School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.
Eur J Phys Rehabil Med. 2017 Dec;53(6):920-927. doi: 10.23736/S1973-9087.17.04598-1. Epub 2017 May 12.
Attempting to perform dual- and complex-tasks obviously reduces the walking ability of individuals with impaired cognitive functions. However, there is no clear evidence describing the effects of dual- and complex-tasks on the walking ability of ambulatory individuals with a spinal cord injury (SCI) who have intact cognitive functions, but suffer from various degrees of sensorimotor deterioration.
To primarily investigate the effects of dual- and complex-task on the walking ability of ambulatory subjects with SCI as compared to healthy individuals. In addition, the study secondarily compared the effects in subgroups of subjects with SCI, including different age groups, lesion severity and level of ability.
Cross-sectional design.
A major tertiary referral and community hospitals in Thailand.
Thirty-seven ambulatory individuals with SCI and 13 healthy subjects.
All subjects were evaluated for outcomes while they walked under four conditions, including single-task overground walking (ST-OG), dual-task overground walking (DT-OG) using a color word Stroop task, single-task obstacle crossing (ST-OC) and dual-task obstacle crossing (DT-OC). The outcomes were compared among the conditions and between the groups of subjects in terms of walking time, obstacle crossing ability and percent of Stroop task errors.
With the increasing complexity of the tasks, both SCI and healthy subjects walked significantly slower (P<0.001 for those with SCI and P<0.05 for healthy subjects), but not when compared between the ST-OC and DT-OG conditions (P>0.05). Subjects also showed a greater percentage of cognitive task errors when they encountered a dual- and complex-task, particularly those with SCI who were over 50 years old, had mild lesion severity or walked with a walking device (P<0.001).
The incorporation of dual- and complex-task challenged cognitive-motor interference of ambulatory individuals with SCI.
The application of such tasks may benefit rehabilitation outcomes in a real-world situation for patients, especially for those who are older than 50, have mild lesion severity or use a walking device.
尝试执行双重和复杂任务显然会降低认知功能受损个体的行走能力。然而，目前尚无明确证据描述双重和复杂任务对认知功能正常但存在不同程度感觉运动恶化的步行脊髓损伤（SCI）个体的行走能力的影响。
主要研究双重和复杂任务对步行 SCI 个体行走能力的影响，并与健康个体进行比较。此外，该研究还次要比较了 SCI 个体亚组（包括不同年龄组、损伤严重程度和能力水平）的影响。
横断面设计。
泰国的一家主要的三级转诊和社区医院。
37 名步行 SCI 个体和 13 名健康受试者。
所有受试者在四种条件下进行行走评估，包括单任务地面行走（ST-OG）、使用颜色词斯特鲁普任务的双重任务地面行走（DT-OG）、单任务障碍物穿越（ST-OC）和双重任务障碍物穿越（DT-OC）。比较了条件之间和两组受试者之间的行走时间、障碍物穿越能力和斯特鲁普任务错误率。
随着任务复杂性的增加，SCI 和健康受试者的行走速度明显减慢（SCI 受试者 P<0.001，健康受试者 P<0.05），但 ST-OC 和 DT-OG 条件之间的比较没有差异（P>0.05）。当受试者遇到双重和复杂任务时，他们也表现出更高的认知任务错误率，特别是年龄超过 50 岁、损伤严重程度较轻或使用行走装置的 SCI 受试者（P<0.001）。
双重和复杂任务的纳入挑战了步行 SCI 个体的认知运动干扰。
在现实情况下，对患者，特别是年龄大于 50 岁、损伤严重程度较轻或使用行走装置的患者，应用此类任务可能会有益于康复结果。
