Speed of Voluntary Stepping in Chronic Stroke Survivors Under Single- and Dual-Task Conditions: A Case-Control Study
Abstract
Melzer I, Tzedek I, Or M, Shvarth G, Nizri O, Ben-Shitrit K, Oddsson LE. Speed of voluntary stepping in chronic stroke survivors under single- and dual-task conditions: a case-control study.
Objective
To investigate voluntary step behavior of chronic stroke survivors during single- and dual-task conditions and compare the results to healthy age- and sex-matched controls.
Design
Case-control.
Setting
Laboratory-based study.
Participants
Chronic stroke survivors (n=16) and healthy controls (n=16).
Interventions
Not applicable.
Main Outcome Measures
Forward and backward rapid voluntary stepping were performed as a reaction time task under 2 conditions: (1) awaiting a cutaneous cue (single task), and (2) awaiting a cutaneous cue while performing an attention-demanding task. Step initiation, preparatory and swing phases, foot-off time, and foot-contact time were extracted from center of pressure and ground reaction forceplate data.
Results
Chronic stroke survivors were significantly slower than healthy controls in all step parameters under single- and dual-task conditions. For dual compared with single task, the foot-contact time increased from 1295ms to 1445ms (12%) in chronic stroke survivors and from 876ms to 1006ms (15%) in controls.
Conclusions
The significant increase in step phase's duration during single- and dual-task conditions may be a factor contributing to the large number of falls seen in stroke patients. The interference effects of attention-demanding task were similar between groups, suggesting that both groups used similar strategies. Future research should determine whether step training can improve step decrements in chronic stroke survivors.
aSchwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
cNeuroMuscular Research Center, Boston University, Boston, MA
dSister Kenny Rehabilitation Institute, Sister Kenny Research Center, Minneapolis, MN
Reprint requests to Itshak Melzer, PhD, PT, Schwartz Movement Analysis & Rehabilitation Laboratory, Dept of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 653, Beer-Sheva 84105, Israel
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT