Ohzuno Tetsuya, Usuda Shigeru
Department of Rehabilitation, Harunaso Hospital: 5989 Nakamuroda-machi, Takasaki-shi, Gunma 370-3347, Japan.
Graduate School of Health Sciences, Gunma University, Japan.
J Phys Ther Sci. 2019 Mar;31(3):255-260. doi: 10.1589/jpts.31.255. Epub 2019 Mar 19.
[Purpose] We aimed to compare the effects of cognitive load and task prioritization on dual task strategies in patients with stroke and healthy adults in order to clarify the characteristics of cognitive-motor interference. [Participants and Methods] In total, 26 patients with stroke and 26 age-matched healthy adults (controls) performed the Timed Up and Go Test while performing a serial subtraction task from random numbers between 90 and 100. Dual task was measured under four conditions in which two difficulty levels of "3 subtraction" and "7 subtraction" were multiplied by two prioritizing tasks that involved "paying equal attention to both walking and subtraction tasks" (no priority) and "paying attention while mainly focusing on subtraction tasks" (cognitive priority). [Results] Increasing cognitive load and prioritizing cognitive tasks affected motor performance in terms of the amount of time and number of steps required to complete the Timed Up and Go Test in both the patients and controls. However, cognitive load and task prioritization did not affect cognitive performance. [Conclusion] When cognitive load increases and instructions are given to prioritize increases in cognitive load, patients with stroke use the "posture first" strategy to stabilize their gait as effectively as healthy adults do.
[目的] 我们旨在比较认知负荷和任务优先级对中风患者和健康成年人双重任务策略的影响，以阐明认知 - 运动干扰的特征。[参与者与方法] 总共26名中风患者和26名年龄匹配的健康成年人（对照组）在执行从90到100的随机数连续减法任务时进行了定时起立行走测试。双重任务在四种条件下进行测量，其中“3减法”和“7减法”这两个难度级别与两个优先级任务相乘，这两个优先级任务涉及“对行走和减法任务同等关注”（无优先级）和“主要专注于减法任务时关注行走”（认知优先级）。[结果] 在患者和对照组中，增加认知负荷和优先处理认知任务在完成定时起立行走测试所需的时间和步数方面影响了运动表现。然而，认知负荷和任务优先级并未影响认知表现。[结论] 当中风患者认知负荷增加且被给予优先处理增加的认知负荷的指令时，他们会像健康成年人一样有效地使用“姿势优先”策略来稳定步态。
