Dataset Information

Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke.

ABSTRACT: BACKGROUND AND PURPOSE:Gait speed does not adequately predict whether stroke survivors will be active in the community. This may be because traditional single-task gait speed does not sufficiently reproduce the demands of walking in the real world. This study assessed whether dual-task gait speed accounts for variance in daily ambulatory activity above what can be predicted with habitual (single task) gait speed in community-dwelling stroke survivors. METHODS:Twenty-eight community-dwelling individuals, 58.2 years of age (SD=16.6), 8.9 months poststroke (interquartile range, 3.7-19.4), completed a gait and cognitive task in single- and dual-task conditions. Daily ambulatory activity was captured using a physical activity monitor. A regression analysis examined R2 changes with single- and dual-task gait speed. RESULTS:Single-task gait speed explained 15.3% of the variance in daily ambulatory activity (P=0.04). Adding dual-task gait speed to the regression model increased the variance explained by an additional 20.6% (P=0.04). CONCLUSIONS:Gait speed assessed under attention-demanding conditions may improve explanation of variance in daily ambulatory activity after stroke.

SUBMITTER: Feld JA

PROVIDER: S-EPMC6034633 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke.

Feld Jody A JA Zukowski Lisa A LA Howard Annie G AG Giuliani Carol A CA Altmann Lori J P LJP Najafi Bijan B Plummer Prudence P

Stroke 20180405 5

<h4>Background and purpose</h4>Gait speed does not adequately predict whether stroke survivors will be active in the community. This may be because traditional single-task gait speed does not sufficiently reproduce the demands of walking in the real world. This study assessed whether dual-task gait speed accounts for variance in daily ambulatory activity above what can be predicted with habitual (single task) gait speed in community-dwelling stroke survivors.<h4>Methods</h4>Twenty-eight communit ...[more]

PMID: 29622624

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Project description:In the process of walking, attentional resources are flexibly allocated to deal with varying environmental constraints correlated with attentional control (AC). A dual-task paradigm was used to investigate the effects of AC on gait and inter-joint coordination. Fifty students volunteered to participate in this study. Based on the reaction time (RT) in the Stroop task, the top 15 participants were assigned to the High Attentional Control (HAC) group, while the last 15 participants were assigned to the Low Attentional Control (LAC) group. The participants in the two groups were randomly asked to perform three tasks: (i) single 2-back working memory task (ST 2-back); (ii) single walking task (ST walking); and (iii) dual task (DT). Cognitive outcomes and gait spatiotemporal parameters were measured. Continuous relative phase (CRP), derived from phase angles of two adjacent joints, was used to assess inter-joint coordination. The LAC group exhibited significant task effects regarding RT, correct rate (CR), step width, gait cycle, step time, forefoot contact times, heel-forefoot times, hip-knee mean absolute relative phase (MARP), and deviation phase (DP) in the stance and swing phases (p < 0.05). In the HAC group, significant task effects were only detected in RT and foot progression angle of the left foot (p < 0.05). Under the three task conditions, the LAC group exhibited a higher CR in ST, longer heel contact times, and longer heel-forefoot times when compared with the LAC group (p < 0.05). Compared with the LAC group, the HAC group exhibited significantly smaller (closer to zero) MARP and weaker hip-knee DP values in the swing phase across all gait conditions (p < 0.05). In the stance phase, the HAC group had smaller MARP (closer to zero) values when compared with the LAC group (p < 0.05). In conclusion, the ability to maintain gait control and modulate inter-joint coordination patterns in young adults is affected by the level of attentional control in accommodating gait disturbances. AC is correlated with the performance of motor control, which theoretically supports the competitive selection of athletes and fall prevention strategies for a specific population.

Project description:BackgroundIndividuals with multiple sclerosis (MS) experience deficits in motor and cognitive domains, resulting in impairment in dual-task walking ability. The goal of this study was to compare performance of forward walking and backward walking in single- and dual-task conditions in persons with MS to age- and sex-matched healthy controls. We also examined relationships between forward and backward walking to cognitive function, balance, and retrospective fall reports.MethodsAll measures were collected in a single session. A 2 × 2 × 2 mixed model ANOVA was used to compare differences in forward and backward walking in single- and dual-task conditions between MS and healthy controls. Spearman correlations were used to examine relationships between gait and cognitive function, falls, and balance.ResultsEighteen individuals with relapsing-remitting MS and 14 age- and sex-matched healthy controls participated. Backward walking velocity revealed significant differences between groups for both single-task (p = 0.015) and dual-task (p = 0.014) conditions. Persons with MS demonstrated significant differences between single- and dual-task forward and backward walking velocities (p = 0.023; p = 0.004), whereas this difference was only apparent in the backward walking condition for healthy controls (p = 0.004). In persons with MS, there were significant differences in double support time between single- and dual-task conditions in both backward (p < 0.001) and forward (p = 0.001) directions. More falls at six months were significantly associated with shorter backward dual-task stride length (r = -0.490; p = 0.046) and slower velocity (r = -0.483; p = 0.050).ConclusionDifferences in MS and age- and sex-matched healthy controls are more pronounced during backward compared to forward walking under single- and dual-task conditions. Future work with a larger sample size is needed to validate the clinical utility of backward walking and dual-task assessments and mitigate the limited sensitivity of the current dual-task assessments that primarily rely upon forward walking.

Dataset Information

Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke.

Publications

Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke.

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