Dual-Tasking in Daily Activities Among Adults With and Without Stroke.

Importance: In laboratory settings, dual-tasking is a performance strategy affected by dominance and stroke. However, the volitional use of dual-tasking has not been examined during naturalistic performance of activities of daily living (ADLs). Objective: To examine dual-tasking in the context of AD...

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Publicado en:American Journal of Occupational Therapy Vol. 77; no. 1; pp. 1 - 9
Autores principales: Fokas, Emily E., Parnandi, Avinash R., Venkatesan, Anita, Pandit, Natasha G., Wirtanen, Audre A., Nilsen, Dawn M., Schambra, Heidi M.
Formato: pictorial research tables/charts Journal Article
Publicado: American Occupational Therapy Association Jan/Feb2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan/Feb2023
      vid: 77
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      pub: American Occupational Therapy Association
      place: North Bethesda, Maryland
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        10.5014/ajot.2023.050063
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        atl: Dual-Tasking in Daily Activities Among Adults With and Without Stroke.
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        au:
          Fokas, Emily E.
          Parnandi, Avinash R.
          Venkatesan, Anita
          Pandit, Natasha G.
          Wirtanen, Audre A.
          Nilsen, Dawn M.
          Schambra, Heidi M.
        affil: Emily E. Fokas, BA, is Clinical Research Coordinator, Department of Neurology, Grossman School of Medicine, NYU Langone Health, New York, NY
      sug:
        subj:
          Stroke Complications
          Activities of Daily Living In Adulthood
          Multitasking Behavior In Adulthood
          Task Performance and Analysis In Adulthood
          Human
          Cross Sectional Studies
          Nonexperimental Studies
          Descriptive Statistics
          Data Analysis Software
          Academic Medical Centers
          Stroke Patients In Adulthood
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Chi Square Test
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Importance: In laboratory settings, dual-tasking is a performance strategy affected by dominance and stroke. However, the volitional use of dual-tasking has not been examined during naturalistic performance of activities of daily living (ADLs). Objective: To examine dual-tasking in the context of ADLs and identify whether dominance and stroke influence its use. Design: Cross-sectional, observational. Setting: Academic medical center. Participants: Forty-three participants with chronic stroke and upper extremity (UE) motor impairment and 19 control participants without stroke. Outcomes and Measures: We identified dual-tasking as the performance of dual-object primitives (DOPs), a functional strategy to manage two objects simultaneously. We videotaped participants performing feeding and toothbrushing tasks and identified the initiation and frequency of DOPs. We assessed whether these outcomes were influenced by UE dominance or paresis and whether among participants with stroke these outcomes were influenced by motor impairment (using the Fugl-Meyer Assessment) or cognitive impairment (using the Montreal Cognitive Assessment). Results: DOP initiation was reduced on the nondominant side of control UEs and in the paretic UE of participants with stroke. After DOPs were initiated, however, their frequency was not significantly related to dominance or paresis. Among participants with stroke, DOP initiation but not DOP frequency was influenced by motor impairment, and neither were influenced by cognitive impairment. Conclusions and Relevance: The initiation of dual-tasking is curtailed in the nondominant and paretic UEs, extending previous laboratory-based findings to a more naturalistic setting. These results may reflect a demand on neural resources that is exceeded when these limbs are used. What This Article Adds: DOPs, a functional strategy to simultaneously engage two objects during ADLs, could serve as a behavioral marker of dual-tasking in real-world activities, supporting their investigation more broadly. Practicing DOPs in rehabilitation could also train the integration of dual-tasking strategies in activity execution. The results of this study demonstrate that the initiation of dual-tasking is curtailed in the nondominant and paretic upper extremities in the context of the performance of activities of daily living (ADLs) among adults with and without stroke, which may reflect a demand on neural resources that is exceeded when these limbs are used.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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