Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial.
Objective: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. Design: A secondary analysis of a trial of dual-task (DT) and sing...
| Publicado en: | Clinical Rehabilitation Vol. 35; no. 11; pp. 1599 - 1611 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Sage Publications Inc.
Nov2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153101650&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153101650 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02692155 31B jtl: Clinical Rehabilitation issn: 02692155 maglogo: Y pubinfo: dt: Nov2021 vid: 35 iid: 11 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 153101650 150586380 153101650 153101650 10.1177/02692155211017360 153101650 ppf: 1599 ppct: 12 formats: tig: atl: Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial. aug: au: Collett, Johnny Fleming, Melanie K Meester, Daan Al-Yahya, Emad Wade, Derick T Dennis, Andrea Salvan, Piergiorgio Meaney, Andrew Cockburn, Janet Dawes, Joanna Johansen-Berg, Heidi Dawes, Helen affil: Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK sug: subj: Walking Walking Speed Evaluation Task Performance and Analysis Stroke Patients Executive Function Resource Allocation Gait Human Randomized Controlled Trials Secondary Analysis Single-Blind Studies Comparative Studies Treadmills Exercise Test United Kingdom Adolescence Adult Middle Age Aged Aged, 80 and Over Magnetic Resonance Imaging T-Tests Mann-Whitney U Test Data Analysis Software Pearson's Correlation Coefficient Chi Square Test Odds Ratio Confidence Intervals Barthel Index Funding Source Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over ab: Objective: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. Design: A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s−1, n = 21) and limited (walking speed <0.79 m s−1, n = 24) capacity at baseline. Setting: Community. Subjects: Adults six-months post stroke with walking impairment. Interventions: Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. Main measures: A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. f NIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an f MRI sub-study used ankle-dorsiflexion to simulate walking. Results: ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). f NIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). f MRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. Conclusion: In individual who walk slowly it may be difficult to improve dual-task walking ability. Registration: ISRCTN50586966 pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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