CMI effect occurred for performance of a 10-meter walking task at two different speed and a cognitive task (p<.05). Stroop had a significantly greater effect than SS and WLG (p<.05). The timed up and go task was affected when performed with fast walking speed during Stroop cognitive task (p<.05), but was not affected if performed with preferred walking speed during a cognitive task (p>.05). This study showed that CMI of Stroop can be used as a rehabilitation program for stroke patients.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.05a
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• pp.394-395
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• 2022

Exergames are playing an important role in healthcare/rehabilitation. It has also been used to improve motivation among patients with reduced cognition. The purpose of this pilot study was to evaluate the feasibility of using augmented reality (AR) with game-based cognitive-motor training programs for executive function, restricted and repetitive behaviors (RRBs) in children with autism spectrum disorder. Sixteen children aged 6 -16 years were randomly allocated to the experimental group and control group. Outcome measures were performed before and after the intervention and included executive function, restricted and repetitive behavior. A satisfactory survey was conducted post-intervention. A statistically significant improvement was observed in working memory and cognitive flexibility in the experimental group (P<0.05). However, despite no statistical improvements in cognitive inhibition and four subscales of RRBs, promising changes were observed in all the subscales of the executive function and the behavioral outcomes. Parents appreciated the program and children enjoyed the interaction with the AR game-based training. The findings of this preliminary feasibility study showed that AR using Kinect v2 motion with a cognitive-motor game content can be used for children with autism. However, there is a need for conducting a large-scale study to evaluate his effectiveness on executive function and restricted and repetitive behaviors.

• The Journal of Korean Physical Therapy
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• v.14 no.3
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• pp.433-449
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• 2002

노인에 있어 낙상 (falls)의 결과는 신체 기능상의 상실을 가져 올 뿐 아니 라 종종 사망에 이르게 하는 원인이 되기도 하여 중대한 건강상의 문제로 다루어지고 있다. 정상적인 노화과정은 감각(sensory)과 운동 (motor)계의 감퇴 그리고 주의력의 쇠퇴와 연관되어 있는데, 노인들은 이러한 감각(sensory)과 운동(motor)계 (system)의 손상으로 여러 가지 자세(posture)와 보행 (walking)등을 수행하는데 어려움을 겪는다. 또한 노화와 관련된 변화들은 자세를 조절 (postural control) 하는데 있어서 주의력 (attention capacity)을 감소시킨다. 이러한 조건 하에서 노인들은 이중과업 (dual task)을 수행하는데 젊은 사랑들보다도 더 많은 어려움을 느끼며 이는 곧바로 낙상 (falls)의 가능성을 증가시키는 중요한 원인이 되고 있다. 이러한 점들을 고려할 때 낙상(falls)을 방지하기 위한 훈련 프로그램 (training program)은 단순한 신체운동(physical exercise) 보다는 자세조절 (postural control)시의 인지시스템 (cognitive system)이 포함된 중추 통합 기전(central integrative mechanisms)을 최적화 (optimize) 시킬 수 있는 방향으로 구성되어야 한다.