Effects of Dual Task Training with Visual Restriction and an Unstable Base on the Balance and Attention of Stroke Patients

Abstract

[Purpose] The purpose of this study was to examine the effects of the visual restriction and unstable base dual-task training (VUDT), the visual restriction dual-task training (VDT), and the unstable base dual-task training (UDT) on the balance and attention of chronic stroke patients. [Subjects and Methods] The subjects were 38 chronic stroke patients, who were divided into two groups of 13 patients each and one group of 12 patients. They were given dual-task training for 30 minutes per session, three times a week, for eight weeks. Their balance was measured using the center of pressure (COP) migration distances, functional reach test (FRT), and Berg balance scale (BBS), and attention was measured with the Trail Making Tests and the Stroop test. [Results] In comparisons within each group, all the three groups showed significant differences before and after the training (p<0.05), and in the comparisons among the three groups, the VUDT group showed more significant differences compared with the other two groups in all tests (p<0.05). [Conclusion] Dual-task training applied with visual restriction and an unstable base in which the subjects attempted to maintain their balance was effective in improving the balance and attention of stroke patients, and the VUDT was more effective than VDT or UDT.

Effects of dual tasks and dual-task training on postural stability: a systematic review and meta-analysis

“…Eight studies under this category analyzed the effects of dual-task training on postural stability, whereas four studies, in two different categories, were included in the meta-analysis 35,48,61,62. From the nonincluded studies, one study analyzed the effects of dual-task training on subacute stroke patients,34 two studies analyzed the effects on elderly participants,36,63 and one study on younger participants 64.…”

“…The review observed beneficial effects of dual-task training in studies analyzing patients affected from sub-acute34 and chronic stroke 48,62. The studies reported patients affected from stroke to possess considerable impairments in their cognitive–motor domain.…”

“…Because of this, altered weight distribution has been reported in stroke patients while maintaining static and dynamic postures 98. However, An et al48 and Kim et al62 performed a dual-task training regime (30-min session, three times a week for 8 weeks) and reported beneficial effects on postural stability even for conditions with visual restriction and/or unstable base when presented with dual tasks. These enhancements were also evident in the meta-analysis where enhancements in functional reach test (Hedge’s g : 0.32) and 95% CI (−0.22 to 0.86) cm were observed.…”

“…Second, two studies analyzing the effects of dual-task training on postural stability among patients affected from chronic stroke were included in the meta-analysis 48,62. The studies utilized a similar dual-task training duration phase of a 30-min session, three times a week for 8 weeks.…”

Fall experience and dual-task during gait performance for community-dwelling persons with stroke

“…Several researchers have reported the relationship between balance and dual-task performance in older adults or persons with neurological diseases [16][17][18][19]. McCulloch et al [19] studied to examine the relationship between postural stability, attention, and dual-task performance in those with acquired brain injury.…”