Abstract
Objectives
To assess (1) the effect of task (single and dual task), time (discharge and 4mo),
and their interaction for mobility; (2) task prioritization during dual-task testing;
and (3) the association between cognition on change in mobility between discharge
from rehabilitation and 4 months’ follow-up.
Design
Prospective cohort study.
Setting
Rehabilitation hospital.
Participants
People with lower extremity amputations (N=22) were consecutively recruited at discharge
from an inpatient prosthetic rehabilitation program.
Interventions
Not applicable.
Main Outcome Measures
Gait velocity and the L Test of Functional Mobility, single and dual task (serial
subtractions by 3), were the primary outcomes. Montreal Cognitive Assessment and Trail
Making Test quantified cognition as secondary outcomes. Repeated measures analysis
of variance evaluated the effects of task (single task and dual task) and time (at
discharge and 4 months’ follow-up) and their interaction on each outcome. A performance-resource
operating characteristic graph evaluated gait and cognitive task prioritization. Multivariable
linear regression evaluated the association between cognition and change in mobility
over time.
Results
No significant interactions between task and time were found (all P>.121) for L Test and gait velocity. The L Test single task (P=.001) and dual task (P=.004) improved over time. Gait velocity improved over time for both single task and
dual task (P<.001). Dual-task performance was slower than single-task performances at each time
point. The Trail Making Test B was independently associated with the change in dual-task
L Test (P=.012), and single-task (P=.003) and dual-task (P=.006) gait velocity at follow-up.
Conclusions
Gait velocity and L Test single and dual task improved over time. No significant interactions
indicated that cognitive task did not differentially affect performance over time.
Lower executive function scores at discharge were independently associated with lower
gains in all gait velocity and dual-task L Test outcomes at follow-up.
Keywords
List of abbreviations:
CRR (correct response rate), DTCcog (dual-task cognition cost), DTCgait (dual-task gait cost), LLA (lower limb amputation), MDC (minimum detectable change), MoCA (Montreal Cognitive Assessment), TMT (Trail Making Test), TMT-B (Trail Making Test Part B)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 24, 2019
Footnotes
Supported by the St. Joseph’s Healthcare Foundation Cognitive Vitality and Brain Health Seed Funding Opportunity in London, Ontario, Canada (grant no. 070-1516). The funding body had no involvement in the conduct of the study.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
