Comparable walking gait performance during executive and non-executive cognitive dual-tasks in chronic stroke: A pilot study |
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| Institution: | 1. Maynooth University, Maynooth, Co Kildare, Ireland;2. Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA;3. Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA;4. Insight Center for Data Analytics, University College Dublin, Dublin, Ireland;5. Tallaght University Hospital, Dublin, Ireland;1. Department of Biological Sciences, Vanderbilt University, Nashville, TN 37202, United States;2. Department of Biological Sciences, East Tennessee State University, Johnson City, TN 37604, United States;3. D.C., Johnson City Chiropractic Clinic, 206 Princeton Road, Johnson City, TN 37614, United States;1. Department of Motion Science, Institute of Sport Science, Friedrich-Schiller-University Jena, Jena, Thuringia, Germany;2. Department for the Psychology of Human Movement and Sport, Institute of Sport Science, Friedrich-Schiller-University Jena, Thuringia, Germany;3. Department of Neurology/Department of Orthopedic Surgery, Bayreuth Hospital, Bayreuth, Bavaria, Germany;1. Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;2. Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;3. University of Arizona, College of Medicine, Tucson, AZ, USA;1. Univ Lyon, IFSTTAR, TS2, LESCOT, F-69675, 25 Avenue François Mitterrand, 69500, Bron, France;2. U1179End:icap UVSQ INSERM CHU Raymond Poincaré APHP, 104 Boulevard Raymond Poincaré, 92380, Garches, France;3. ENS Cachan, 61 Avenue du Président Wilson, 94230, France;1. Children’s Hospital of Philadelphia, Philadelphia, PA, USA;2. University of Michigan School of Public Health, MI, USA;3. University of Pennsylvania, Philadelphia, PA, USA;4. Diagnostic Driving, Inc., Philadelphia, PA, USA;5. Computer Science Department, Drexel University, Philadelphia, PA, USA |
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| Abstract: | BackgroundFalls are a serious problem among stroke survivors due to subsequent injuries, recovery setbacks, dependence, and mortality. A growing body of dual-task (DT) studies suggests a role of executive functions in gait control and falls, particularly in subacute stroke. However, few studies have compared distinct executive and non-executive tasks, nor their effects on chronic stroke gait. Research question: The purpose of this cross-sectional study was to compare the effects of distinct working memory (2-back) and inhibition (Stroop) tasks on walking gait performance in chronic stroke survivors.MethodsA pilot sample of chronic stroke survivors (n = 11, 8 males, mean age = 70.91, 6-12months post-stroke event) and age-matched healthy controls (n = 13, 4 male; mean age = 68.46) were tested. Gait performance (speed, stride time, stride time variability, stride length and stride length variability) was measured using 2 wireless inertial measurement sensors under 4 walking conditions: 1) preferred walking (single-task: ST), 2) walking with a 2-back DT, 3) walking with a Stroop DT, and 4) walking with a non-executive motor response DT. The secondary tasks were also carried out in both ST (seated) and DT conditions, to examine bidirectional effects.ResultsWhile the stroke survivor sample had a slower gait speed across conditions and tasks, there were no significant differences between the groups F(1, 22) = 1.13, p =.299, η2p = .049] on the spatial or temporal gait characteristics recorded: gait performance was maintained during executive and non-executive DTs. In addition, we did not find a significant effect of group on cognitive task performance (all p > .052). However, we observed a cost in accuracy on the 2-back DT for both groups, suggesting resource overlap and greater cognitive load (all t > 19.72, all p < .001).SignificanceOur gait data contradict previous studies evidencing impaired gait post-stroke, suggesting functional recovery in this chronic stroke sample. |
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| Keywords: | Gait Stroke Dual-task Executive function Older adults |
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