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Title: Association of subsequent falls with evidence of dual-task interference while walking in community-dwelling individuals after stroke
Authors: Tsang, CSL 
Pang, MYC 
Issue Date: 1-Jul-2020
Source: Clinical rehabilitation, 1 July 2020, v. 34, no. 7, p. 971-980
Abstract: Objective: The aim of this study was to examine the fall predictive value of single-task walking tests and extent of interference observed in dual-task walking tests in ambulatory individuals post stroke.
Design: This is an observational study with prospective cohort.
Setting: The study was conducted at the university laboratory.
Participants: A total of 91 community-dwelling individuals with chronic stroke participated in the study.
Main outcome measures: Time required to complete a 10-m walk test with and without obstacle negotiation was measured in isolation and in conjunction with performance of a verbal fluency task (category naming). Fall incidence, circumstances, and related injuries were recorded by monthly telephone calls for 12 months.
Results: A total of 91 individuals (mean (SD) age = 62.7 (8.3) years; mean (SD) post-stroke duration = 8.8 (5.3) years) participated in the study; 29 (32%) of them reported at least one fall during the follow-up period, with a total of 71 fall episodes. There was a significant difference in obstacle-crossing time under single-task (mean difference = 8.3 seconds) and dual-task (mean difference = 7.4 seconds) conditions, and also the degree of interference in mobility performance (increased dual-task obstacle-crossing time relative to the single-task obstacle-crossing time; mean difference = 3.3%) between the fallers and the non-fallers (P < 0.05). After adjusting for the effects of other relevant factors, a greater degree of interference in mobility performance remained significantly associated with a decreased risk of falling (adjusted odds ratio = 0.951, 95% CI = 0.907–0.997, P = 0.037).
Conclusion: The degree of mobility interference during dual-task obstacle-crossing was the most effective in predicting falls among all the single-task and dual-task walking measure parameters tested. This simple dual-task walking assessment has potential clinical utility in identifying people post stroke at high risk of future falls.
Keywords: Cognition
Dual-task interference
Publisher: SAGE Publications
Journal: Clinical rehabilitation 
ISSN: 0269-2155
EISSN: 1477-0873
DOI: 10.1177/0269215520923700
Rights: This is the accepted version of the publication Tsang, Charlotte Sau Lan, and Marco Yiu Chung Pang. “Association of Subsequent1 Falls with Evidence of Dual-Task Interference While Walking in Community-Dwelling Individuals after Stroke.” Clinical Rehabilitation, vol. 34, no. 7, July 2020, pp. 971–980. Copyright © 2020 (The Author(s)). DOI: 10.1177/0269215520923700
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