Zhang Xueyi, Wang Qi, Li Qiujie, Liu Hui, Wan Xianglin
School of Sport Science, Beijing Sport University, Beijing, China.
Key Laboratory for Performance Training and Recovery of General Administration of Sport of China, Beijing, China.
Front Hum Neurosci. 2025 May 7;19:1587153. doi: 10.3389/fnhum.2025.1587153. eCollection 2025.
The application of dual-task walking paradigms for gait assessment in stroke patients is critical, where varying concurrent tasks may elicit distinct gait patterns of dual-task interference. This study assessed the acute effects of different types of dual tasks on gait in stroke patients during task performance, informing occupational, and physical therapists about care recommendations to prevent patients from falling and improve their balance function in daily life.
A total of 19 stroke patients (52.7 ± 6.9 years old) performed the walking-only and dual-task walking (motor, arithmetic and speech) task test while a 3D motion capture system measured the gait parameters (the gait spatial-temporal parameters, sagittal angle of lower-limb joints, gait parameter variability and dual-task cost). One-way repeated measures ANOVA was used to test the effects of the above four walking conditions on gait parameters.
Arithmetic task and speech task interference can affect the gait of stroke patients ( < 0.05). Arithmetic task interference has the greatest impact on step speed, cadence, single support phase, hip joint range in support period and has the greatest dual-task cost, speech task interference has the greatest impact on cadence coefficient of variation ( < 0.05). The motor task was not significantly different from walking-only ( >0.05).
Both arithmetic and speech tasks have a great impact on gait in stroke patients. Faced with cognitive interference, stroke patients spontaneously adopted a "cautious gait" walking pattern. In future rehabilitation training, diversity of task types is critical for gait rehabilitation training based on the walking ability of the patients.
双任务步行范式在中风患者步态评估中的应用至关重要，不同的并发任务可能引发不同的双任务干扰步态模式。本研究评估了不同类型双任务对中风患者任务执行期间步态的急性影响，为职业治疗师和物理治疗师提供护理建议，以防止患者跌倒并改善其日常生活中的平衡功能。
共有19名中风患者（52.7±6.9岁）进行了仅步行和双任务步行（运动、算术和言语）任务测试，同时使用三维运动捕捉系统测量步态参数（步态时空参数、下肢关节矢状角、步态参数变异性和双任务成本）。采用单向重复测量方差分析来测试上述四种步行条件对步态参数的影响。
算术任务和言语任务干扰会影响中风患者的步态（<0.05）。算术任务干扰对步速、步频、单支撑相、支撑期髋关节活动范围影响最大，且双任务成本最高；言语任务干扰对步频变异系数影响最大（<0.05）。运动任务与仅步行无显著差异（>0.05）。
算术和言语任务均对中风患者的步态有较大影响。面对认知干扰时，中风患者会自发采用“谨慎步态”的行走模式。在未来的康复训练中，根据患者的步行能力，任务类型的多样性对步态康复训练至关重要。
