Effects of Attentional Loadings on Gait Performance Before Turning in Stroke Survivors

• Published in: PM and R
• Main Author: Manaf H.; Justine M.; Goh H.-T.
• Format: Article
• Language: English
• Published: Elsevier Inc. 2015
• Online Access: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84947863034&doi=10.1016%2fj.pmrj.2015.05.007&partnerID=40&md5=a4ec82df0fefde8fe3bf084d492a7508

Background: Attentional loadings have significant impacts on turning performance in individuals with stroke. Improper gait modification before turning may contribute to falls after stroke. Therefore, examination of the changes in temporal-spatial gait parameters before turning may reveal important deficits in gait control when stroke survivors are challenged by dual-tasking. Objective: To compare the effects of 3 attentional loading conditions on spatial-temporal gait parameters before turning between stroke survivors and healthy control subjects. Design: Case-control study design. Setting: University motion analysis laboratory. Participants: Ten chronic stroke survivors (mean age = 49 ± 9 years) and 10 healthy control subjects (mean age = 53 ± 5 years) were included. Methods: Spatial-temporal gait parameters were obtained by the use of a motion-capture system while participants performed the Timed-Up and Go (TUG) test under 3 attentional loading conditions: single, dual-motor, and dual-cognitive task conditions. A repeated-measure analysis of variance was used to analyze the data. Main outcome measures: We measured gait speed, stride length, and stride time during the straight walking phase (one gait cycle before turn) of the TUG test. Results: We found that attentional loadings had a differential effect on gait speed measured for both groups (P = 001). The dual-motor and dual-cognitive task conditions led to a slower gait speed compared with the single-task condition in stroke survivors (both P = 02). However, in the TUG scores of healthy control subjects, only the dual-cognitive condition led to a significantly reduced gait speed compared with the single task condition (P = 001) and dual motor condition (P = 01). Conclusion: The results demonstrated that attentional loadings resulted in a greater deterioration of gait performance before turning in stroke survivors compared with healthy control subjects. Particularly, temporal gait parameter was more vulnerable to dual-task interference than the spatial gait parameter. © 2015 American Academy of Physical Medicine and Rehabilitation.