Kinetic Approach in Overcoming Dual-Task Interference for Functional Proficiency, Societal Participation, and Community Re-Integration After Stroke (Preprint)

Abstract

BACKGROUND Background and Objectives: Engaging in daily activities often requires simultaneously performing multiple tasks, as the execution of only one task at a time is infrequent. The capability to handle two tasks concurrently allows individuals to multitask without compromising balance and concentration, thereby enhancing optimal functional proficiency and societal participation. A reduced capacity for dual-task performance can markedly hinder engagement in functional mobility activities and community participation. OBJECTIVE This study was designed to assess the effectiveness of approaches in overcoming dual-task interference for functional proficiency, community re-integration, societal participation, and the return to productivity after a stroke. METHODS Methodology: In this double-blind, randomized controlled trial, 40 stroke participants with hemiparesis after cerebrovascular injury (mean age = 53.07± 10.15 years) were recruited from Lagos University Teaching Hospital (LUTH) Idi-Araba and Isolo General Hospital, Lagos. They were randomly assigned into two groups; Group A (Study Group) received Conventional Balance Training concurrently with an additional task and Group B (Control Group) received Conventional Balance Training. The participants were involved in a 12-week training intervention and 8 weeks of follow-up, 2 times a week for 45minutes per session. The outcome was assessed using Activities-specific Balance Confidence (ABC) Scale and Dynamic Gait Index for the assessment of functional performance and Dual Task Effect for assessment of level of dual-task interference. Data collected were analyzed using descriptive statistics of mean and standard deviation; the Mann-Whitney U test, Wilcoxon rank-sum test. The level of significance was established at p <.05. RESULTS Result: The study group had significant improvement in ABC (p<0.01), DGI (p<0.01), PS (p<0.05), MSCRIM (p<0.01), DTEFT1 (p<0.01), DTEFT2 (p<0.01), DTEFT3 (p<0.01), DTECRR1 (p<0.00), DTECRR2 (p<0.01) after eight and twelve weeks of intervention when compared to the control group, which revealed that Dual Task Training was more effective approach to overcoming dual-task interference for improved functional proficiency, community re-integration, societal participation, and the return to productivity after a stroke. CONCLUSIONS Conclusion: This study found that it was feasible to overcome dual task interference by implementing a long duration practice of individualized dual-task training, combining a conventional intervention with a variety of motor and cognitive tasks to enhance effective task integration, coordination and automatization in the rehabilitating post stroke survivors to enhance functional proficiency, community re-integration, societal participation and return to productivity after stroke. CLINICALTRIAL PACTR202012851961769