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  • Title: Effects of Attentional Loadings on Gait Performance Before Turning in Stroke Survivors.
    Author: Manaf H, Justine M, Goh HT.
    Journal: PM R; 2015 Nov; 7(11):1159-1166. PubMed ID: 25978943.
    Abstract:
    BACKGROUND: Attentional loadings have significant impacts on turning performance in individuals with stroke. Improper gait modification before turning may contribute to falls after stroke. Therefore, examination of the changes in temporal-spatial gait parameters before turning may reveal important deficits in gait control when stroke survivors are challenged by dual-tasking. OBJECTIVE: To compare the effects of 3 attentional loading conditions on spatial-temporal gait parameters before turning between stroke survivors and healthy control subjects. DESIGN: Case-control study design. SETTING: University motion analysis laboratory. PARTICIPANTS: Ten chronic stroke survivors (mean age = 49 ± 9 years) and 10 healthy control subjects (mean age = 53 ± 5 years) were included. METHODS: Spatial-temporal gait parameters were obtained by the use of a motion-capture system while participants performed the Timed-Up and Go (TUG) test under 3 attentional loading conditions: single, dual-motor, and dual-cognitive task conditions. A repeated-measure analysis of variance was used to analyze the data. MAIN OUTCOME MEASURES: We measured gait speed, stride length, and stride time during the straight walking phase (one gait cycle before turn) of the TUG test. RESULTS: We found that attentional loadings had a differential effect on gait speed measured for both groups (P = .001). The dual-motor and dual-cognitive task conditions led to a slower gait speed compared with the single-task condition in stroke survivors (both P = .02). However, in the TUG scores of healthy control subjects, only the dual-cognitive condition led to a significantly reduced gait speed compared with the single task condition (P = .001) and dual motor condition (P = .01). CONCLUSION: The results demonstrated that attentional loadings resulted in a greater deterioration of gait performance before turning in stroke survivors compared with healthy control subjects. Particularly, temporal gait parameter was more vulnerable to dual-task interference than the spatial gait parameter.
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