Effects of cognitive and motor tasks on the walking speed of individuals with chronic stroke

Abstract

Walking speed is a measure of gait performance after a stroke and a predictor of community ambulatory competence. Although gait decrements during a cognitive or motor task after stroke are well-documented, the differential effects of motor and cognitive tasks on the comfortable and maximum walking speeds of individuals with chronic stroke have not been investigated. This study aimed to compare the effects of cognitive and motor tasks on the comfortable and maximum walking speeds of individuals with chronic stroke.This is a cross-sectional study. Thirty community-dwelling chronic stroke individuals were included. Time taken to complete the 10-meter Walk Test under various conditions, including walking alone, walking while completing a cognitive task, and walking while completing a motor task, was recorded, with each condition performed at comfortable as well as maximum walking speeds. Accuracy in performing the cognitive tasks was also assessed.The cognitive and motor tasks caused decrements in both comfortable and maximum walking speeds (P ≤ 0.001). The cognitive task had a greater influence than the motor task on maximum walking speed (P < 0.01).Individuals with chronic stroke tend to prioritize task accuracy and completion over maintaining walking speed. This phenomenon was more evident during the cognitive task than the motor task and was especially evident at maximum walking speed.

Cognitive-Locomotor Dual-Task Interference in Stroke Survivors and the Influence of the Tasks: A Systematic Review

“…One hundred and eighteen (118) full texts were read, and 98 articles did not meet the inclusion criteria. Twenty articles were therefore included in this systematic review Figure 1; (20,(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Among these, 17 studies were considered for the first and second objectives, while 7 studies contributed to the third objective.…”

“…A diverse array of locomotor tasks was used in the selected studies including simple forward locomotion (25,28,31,(33)(34)(35)(36)(37)(38)40), walking with direction changes (24,26,27,29,30,32,38,41,42), and avoiding obstacles during walking (36,39). One study used a challenging locomotor task consisting of a 10-m walking test combining obstacles, tandem-walking paths, and stepping onto targets (20).…”

“…Participants were instructed to perform various cognitive tasks while walking. The most frequently used cognitive tasks were mental tracking tasks (20,24,25,27,30,31,(34)(35)(36)(37)(38)41), discrimination and decision-making tasks (26,31,39,40,42) and verbal fluency tasks (29,32,34,37,38,41). In terms of outcomes, accuracy was the most frequently reported variable to quantify cognitive performance in the aforementioned categories.…”

“…Seventeen studies (20,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(39)(40)(41)(42) out of 20 contributed to reach the first and second objectives of this systematic review, i.e., to examine cognitive-locomotor DTI magnitude and pattern while walking in people who sustained a stroke and explore the impact of the nature of the tasks on DTI ( Table 3). Three studies that were not considered (24,37,38) due to the absence of statistical comparison between single-and dual-task conditions.…”

Occupational Physical Activity in Young Adults and Stroke: Was It Due to My Job?

“…Interestingly, according to a cross-sectional study done in 2017, patients with chronic stroke showed that cognitive tasks had a more significant influence than the motor tasks when patients were assessed during the completion of the study requirement. In other words, patients with chronic stroke tend to prioritize task accuracy and completion over maintaining activity speed [ 20 ].…”