Effects of dual-task gait treadmill training on gait ability, dual-task interference, and fall efficacy in people with stroke: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Chang Yoon Baek ◽  
Woo Nam Chang ◽  
Beom Yeol Park ◽  
Kyoung Bo Lee ◽  
Kyoung Yee Kang ◽  
...  
Keyword(s):  
Dual Task ◽  
Cognitive Task ◽  
Gait Training ◽  
Control Group ◽  
Task Condition ◽  
Dual Task Condition ◽  
Single Task ◽  
Gait Parameters ◽  
Task Training ◽  
Task Conditions

Abstract Objective This study aimed to investigate the effects of dual-task gait training using a treadmill on gait ability, dual-task interference, and fall efficacy in people with stroke. Methods Patients with chronic stroke (N = 34) were recruited and randomly allocated to the experimental or control group. Both groups underwent gait training on a treadmill and a cognitive task. In the experimental group, gait training was conducted in conjunction with the cognitive task, whereas in the control group, the training and the cognitive task were conducted separately. Each intervention was provided for 60 minutes, twice a week, for a period of 6 weeks for both groups. The primary outcomes were as follows: gait parameters (speed, stride, variability, and cadence) under single-task and dual-task conditions, correct response rate (CRR) under single-task and dual-task conditions, and dual-task cost (DTC) in gait parameters and CRR. The secondary outcome was the fall efficacy scale. Results Dual-task gait training using a treadmill improved all gait parameters in the dual-task condition, speed, stride, and variability in the single-task condition, and CRR in both conditions. Difference between the groups was observed in speed, stride, and variability in the dual-task condition. Furthermore, dual-task gait training on a treadmill improved DTC in speed, variability, and cadence along with that in CRR, indicating true improvement of DTC, which led to significant improvement in DTC in speed and variability compared with single-task training. Conclusions Dual-task gait treadmill training was more effective in improving gait ability in dual-task training and DTI than single-task training involving gait and cognitive task separately in people with chronic stroke.

scholarly journals Balance performance maintained during dual-task condition with a cognitive task across menstrual cycle

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S6.1-S6 ◽  
Author(s):  
Meng Ni ◽  
Joseph Hazzard ◽  
Pamela Smith
Keyword(s):  
Menstrual Cycle ◽  
Task Performance ◽  
Dual Task ◽  
Cognitive Task ◽  
Task Condition ◽  
Balance Performance ◽  
Dual Task Condition ◽  
Single Task ◽  
Dual Task Performance ◽  
Task Conditions

BackgroundDual-task, performing a balance task and a cognitive task simultaneously, has been used as sport-related concussion assessment tool. However, the effect of dual task on balance performance remains controversial. Also, the fluctuation of hormone across menstrual cycle on balance and dual-task performance has not been fully examined.ObjectiveTo examine (1) the effect of dual task on balance performance, (2) the interaction of female sex hormonal level, balance, and dual-task performance.DesignA cohort study.SettingA laboratory of concussion research and services.ParticipantsA group of 49 healthy female college-aged students (age = 21.6 ± 2.0 years).Main outcome measuresThe Stability Evaluation Test (SET) protocol, Balance error scoring system (BESS) test and postural sway velocity (deg/sec) by using VSR SPORT force plate. Three auditory mathematics questions were given for each condition of the SET test. Two single-task conditions were provided, including balance only and math only. Balance test and math questions were given simultaneously during the dual-task condition.ResultsThere was no significantly statistically difference in BESS or sway velocity between single and dual task. However, the performance of math calculation is better in dual-task comparing to the single task (math only), with an 8%–12% higher rate of accuracy, but it didn't reach a statistical significance. The rate of accuracy during the dual task didn't vary among menstrual phases.ConclusionsBalance performance was maintained under dual-task conditions and fluctuation of female sex hormones across the menstrual cycle may not affect working memory and executive function. These findings are potentially clinically applicable to detecting balance deficits and cognitive alterations in female concussed individuals. Future studies are needed to investigate the underlying mechanism of balance maintenance and attention dividend under dual-task conditions.

Obstacle Avoidance and Dual-Tasking During Reaching While Standing in Patients With Mild Chronic Stroke

2021 ◽  
pp. 154596832110231
Author(s):  
Aditi A. Mullick ◽  
Melanie C. Baniña ◽  
Yosuke Tomita ◽  
Joyce Fung ◽  
Mindy F. Levin
Keyword(s):  
Obstacle Avoidance ◽  
Dual Task ◽  
Memory Task ◽  
Verbal Working Memory ◽  
Avoidance Task ◽  
Success Rates ◽  
Task Condition ◽  
Dual Task Condition ◽  
Single Task ◽  
Task Conditions

Background. Poststroke individuals use their paretic arms less often than expected in daily life situations, even when motor recovery is scored highly in clinical tests. Real-world environments are often unpredictable and require the ability to multitask and make decisions about rapid and accurate arm movement adjustments. Objective. To identify whether and to what extent cognitive–motor deficits in well-recovered individuals with stroke affect the ability to rapidly adapt reaching movements in changing cognitive and environmental conditions. Methods. Thirteen individuals with mild stroke and 11 healthy controls performed an obstacle avoidance task in a virtual environment while standing. Subjects reached for a virtual juice bottle with their hemiparetic arm as quickly as possible under single- and dual-task conditions. In the single-task condition, a sliding glass door partially obstructed the reaching path of the paretic arm. A successful trial was counted when the subject touched the bottle without the hand colliding with the door. In the dual-task condition, subjects repeated the same task while performing an auditory–verbal working memory task. Results. Individuals with stroke had significantly lower success rates than controls in avoiding the moving door in single-task (stroke: 51.8 ± 21.2%, control: 70.6 ± 12.7%; P = .018) and dual-task conditions (stroke: 40.0 ± 27.6%, control: 65.3 ± 20.0%; P = .015). Endpoint speed was lower in stroke subjects for successful trials in both conditions. Obstacle avoidance deficits were exacerbated by increased cognitive demands in both groups. Individuals reporting greater confidence using their hemiparetic arm had higher success rates. Conclusion. Clinically well-recovered individuals with stroke may have persistent deficits performing a complex reaching task.

scholarly journals Localization of Executive Functions in Dual-Task Performance with fMRI

2002 ◽  
Vol 14 (8) ◽  
pp. 1184-1199 ◽  
Author(s):  
André J. Szameitat ◽  
Torsten Schubert ◽  
Karsten Müller ◽  
D. Yves von Cramon
Keyword(s):  
Executive Functions ◽  
Task Performance ◽  
Dual Task ◽  
Task Difficulty ◽  
Task Condition ◽  
Subtraction Method ◽  
Dual Task Condition ◽  
Single Task ◽  
Dual Task Performance ◽  
Task Conditions

We report a study that investigated the neuroanatomical correlates of executive functions in dual-task performance with functional magnetic resonance imaging. Participants performed an auditory and a visual three-choice reaction task either separately as single tasks or concurrently as dual tasks. In the dual-task condition, two stimuli were presented in rapid succession to ensure interference between the component tasks (psychological refractory period). The behavioral data showed considerable performance decrements in the dual-task compared to the single-task condition. Dual-task-related activation was detected with two different neuroimaging methods. First, we determined dual-task-related activation according to the method of cognitive subtraction. For that purpose, activation in the dual-task was compared directly with activation in the single-task conditions. This analysis revealed that cortical areas along the inferior frontal sulcus (IFS), the middle frontal gyrus (MFG), and the intraparietal sulcus (IPS) are involved in dual-task performance. The results of the subtraction method were validated with the method of parametric manipulation. For this purpose, a second dual-task condition was introduced, where the difficulty of the dual-task coordination was increased compared with the first dual-task condition. As expected, behavioral dual-task performance decreased with increased dual-task difficulty. Furthermore, the increased dual-task difficulty led to an increase of activation in those cortical regions that proved to be dual-task related with the subtraction method, that is, the IFS, the MFG, and the IPS. These results support the conclusion that dorsolateral prefrontal and superior parietal cortices are involved in the coordination of concurrent and interfering task processing.

scholarly journals The Effect of Cognitive and Motor Dual-task Training on Improvement of Balance and Some Spatiotemporal Gait Parameters in People With Idiopathic Parkinson's Disease

2019 ◽  
Vol 5 (4) ◽  
pp. 190-198
Author(s):  
Tahereh Pourkhani ◽  
◽  
Hassan Daneshmandi ◽  
Ali Asghar Norasteh ◽  
Babak Bakhshayesh Eghbali ◽  
...  
Keyword(s):  
Dual Task ◽  
Controlled Trial ◽  
Training Group ◽  
Control Group ◽  
Timed Up And Go ◽  
Yahr Stage ◽  
Single Task ◽  
Gait Parameters ◽  
Task Training ◽  
Dual Task Training

Background: Parkinson disease (PD) is characterized by motor and non-motor symptoms that affect patients’ functions, especially while performing dual-tasks a critical factor in everyday living. However, many controversies exist about the benefits of dual-task training in patients with PD. Objectives: This study assessed the efficacy of motor and cognitive dual-task training in improving balance and gait parameters in people with idiopathic PD. Materials & Methods: A single-blind controlled trial was conducted on PD patients living in Guilan Province of Iran, in 2018-2019. A total of 30 PD patients (Hoehn and Yahr stage II-III while on medication) were assigned to the cognitive dual-task training group (n=10), motor dual-task training group (n=10), and single-task control group (n=10). All groups received 30 sessions of different exercises for 10 consecutive weeks. The patients’ balance and some spatiotemporal gait parameters were respectively assessed with timed up and go test and HD VideoCam-Kinovea before and after training and then 1 month later. Results: Both dual-task and single-task trainings improved the outcome measures (timed up and go test (F=535.54; P=0.000), stride length (F=87.41; P=0.00), stride time (F=102.11; P=0.00), cadence (F=286.36; P=0.00), swing time (F=48.90; P=0.00), and stance time (F=40.56; P=0.00)). These improvements were maintained at 1-month follow-up, although the effect slightly reduced. No significant differences were found between the study groups (P>0.05). Conclusion: Motor/cognitive dual-task training and single-task training were found to be significantly and equally effective in improving balance and gait parameters in people with PD.

Physical and Cognitive Performance During Upper-Extremity Versus Full-Body Exercise Under Dual Tasking Conditions

2020 ◽  
pp. 003151252094508
Author(s):  
Sarah C. Duckworth ◽  
Carrie S. Higginbotham ◽  
Joseph A. Pederson ◽  
Rebecca R. Rogers ◽  
Mallory R. Marshall ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Dual Task ◽  
Power Output ◽  
Word List ◽  
Task Condition ◽  
Dual Task Condition ◽  
Single Task ◽  
List Memory ◽  
Task Conditions ◽  
Full Body

The purpose of this study was to investigate physical and cognitive performance during dual task conditions of upper-extremity (UE) or full-body (FB) rowing exercise. In a crossover counterbalanced design, college-aged male and female participants completed five conditions: (a) Sitting, (b) Single task UE rowing, (c) Single task FB rowing, (d) Dual task UE rowing, and (e) Dual task FB rowing. For single task UE and FB rowing conditions, participants were asked to row as hard as possible. After sitting and dual-task conditions, we administered the Paced Auditory Serial Addition Test (PASAT) and a word-list memory test. We analyzed participants’ absolute differences (single task – dual task) in power output and their cognitive test scores to compare UE and FB rowing. There were no significant absolute differences from sitting to dual task conditions of UE and FB rowing for either PASAT ( p = 0.958) or word list memory ( p = 0.899) cognitive scores. Absolute power output loss from single to dual task conditions was significantly higher in FB versus UE for PASAT ( p = 0.039; d = 0.54) and word list memory ( p = 0.021; d = 0.66) in the dual task condition. These results suggest that, while cognitive performance was preserved regardless of the amount of muscle mass activated during dual task rowing, physical performance suffered more during FB than UE rowing under the dual task condition. These findings have important implications for optimizing cognitive and physical performance in dual task situations.

scholarly journals Speech Fluency in Acquired Apraxia of Speech During Narrative Discourse: Group Comparisons and Dual-Task Effects

2019 ◽  
Vol 28 (2S) ◽  
pp. 905-914
Author(s):  
Tyson G. Harmon ◽  
Adam Jacks ◽  
Katarina L. Haley
Keyword(s):  
Cognitive Load ◽  
Dual Task ◽  
Narrative Discourse ◽  
Control Group ◽  
Apraxia Of Speech ◽  
Task Condition ◽  
Sample Duration ◽  
Dual Task Condition ◽  
Single Task ◽  
Speech Fluency

Purpose Slowed speech and interruptions to the flow of connected speech are common in aphasia. These features are also observed during dual-task performance for neurotypical adults. The purposes of this study were to determine (a) whether indices of fluency related to cognitive–linguistic versus motor processing would differ between speakers with aphasia plus apraxia of speech (AOS) and speakers with aphasia only and (b) whether cognitive load reduces fluency in speakers with aphasia with and without AOS. Method Fourteen speakers with aphasia (7 with AOS) and 7 neurotypical controls retold short stories alone (single task) and while simultaneously distinguishing between a high and a low tone (dual task). Their narrative samples were analyzed for speech fluency according to sample duration, speech rate, pause/fill time, and repetitions per syllable. Results As expected, both speaker groups with aphasia spoke slower and with more pauses than the neurotypical controls. The speakers with AOS produced more repetitions and longer samples than controls, but they did not differ on these measures from the speakers with aphasia without AOS. Relative to the single-task condition, the dual-task condition increased the duration of pauses and fillers for all groups but reduced speaking rate only for the control group. Sample duration and frequency of repetitions did not change in response to cognitive load. Conclusions Speech output in aphasia becomes less fluent when speakers have to engage in simultaneous tasks, as is typical in everyday conversation. Although AOS may lead to more sound and syllable repetitions than normal, speaking tasks other than narrative discourse might better capture this specific type of disfluency. Future research is needed to confirm and expand these preliminary findings. Supplemental Material https://doi.org/10.23641/asha.8847845

Effects of Concurrent Manual Task Performance on Connected Speech Acoustics in Individuals With Parkinson Disease

2019 ◽  
Vol 62 (7) ◽  
pp. 2099-2117 ◽  
Author(s):  
Jason A. Whitfield ◽  
Zoe Kriegel ◽  
Adam M. Fullenkamp ◽  
Daryush D. Mehta
Keyword(s):  
Task Performance ◽  
Speech Production ◽  
Dual Task ◽  
Motor Task ◽  
Task Condition ◽  
Connected Speech ◽  
Speech Acoustics ◽  
Single Task ◽  
Manual Task ◽  
Task Conditions

Purpose Prior investigations suggest that simultaneous performance of more than 1 motor-oriented task may exacerbate speech motor deficits in individuals with Parkinson disease (PD). The purpose of the current investigation was to examine the extent to which performing a low-demand manual task affected the connected speech in individuals with and without PD. Method Individuals with PD and neurologically healthy controls performed speech tasks (reading and extemporaneous speech tasks) and an oscillatory manual task (a counterclockwise circle-drawing task) in isolation (single-task condition) and concurrently (dual-task condition). Results Relative to speech task performance, no changes in speech acoustics were observed for either group when the low-demand motor task was performed with the concurrent reading tasks. Speakers with PD exhibited a significant decrease in pause duration between the single-task (speech only) and dual-task conditions for the extemporaneous speech task, whereas control participants did not exhibit changes in any speech production variable between the single- and dual-task conditions. Conclusions Overall, there were little to no changes in speech production when a low-demand oscillatory motor task was performed with concurrent reading. For the extemporaneous task, however, individuals with PD exhibited significant changes when the speech and manual tasks were performed concurrently, a pattern that was not observed for control speakers. Supplemental Material https://doi.org/10.23641/asha.8637008

2BALANCE: Test-retest reliability of a cognitive-motor dual-task protocol

2021 ◽  
pp. 1-13
Author(s):  
Maya Danneels ◽  
Ruth Van Hecke ◽  
Laura Leyssens ◽  
Dirk Cambier ◽  
Raymond van de Berg ◽  
...  
Keyword(s):  
Mental Rotation ◽  
Dual Task ◽  
Motor Task ◽  
Mental Rotation Task ◽  
Cognitive Tasks ◽  
Task Condition ◽  
Dual Task Condition ◽  
Single Task ◽  
Retest Reliability ◽  
Test Retest Reliability

PURPOSE: Aside from typical symptoms such as dizziness and vertigo, persons with vestibular disorders often have cognitive and motor problems. These symptoms have been assessed in single-task condition. However, dual-tasks assessing cognitive-motor interference might be an added value as they reflect daily life situations better. Therefore, the 2BALANCE protocol was developed. In the current study, the test-retest reliability of this protocol was assessed. METHODS: The 2BALANCE protocol was performed twice in 20 healthy young adults with an in-between test interval of two weeks. Two motor tasks and five different cognitive tasks were performed in single and dual-task condition. Intraclass correlation coefficients (ICC), the standard error of measurement, and the minimal detectable difference were calculated. RESULTS: All cognitive tasks, with the exception of the mental rotation task, had favorable reliability results (0.26≤ICC≤0.91). The dynamic motor task indicated overall substantial reliability values in all conditions (0.67≤ICC≤0.98). Similar results were found for the static motor task during dual-tasking (0.50≤ICC≤0.92), but were slightly lower in single-task condition (–0.26≤ICC≤0.75). CONCLUSIONS: The 2BALANCE protocol was overall consistent across trials. However, the mental rotation task showed lowest reliability values.

scholarly journals Impaired attentional modulation of sensorimotor control and cortical excitability in schizophrenia

Brain ◽  
2019 ◽  
Vol 142 (7) ◽  
pp. 2149-2164 ◽  
Author(s):  
Loïc Carment ◽  
Lucile Dupin ◽  
Laura Guedj ◽  
Maxime Térémetz ◽  
Marie-Odile Krebs ◽  
...  
Keyword(s):  
Dual Task ◽  
Cortical Excitability ◽  
Task Force ◽  
Tracking Error ◽  
Sensorimotor Control ◽  
Group Differences ◽  
Task Condition ◽  
Dual Task Condition ◽  
Single Task ◽  
Force Tracking

Abstract Impairments in attentional, working memory and sensorimotor processing have been consistently reported in schizophrenia. However, the interaction between cognitive and sensorimotor impairments and the underlying neural mechanisms remains largely uncharted. We hypothesized that altered attentional processing in patients with schizophrenia, probed through saccadic inhibition, would partly explain impaired sensorimotor control and would be reflected as altered task-dependent modulation of cortical excitability and inhibition. Twenty-five stabilized patients with schizophrenia, 17 unaffected siblings and 25 healthy control subjects were recruited. Subjects performed visuomotor grip force-tracking alone (single-task condition) and with increased cognitive load (dual-task condition). In the dual-task condition, two types of trials were randomly presented: trials with visual distractors (requiring inhibition of saccades) or trials with addition of numbers (requiring saccades and addition). Both dual-task trial types required divided visual attention to the force-tracking target and to the distractor or number. Gaze was measured during force-tracking tasks, and task-dependent modulation of cortical excitability and inhibition were assessed using transcranial magnetic stimulation. In the single-task, patients with schizophrenia showed increased force-tracking error. In dual-task distraction trials, force-tracking error increased further in patients, but not in the other two groups. Patients inhibited fewer saccades to distractors, and the capacity to inhibit saccades explained group differences in force-tracking performance. Cortical excitability at rest was not different between groups and increased for all groups during single-task force-tracking, although, to a greater extent in patients (80%) compared to controls (40%). Compared to single-task force-tracking, the dual-task increased cortical excitability in control subjects, whereas patients showed decreased excitability. Again, the group differences in cortical excitability were no longer significant when failure to inhibit saccades was included as a covariate. Cortical inhibition was reduced in patients in all conditions, and only healthy controls increased inhibition in the dual-task. Siblings had similar force-tracking and gaze performance as controls but showed altered task-related modulation of cortical excitability and inhibition in dual-task conditions. In patients, neuropsychological scores of attention correlated with visuomotor performance and with task-dependant modulation of cortical excitability. Disorganization symptoms were greatest in patients with weakest task-dependent modulation of cortical excitability. This study provides insights into neurobiological mechanisms of impaired sensorimotor control in schizophrenia showing that deficient divided visual attention contributes to impaired visuomotor performance and is reflected in impaired modulation of cortical excitability and inhibition. In siblings, altered modulation of cortical excitability and inhibition is consistent with a genetic risk for cortical abnormality.

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