Effects of dual task on turning ability in stroke survivors and older adults

Hollands, Kristen; Agnihotri, D.; Tyson, Sarah

doi:10.1016/j.gaitpost.2014.06.019

Cited by 37 publications

(44 citation statements)

References 28 publications

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“…This finding is also consistent with previous studies which highlight the importance of single support time in functional mobility and adaptations of gait in stroke survivors i.e. single support time has been related to turning ability [7] balance control [31] and is an important determinant of gait function post-stroke [32].…”

Section: Discussionsupporting

confidence: 92%

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A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

et al. 2016

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Background:Although there is evidence that stroke survivors have reduced gait adaptability, the underlying mechanisms and the relationship to functional recovery are largely unknown. We explored the relationships between walking adaptability and clinical measures of balance, motor recovery and functional ability in stroke survivors. Methods:Stroke survivors (n=42) stepped to targets, on a 6m walkway, placed to elicit step lengthening, shortening and narrowing. The number of targets missed during six walks (3 targeting with paretic limb and 3 with non-paretic) and target stepping speed was recorded. Fugl-Meyer scores (FM), Berg Balance Scale (BBS), self-selected walking speed (SWWS) and single support (SS) and step length (SL) symmetry (using GaitRite when not walking to targets) were also assessed. Stepwise multiple-linear regression was used to model the relationships between: total targets missed, number missed with paretic and non-paretic legs, target stepping speed, and each clinical measure. Results:Regression revealed a significant model for each outcome variable that included only one independent variable. Targets missed by the paretic limb, was a significant predictor of FM(F(1,40)=6.54, p=0.014,). Speed of target stepping was a significant predictor of each of BBS(F(1,40)=26.36, p<0.0001), SSWS(F(1,40)=37.00, p<0.0001) and SS asymmetry (F(1,38)=5.57, p=.006). No variables were significant predictors of SL asymmetry. Discussion: Speed of target stepping was significantly predictive of SS symmetry, BBS and SSWS and paretic targets missed predicted FM, suggesting that fast target stepping requires good balance and temporal symmetry of gait and accurate stepping demands good paretic leg function. The relationships between these parameters indicate gait adaptability is a clinically meaningful target for measurement and treatment of functionally adaptive walking ability in stroke survivors. Keywords: gait, adaptability, stroke, visionGait adaptability and functional mobility in stroke Background:

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Section: Discussionsupporting

confidence: 92%

“…[5,6]), turning (e.g. [7][8][9]) and in initiating and executing step adjustments (particularly to place the foot medially) in response to external cues [10,11]. However, the relationships between poor gait adaptability and functional recovery/mobility are still largely unknown.…”

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confidence: 99%

A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

et al. 2016

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“…Kinematic analysis indicates that turning is less stable than straight walking as it demands constant body reorientation [2–4]. The majority of the mobility-impaired population has difficulty in turning, especially patients with Parkinson’s disease and stroke and older adults [5, 6]. In view of the risks of falling, the stability of turning warrants analysis and investigation.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the COM-FCP inclination angle and other mediolateral stability indicators for turning

Wang

Yang

et al. 2017

BioMed Eng OnLine

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BackgroundStudies have shown that turning is associated with more instability than straight walking and instability increases with turning angles. However, the precise relationship of changes in stability with the curvature and step length of turning is not clear. The traditional center of mass (COM)-center of pressure (COP) inclination angle requires the use of force plates. A COM-foot contact point (FCP) inclination angle derived from kinematic data is proposed in this study as a measure of the stability of turning.MethodsIn order to generate different degrees of stability, we designed an experiment of walking with different curvatures and step lengths. Simultaneously, a novel method was proposed to calculate the COM-FCP inclination angles of different walking trajectories with different step lengths for 10 healthy subjects. The COM-FCP inclination angle, the COM acceleration, the step width and the COM-ankle inclination angles were statistically analyzed.ResultsThe statistical results showed that the mediolateral (ML) COM-FCP inclination angles increased significantly as the curvature of the walking trajectories or the step length in circular walking increased. Changes in the ML COM acceleration, the step width and the ML COM-ankle inclination angle verified the feasibility and reliability of the proposed method. Additionally, the ML COM-FCP inclination angle was more sensitive to the ML stability than the ML COM-ankle inclination angle.ConclusionsThe work suggests that it is more difficult to keep balance when walking in a circular trajectory with a larger curvature or in a larger step length. Essentially, turning with a larger angle in one step leads to a lower ML stability. A novel COM-FCP inclination angle was validated to indicate ML stability. This method can be applied to complicated walking tasks, where the force plate is not applicable, and it accounts for the variability of the base of support (BOS) compared to the COM-ankle inclination angle.

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“…Reduction in motor performance during walking, including decreased walking speed 1 , increased stride length and stride time 2 , increased double limb support duration 3 , and stop walking 4 is evident when patients are challenged by cognitive tasks during walking. The effect of cognitive task on gait performance is more pronounced during the more attention demanding task, as shown by decreased gait speed, decreased stride time before turning and increased time to turn 5 as well as decreased number of correct cognitive response 6 . Age 7 and education level 8 are the important factors for determining cognitive function.…”

Section: Introductionmentioning

confidence: 99%

Effect of cognitive task on components of 7 metertimed up-and-go test in persons with stroke

Chaikeeree¹,

Chinsongkram²,

Saengsirisuwan³

et al. 2018

ScienceAsia

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A problem dealing with dual task is commonly found in persons post-stroke but it is unclear whether age and educational levels influence this performance. The timed up-and-go test with cognitive task (TUG-dual) is recommended for assessing such problem but focusing only on total TUG time may mask the extent of cognitive tasks affecting each TUG component. This study investigates the effect of age and educational level on dual task performance during each component of TUG in patients with stroke. This cross-sectional study evaluated 25 patients with stroke and 25 healthy persons when performing 7 m TUG with and without counting backward by three. Total time to perform TUG, movement parameters, and rates of counting correct answers were measured. Four components of 7 m TUG (sit-to-stand, walk, turn, and turn-to-sit) were classified using portable accelerometers. The duration of TUG-dual increased in both groups but the amount of increase was larger in patients (p < 0.001). The rate of counting correct answer was affected by age (p = 0.004), but not educational levels (p = 0.267). In patients, the decreased rate of counting was found across all age ranges (35-54, 55-64, and 65-78 years), but in healthy persons, it was found only in the oldest age range. Cognitive tasks led to longer time during walk, turn, and turn to sit in patients. Changes in movement parameters including decreased peak angular velocity during turn and turn-to-sit, decreased stride length, stride velocity, and increased single leg stance time during walking suggested adaptation patterns in patients with stroke.

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Effects of dual task on turning ability in stroke survivors and older adults

Abstract: Abstract:Background: Turning is an integral component of independent mobility in which stroke

Cited by 37 publications

References 28 publications

A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

A novel and simple test of gait adaptability predicts gold standard measures of functional mobility in stroke survivors

Comparison of the COM-FCP inclination angle and other mediolateral stability indicators for turning

Effect of cognitive task on components of 7 metertimed up-and-go test in persons with stroke

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