Interference between gait and cognitive tasks in a rehabilitating neurological population
Interference between gait and cognitive tasks in a rehabilitating neurological population
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DOI：
10.1136/jnnp.69.4.479
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发表时间：
2000-10-01
影响因子：
11
通讯作者：
Wade, D
中科院分区：
文献类型：
--
作者：
Haggard, P;Cockburn, J;Wade, D
目的-量化脑损伤后步态和认知任务之间的干扰程度；调查这种干扰是否在各种认知任务中普遍存在，或仅限于特定的认知模块；调查这种干扰是否在脑损伤后的康复过程中减少。方法从神经康复病房(33人，占样本的75%)、急性医院中风康复病房(11人，20%)和青年残疾人单位(6人，5%)招募50名参与者。步幅持续时间的测量是在单一任务条件下进行的，并与四项认知任务中的每一项任务相结合。结果：总体上，与单一任务相比，双任务条件下步态持续时间减少了7%，在同时执行每个认知任务的过程中，步幅持续时间显著延长。在双重任务条件下，认知任务绩效平均下降4%，其中行走时的单词生成和行走时的配对联想监控显著减少。双任务减少量与标准残疾标准Barthel日常生活活动量表的得分之间存在显著的相关性(r=0.45)，但与10m步行时间的相关性不显著(r=0.18)。结论认知任务与步态等运动控制活动之间的干扰是神经康复环境中的一个问题，认知任务与运动任务之间的干扰可能在评估神经科患者的独立功能能力以及设计认知和运动康复的治疗方法方面具有重要意义。
Objectives-To quantify the extent of interference between gait and cognitive tasks after brain injury; to investigate whether such interference is common to various cognitive tasks, or confined to specific cognitive modules; to investigate whether such interference declines during recovery from brain injury.Method-Fifty participants were recruited from a neurological rehabilitation unit (33 people, 75% of sample); the stroke rehabilitation ward of an acute hospital (11 people, 20%); and a young disabled unit (six people, 5%). Measures of stride duration were taken in single task conditions, and in conjunction with each of four cognitive tasks. Outcome measures were dual task decrements in gait and in cognitive task performance.Results-Overall, a 7% decrement in stride duration was recorded under dual task conditions compared with single task, with stride duration being significantly longer during simultaneous performance of each cognitive task. There was a 4% decrement on average in cognitive task performance under dual task conditions, with significant decrements being recorded for word generation while walking and paired associate monitoring while walking. A significant correlation (r=0.45) was found between dual task decrements and scores on a standard measure of disability-the Barthel activities of daily living scale-but the correlation with 10 m walking time was not significant (r=0.18).Conclusion-Interference between cognitive tasks and motor control activities such as gait is a problem in neurological rehabilitation settings, interference between cognition and locomotor tasks may be important in assessing neurological patients' ability to function independently, and in designing therapies for both cognitive and motor rehabilitation.