Deblock-Bellamy Anne, Lamontagne Anouk, Blanchette Andréanne K
Faculty of Medicine, Universite Laval, Quebec City, QC, Canada.
Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris) - CIUSSS de la Capitale-Nationale, Quebec City, QC, Canada.
Front Neurol. 2020 Aug 18;11:882. doi: 10.3389/fneur.2020.00882. eCollection 2020.
Walking in the community can be challenging for stroke survivors. The fact that community walking often requires performing another task while walking further adds to this challenge and can lead to a deterioration of performance in one or both tasks. To review the existing literature about cognitive-locomotor dual-task interference (DTI) magnitude and pattern while walking in patients with stroke and to explore the influence of tasks' nature on DTI. Moreover, this review investigated the differences in DTI between stroke survivors and age-matched healthy adults. The literature search was conducted in 4 databases (MEDLINE, CINAHL, EMBASE and PEDro). Two authors independently identified relevant studies based on predetermined selection criteria. Among these criteria, studies had to include both locomotor and cognitive DTI. Methodological quality of the studies was independently assessed by two raters using a standardized checklist. Studies were categorized according to the nature of the locomotor and the cognitive tasks. A total of twenty studies, with good to high methodological quality, were selected. Task combinations, outcome measures and participants characteristics varied widely from one study to another. Despite heterogeneous results across studies, mutual DTI (decrements in both locomotor and cognitive performance) was the most frequently observed pattern in participants with stroke. Interestingly, this DTI pattern was systematically obtained when participants had to avoid obstacles while walking. DTI seemed also to be influenced by the nature of the cognitive task. Compared to age-matched healthy participants, stroke survivors had greater DTI. Mutual interferences were also more frequently observed in stroke survivors than in age-matched healthy adults. DTI magnitude and pattern in persons with stroke varied considerably across studies. Multiple factors, including nature of the tasks, may influence dual-task abilities when assessing individuals with stroke. Consequently, dual-task assessments should be performed in similar contexts of individuals' daily lives to ensure ecological validity.
对于中风幸存者来说，在社区中行走可能具有挑战性。事实上，在社区行走时通常需要在行走的同时执行另一项任务，这进一步增加了挑战，并可能导致一项或两项任务的表现恶化。回顾关于中风患者行走时认知 - 运动双重任务干扰（DTI）程度和模式的现有文献，并探讨任务性质对DTI的影响。此外，本综述研究了中风幸存者与年龄匹配的健康成年人之间DTI的差异。在4个数据库（MEDLINE、CINAHL、EMBASE和PEDro）中进行了文献检索。两位作者根据预先确定的选择标准独立识别相关研究。在这些标准中，研究必须包括运动和认知DTI。两位评估者使用标准化清单独立评估研究的方法学质量。根据运动和认知任务的性质对研究进行分类。总共选择了20项方法学质量良好至高的研究。从一项研究到另一项研究，任务组合、结果测量和参与者特征差异很大。尽管各研究结果存在异质性，但相互DTI（运动和认知表现均下降）是中风参与者中最常观察到的模式。有趣的是，当参与者在行走时必须避开障碍物时，系统地获得了这种DTI模式。DTI似乎也受到认知任务性质的影响。与年龄匹配的健康参与者相比，中风幸存者的DTI更大。中风幸存者中也比年龄匹配的健康成年人更频繁地观察到相互干扰。中风患者的DTI程度和模式在各研究中差异很大。在评估中风个体时，包括任务性质在内的多个因素可能会影响双重任务能力。因此，应在个体日常生活的相似背景下进行双重任务评估，以确保生态效度。
