Effect of Combined Mental Tracking Dual-Task During Walking on Gait Speed and Cognitive Performance in Stroke Patients

Abstract

Subtraction has been commonly used as a part of cognitive dual-task for advanced gait assessment in persons with stroke in clinic. As many patients with stroke were unable to perform subtraction, more practical tasks should be examined for substitution. The main objectives of this study were 1) to compare the feasibility of cognitive tasks in the same mental tracking category as subtraction for substitution purpose; and 2) to examine their effects on gait speed and cognitive performance in stroke. Twenty-nine participants with stroke were asked to perform cognitive tasks, namely, subtraction by 3, spelling backward, arithmetic, and reciting alternate tasks, in sitting and during 10-meter walking. Gait speed and stride lengths were monitored by accelerometers. The correct answers were recorded, and the cognitive dual-task cost was calculated. The feasibility of task was calculated as the percentage of participants who could perform the cognitive task in sitting. The effect of cognitive tasks on gait speed and stride length were compared with normal walk. Our results showed that the feasibility of the subtraction, spelling backward, arithmetic, and reciting alternate tasks were 62.07%, 75.86%, 100%, and 89.66%, respectively. Cognitive dual-task costs were reduced in all cognitive tasks. Gait speed was significantly decreased while performing the subtraction task (P = 0.005), spelling backward task (P = 0.011), and reciting alternate task (P = 0.016), and was not affected during the arithmetic task. Therefore, our results indicate that the reciting alternate and spelling backward task can be used as substitution for subtraction task in dual-task assessment for stroke patients.