Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada.
Assistive Technology, Nova Scotia Health Authority, Halifax, Canada.
Top Stroke Rehabil. 2021 Sep;28(6):463-473. doi: 10.1080/10749357.2020.1834271. Epub 2020 Oct 16.
Cognitive-motor interference, as measured by dual-task walking (performing a mental task while walking), affects many clinical populations. Ankle-foot orthoses (AFOs) are lower-leg splints prescribed to provide stability to the foot and ankle, as well as prevent foot drop, a gait deficit common after stroke. AFO use has been shown to improve gait parameters such as speed and step time, which are often negatively impacted by dual-task walking.
Our objective was to establish whether AFOs could protect against cognitive-motor interference, as measured by dual-task walking, following post-stroke hemiplegia.
A total of 21 individuals with post-stroke hemiplegia that use an AFO completed a dual-task walking paradigm in the form of a 2 (walking with vs. without a concurrent cognitive task) by 2 (walking with vs. without an AFO) repeated-measures design. Changes to both motor and cognitive performance were analyzed.
The results suggest that the use of an AFO improves gait overall in both single- and dual-task walking, particularly with respect to stride regularity, but there were no interactions to suggest that AFOs reduce the cognitive-motor dual-task costs themselves. A lack of differences in cognitive performance during dual-task walking with and without the AFO suggests that the AFO's benefit to motor performance cannot be attributed to task prioritization.
These data support the use of AFOs to improve certain gait parameters for post-stroke hemiplegia, but AFOs do not appear to protect against cognitive-motor interference during dual-task walking. Future research should pursue alternate therapeutics for ameliorating task-specific declines under cognitively demanding circumstances.
认知-运动干扰（通过双重任务行走来衡量，即在行走的同时执行一项心理任务）会影响许多临床人群。踝足矫形器（AFO）是一种小腿夹板，用于为足部和踝关节提供稳定性，并防止足下垂，这是中风后常见的步态缺陷。AFO 的使用已被证明可以改善步态参数，例如速度和步时，而这些参数通常会受到双重任务行走的负面影响。
我们的目的是确定 AFO 是否可以预防中风后偏瘫患者的双重任务行走时的认知-运动干扰。
共有 21 名使用 AFO 的中风后偏瘫患者采用 2（行走时有无同时进行认知任务）×2（行走时有无 AFO）重复测量设计完成了双重任务行走范式。分析了运动和认知表现的变化。
结果表明，AFO 的使用总体上改善了单任务和双重任务行走的步态，特别是在步幅规律性方面，但没有交互作用表明 AFO 本身可以降低认知-运动双重任务的成本。在有无 AFO 的双重任务行走中，认知表现没有差异，这表明 AFO 对运动表现的益处不能归因于任务优先级。
这些数据支持使用 AFO 来改善中风后偏瘫的某些步态参数，但 AFO 似乎不能预防双重任务行走时的认知-运动干扰。未来的研究应寻求改善认知要求高的情况下特定任务下降的替代治疗方法。
