Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Clin Rehabil. 2019 Jun;33(6):1066-1078. doi: 10.1177/0269215519828146. Epub 2019 Feb 6.
To explore the reliability and validity of a series of dual-task mobility assessments among individuals post-stroke.
Observational study with repeated measures.
University laboratory.
Thirty community-dwelling individuals with chronic stroke.
Not applicable.
Each of the two mobility tasks (1-minute level-ground walking with and without obstacle-negotiation) was performed concurrently with each of the eight cognitive tasks (auditory Stroop test, serial subtraction, shopping list recall and category naming at two difficulty levels). Walking distance and obstacle hitting rate (OHR) indicated dual-task mobility performance. Number of correct responses (NCR) indicated cognitive performance. Reaction time was additionally measured for the auditory Stroop test. Construct validity was examined by correlations between the dual-task assessments. The dual-task assessments were repeated within 7-14 days for test-retest reliability.
Excellent test-retest reliability in walking distance and OHR was found (intraclass correlation coefficient, ICC(3,1) = 0.891-0.984, P < 0.05). Moderate to excellent reliability was found in NCR and reaction time (ICC(3,1) = 0.480-0.911, P < 0.01). Correlations between walking distance were excellent ( r = 0.840-0.985, P < 0.01). Correlations of NCR and reaction time between low- and high-level cognitive tasks were mostly moderate to excellent ( r = 0.515-0.793, P < 0.01). Generally no significant correlations were found in NCR between the dual-task assessments with different cognitive domains.
The dual-task walking assessments are reliable and valid for evaluating cognitive-motor interference in community-dwelling individuals post-stroke. The lack of correlations between the tasks of different cognitive domains indicates the need of using different cognitive domains in dual-task walking assessment post-stroke.
探索一系列针对脑卒中后个体的双重任务移动评估的可靠性和有效性。
具有重复测量的观察性研究。
大学实验室。
30 名居住在社区的慢性脑卒中患者。
不适用。
两个移动任务（1 分钟平地行走，有和没有障碍物穿越）与八个认知任务（听觉斯特鲁普测试、连续减法、购物清单回忆和类别命名，分为两个难度级别）同时进行。行走距离和障碍物碰撞率（OHR）表示双重任务移动表现。正确反应次数（NCR）表示认知表现。听觉斯特鲁普测试的反应时间也被测量。构念效度通过双重任务评估之间的相关性来检验。双重任务评估在 7-14 天内重复进行以检验测试-重测信度。
行走距离和 OHR 的测试-重测信度非常好（组内相关系数 ICC（3,1）=0.891-0.984，P<0.05）。NCR 和反应时间的可靠性为中度到高度（ICC（3,1）=0.480-0.911，P<0.01）。行走距离之间的相关性非常好（r=0.840-0.985，P<0.01）。低水平和高水平认知任务之间的 NCR 和反应时间的相关性大多为中度到高度（r=0.515-0.793，P<0.01）。一般来说，在不同认知领域的双重任务评估之间，NCR 之间没有显著的相关性。
双重任务行走评估在评估社区居住的脑卒中后个体的认知-运动干扰方面是可靠和有效的。不同认知领域任务之间缺乏相关性表明，在脑卒中后双重任务行走评估中需要使用不同的认知领域。
