Degree and pattern of dual-task interference during walking vary with component tasks in people after stroke: a systematic review

Tsang, Charlotte Sau Lan; Shu-ting, Wang; Miller, Tiev; Pang, M.Y.C.

doi:10.1016/j.jphys.2021.12.009

Cited by 16 publications

(15 citation statements)

References 78 publications

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“…The demand for cognitive brain function resources of the subjects is not large, and it is not easy to occupy significant cognitive resources compared to the single walking task. However, the subjects in WCT with continuous subtraction by 7 needed more cognitive brain function resources, which is more challenging for MCI patients ( Tsang et al, 2022 ). Therefore, WCT is more likely to identify MCI patients than WMT.…”

Section: Discussionmentioning

confidence: 99%

Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Zheng

Lang

Liang

et al. 2022

Front. Aging Neurosci.

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BackgroundMild cognitive impairment (MCI) is considered a transitional stage between cognitive normality and dementia among the elderly, and its associated risk of developing Alzheimer’s disease (AD) is 10–15 times higher than that of the general population. MCI is an important threshold for the prevention and control of AD, and intervention in the MCI stage may be the most effective strategy to delay the occurrence of AD.Materials and methodsIn this study, 68 subjects who met the inclusion criteria were divided into an MCI group (38 subjects) and normal elderly (NE) group (30 subjects). Both groups underwent clinical function assessments (cognitive function, walking function, and activities of daily living) and dual-task three-dimensional gait analysis (walking motor task and walking calculation task). Spatial-temporal parameters were obtained and reduced by principal component analysis, and the key biomechanical indexes were selected. The dual-task cost (DTC) was calculated for intra-group (task factor) and inter-group (group factor) comparisons.ResultsThe results of the principal component analysis showed that the cadence parameter had the highest weight in all three walking tasks. In addition, there were significant differences in the cadence both walking motor task (WMT) vs. walking task (WT) and walking calculation task (WCT) vs. WT in the MCI group. The cadence in the NE group only showed a significant difference between WMT and WT. The only differences between the MCI group and NE group was DTC cadence in WCT, and no differences were found for cadence in any of the three walking tasks.ConclusionThe results show that dual tasks based on cognitive-motor gait analysis of DTCcadence in MCI have potential value for application in early identification and provide theoretical support to improve the clinical diagnosis of MCI.

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Section: Discussionmentioning

confidence: 99%

Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Zheng

Lang

Liang

et al. 2022

Front. Aging Neurosci.

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“…The development of effective methods for balance and mobility rehabilitation is a priority for stroke patients, their caregivers, and healthcare professionals [18]. Although GR is often effective for gait during rehabilitation sessions, the transfer of gait skills to daily living is more challenging; this discrepancy can be due to a change in attention, which is focused on gait during the training session but not on gait in everyday life [19][20][21]. These observations suggest that cognitive-motor interference (CMI) is a major contributor to activities of daily living after stroke [19][20][21].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT)

Tasseel‐Ponche

Roussel

Toba

et al. 2023

Trials

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Background Gait disorders and cognitive impairments are prime causes of disability and institutionalization after stroke. We hypothesized that relative to single-task gait rehabilitation (ST GR), cognitive-motor dual-task (DT) GR initiated at the subacute stage would be associated with greater improvements in ST and DT gait, balance, and cognitive performance, personal autonomy, disability, and quality of life in the short, medium and long terms after stroke. Methods This multicenter (n=12), two-arm, parallel-group, randomized (1:1), controlled clinical study is a superiority trial. With p<0.05, a power of 80%, and an expected loss to follow-up rate of 10%, the inclusion of 300 patients will be required to evidence a 0.1-m.s−1 gain in gait speed. Trial will include adult patients (18–90 years) in the subacute phase (0 to 6 months after a hemispheric stroke) and who are able to walk for 10 m (with or without a technical aid). Registered physiotherapists will deliver a standardized GR program (30 min three times a week, for 4 weeks). The GR program will comprise various DTs (phasic, executive function, praxis, memory, and spatial cognition tasks during gait) in the DT (experimental) group and gait exercises only in the ST (control) group. The primary outcome measure is gait speed 6 months after inclusion. The secondary outcomes are post-stroke impairments (National Institutes of Health Stroke Scale and the motor part of the Fugl-Meyer Assessment of the lower extremity), gait speed (10-m walking test), mobility and dynamic balance (timed up-and-go test), ST and DT cognitive function (the French adaptation of the harmonization standards neuropsychological battery, and eight cognitive-motor DTs), personal autonomy (functional independence measure), restrictions in participation (structured interview and the modified Rankin score), and health-related quality of life (on a visual analog scale). These variables will be assessed immediately after the end of the protocol (probing the short-term effect), 1 month thereafter (the medium-term effect), and 5 months thereafter (the long-term effect). Discussion The main study limitation is the open design. The trial will focus on a new GR program applicable at various stages after stroke and during neurological disease. Trial registration NCT03009773. Registered on January 4, 2017.

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“…As compared to processing one task alone, the performance of one or even both tasks can be degraded when processing two tasks at the same time. This common situation is called dual-task interference (DTI; Tsang et al, 2022 ). This is manifested in stroke patients by slowed gait speed and increased gait variability (Chatterjee et al, 2019 ; Hermand et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…The relevant reviews are mostly qualitative descriptions of the activation of brain regions and the type of tasks (Lim et al, 2021 ; Veldkamp et al, 2021 ). The quantitative analysis of the dual task was also about spatiotemopral gait parameters such as walking speed and walking distance, with few fNIRS metrics (Tsang et al, 2022 ). In addition to that, many studies are currently conducted on dual-task training (Pang et al, 2018 ; Iqbal et al, 2020 ; Collett et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Brain activation of the PFC during dual-task walking in stroke patients: A systematic review and meta-analysis of functional near-infrared spectroscopy studies

Wang

Dai²,

Xu³

et al. 2023

Front. Neurosci.

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BackgroundDual-task walking is a good paradigm to measure the walking ability of stroke patients in daily life. It allows for a better observation of brain activation under dual-task walking to assess the impact of the different tasks on the patient when combining with functional near-infrared spectroscopy (fNIRS). This review aims to summarize the cortical change of the prefrontal cortex (PFC) detected in single-task and dual-task walking in stroke patients.MethodsSix databases (Medline, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library) were systematically searched for relevant studies, from inception to August 2022. Studies that measured the brain activation of single-task and dual-task walking in stroke patients were included. The main outcome of the study was PFC activity measured using fNIRS. In addition, a subgroup analysis was also performed for study characteristics based on HbO to analyze the different effects of disease duration and the type of dual task.ResultsTen articles were included in the final review, and nine articles were included in the quantitative meta-analysis. The primary analysis showed more significant PFC activation in stroke patients performing dual-task walking than single-task walking (SMD = 0.340, P = 0.02, I2 = 7.853%, 95% CI = 0.054–0.626). The secondary analysis showed a significant difference in PFC activation when performing dual-task walking and single-task walking in chronic patients (SMD = 0.369, P = 0.038, I2 = 13.692%, 95% CI = 0.020–0.717), but not in subacute patients (SMD = 0.203, P = 0.419, I2 = 0%, 95% CI = −0.289–0.696). In addition, performing walking combining serial subtraction (SMD = 0.516, P < 0.001, I2 = 0%, 95% CI = 0.239–0.794), obstacle crossing (SMD = 0.564, P = 0.002, I2 = 0%, 95% CI = 0.205–0.903), or a verbal task (SMD = 0.654, P = 0.009, I2 = 0%, 95% CI = 0.164–1.137) had more PFC activation than single-task walking, while performing the n-back task did not show significant differentiation (SMD = 0.203, P = 0.419, I2 = 0%, 95% CI = −0.289–0.696).ConclusionsDifferent dual-task paradigms produce different levels of dual-task interference in stroke patients with different disease durations, and it is important to choose the matching dual-task type in relation to the walking ability and cognitive ability of the patient, in order to better improve the assessment and training effects.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022356699.

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Degree and pattern of dual-task interference during walking vary with component tasks in people after stroke: a systematic review

Cited by 16 publications

References 78 publications

Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Effects of motor-cognitive interaction based on dual-task gait analysis recognition in middle age to aging people with normal cognition and mild cognitive impairment

Dual-task versus single-task gait rehabilitation after stroke: the protocol of the cognitive-motor synergy multicenter, randomized, controlled superiority trial (SYNCOMOT)

Brain activation of the PFC during dual-task walking in stroke patients: A systematic review and meta-analysis of functional near-infrared spectroscopy studies

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