Task Matters: Influence of Different Cognitive Tasks on Cognitive-Motor Interference During Dual-Task Walking in Chronic Stroke Survivors

Abstract

CMI pattern in chronic stroke survivors differs significantly with type of cognitive task. Gradual cognitive decline with chronicity of condition might have a role in altering the CMI pattern in this population. Future studies of DT interventions for stroke survivors might benefit from incorporating working memory tasks in their protocols.

Association between dual-task performance and balance during gait in community-dwelling elderly people after stroke

“…Studies have shown that the more complex the associated task, the greater the interference with the performance of the primary task [18], for example, talking while walking reduces gait speed [19].…”

Retraining Automaticity: Recovering the Procedural Memory of Walking after Stroke

“…Most typically, studies do operationalize the primary task as ambulation. The variables combined with walking have a broad range, and have included: 1) various types of secondary task distracter, or "modes" of distraction: cognitive, visual, auditory, or manual [42,43]; 2) different methodologies (testing each task as a single-task prior to combining) [43,[44][45][46][47]; 3) considerations of task complexity/novelty and reality (meaning how contrived or realitybased the task should or can be) [42,47], and 4) different forms of walking (direction, or speed) including backwards, self-selected, and maximal efforts [42,47]. In all, the most common investigations in dual task literature are dual task cost (DTC) or dual task effect (DTE), being the statistical reflection of change in performance in the primary task from single-task to dual task conditions.…”

“…In all, the most common investigations in dual task literature are dual task cost (DTC) or dual task effect (DTE), being the statistical reflection of change in performance in the primary task from single-task to dual task conditions. In many recent studies, scientists have measured cost for walking and the distracter, in an attempt to investigate the relative cognitive participation for each stimulus [42,[44][45][46][47]. Well-established tests that are intended to reflect DT capacity include versions of the Timed Up and Go test, specifically the cognitive and manual dual task versions (CTUG and TUG-m).…”

“…These distinct modalities include: cognitive, visual, auditory, and manual distractions [42,43]. Table 1 describes the four modalities and provides some examples of each in daily function.…”

“…In all, the best DT training takes into consideration the following: 5) Specificity. Exposure to one condition/environment of gait or modality of DT condition should not be expected to transfer to skill (tolerance) in another [42]. 6) Intensity.…”