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| Title: | Dual-task exercise reduces cognitive-motor interference in walking and falls after stroke : a randomized controlled study | Authors: | Pang, MYC Yang, L Ouyang, H Lam, FMH Huang, M Jehu, DA |
Issue Date: | Dec-2018 | Source: | Stroke, Dec. 2018, v. 49, no. 12, p. 2990-2998 | Abstract: | Background and Purpose-Functional community ambulation requires the ability to perform mobility and cognitive task simultaneously (dual-tasking). This single-blinded randomized controlled study aimed to examine the effects of dual-task exercise in chronic stroke patients. Methods-Eighty-four chronic stroke patients (24 women; age, 61.2±6.4 years; time since stroke onset, 75.3±64.9 months) with mild to moderate motor impairment (Chedoke-McMaster leg motor score: median, 5; interquartile range, 4-6) were randomly allocated to the dual-task balance/mobility training group, single-task balance/mobility group, or upperlimb exercise (control) group. Each group exercised for three 60-minute sessions per week for 8 weeks. The dual-task interference effect was measured for the time to completion of 3 mobility tests (forward walking, timed-up-and-go, and obstacle crossing) and for the correct response rate during serial-3-subtractions and verbal fluency task. Secondary outcomes included the Activities-specific Balance Confidence Scale, Frenchay Activities Index, and Stroke-specific Quality of Life Scale. The above outcomes were measured at baseline, immediately after, and 8 weeks after training. Fall incidence was recorded for a 6-month period posttraining. Results-Only the dual-task group exhibited reduced dual-task interference in walking time posttraining (forward walking combined with verbal fluency [9.5%, P=0.014], forward walking with serial-3-subtractions [9.6%, P=0.035], and the timed-up-and-go with verbal fluency [16.8%, P=0.001]). The improvements in dual-task walking were largely maintained at the 8-week follow-up. The dual-task cognitive performance showed no significant changes. The dual-task program reduced the risk of falls and injurious falls by 25.0% (95% CI, 3.1%-46.9%; P=0.037) and 22.2% (95% CI, 4.0%-38.4%; P=0.023), respectively, during the 6-month follow-up period compared with controls. There was no significant effect on other secondary outcomes (P>0.05). Conclusions-The dual-task program was effective in improving dual-task mobility, reducing falls and fall-related injuries in ambulatory chronic stroke patients with intact cognition. It had no significant effect on activity participation or quality of life. |
Keywords: | Cognition Exercise Patients Stroke Walking |
Publisher: | Lippincott Williams & Wilkins | Journal: | Stroke | ISSN: | 0039-2499 | EISSN: | 1524-4628 | DOI: | 10.1161/STROKEAHA.118.022157 | Rights: | © 2018 American Heart Association, Inc. This is the accepted version of the publication Pang, M. Y. C., Yang, L., Ouyang, H., Lam, F. M. H., Huang, M., & Jehu, D. A. (2018). Dual-task exercise reduces cognitive-motor interference in walking and falls after stroke: a randomized controlled study. Stroke, 49(12), 2990-2998. |
| Appears in Collections: | Journal/Magazine Article |
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| a0590-n36_Leon_DT_RCT_v60.pdf | Pre-Published version | 732.72 kB | Adobe PDF | View/Open |
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