PTOTSLPOtherJournal of neurologic physical therapy : JNPT2022

Greater Cognitive-Motor Interference in Individuals Post-Stroke During More Complex Motor Tasks.

Jordyn Rice, Daniel T Corp, Alessandra Swarowsky and 6 others

PMID 34628438

WHAT IT FOUND

People post-stroke slowed down significantly more than healthy adults during a dual-task Timed Up-and-Go, but their counting accuracy stayed stable.

Healthy adults slowed down less but made more counting errors. The complex TUG reveals motor interference in stroke without cognitive cost.

Key findings

01Individuals post-stroke showed a significantly larger drop in Timed Up-and-Go performance when adding a cognitive task compared to healthy controls.

02Healthy individuals demonstrated a significant decrease in cognitive performance during the 90-second dual-task walk, while individuals post-stroke did not show this cognitive decline.

03The Timed Up-and-Go task produced greater motor performance decrements in both groups compared to the 90-second walk, indicating it is a more cognitively demanding motor task.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The sample size was small, and the study was not powered for all comparisons. Participants were sub-acute (mean 5 months post-stroke) and predominantly high-functioning (65.2% with mild disability scores), so results may not apply to chronic or severely impaired patients. The cognitive single-task baseline was performed while standing, which may have influenced the dual-task effect calculations. Fall history and specific fall characteristics were not collected. The 90-second walk required turns in a hallway, but the number of turns was not quantified, making it difficult to control for turning complexity.

Declared interests

No conflicts of interest were declared. The study was supported by NIH and non-U.S. government grants.

The easy way to misread this

Do not assume that individuals post-stroke have preserved cognitive function during walking simply because their counting accuracy did not drop. Their motor performance slowed significantly more than controls, suggesting they may have prioritized gait stability at the expense of walking speed, or that the cognitive task was too easy to show interference in this high-functioning group.

Read it on PubMed →