Cargando…
Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial
OBJECTIVE: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. DESIGN: A secondary analysis of a trial of dual-task (DT) and sing...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524683/ https://www.ncbi.nlm.nih.gov/pubmed/34053250 http://dx.doi.org/10.1177/02692155211017360 |
_version_ | 1784585528112316416 |
---|---|
author | Collett, Johnny Fleming, Melanie K Meester, Daan Al-Yahya, Emad Wade, Derick T Dennis, Andrea Salvan, Piergiorgio Meaney, Andrew Cockburn, Janet Dawes, Joanna Johansen-Berg, Heidi Dawes, Helen |
author_facet | Collett, Johnny Fleming, Melanie K Meester, Daan Al-Yahya, Emad Wade, Derick T Dennis, Andrea Salvan, Piergiorgio Meaney, Andrew Cockburn, Janet Dawes, Joanna Johansen-Berg, Heidi Dawes, Helen |
author_sort | Collett, Johnny |
collection | PubMed |
description | OBJECTIVE: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. DESIGN: A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s(−1), n = 21) and limited (walking speed <0.79 m s(−1), n = 24) capacity at baseline. SETTING: Community. SUBJECTS: Adults six-months post stroke with walking impairment. INTERVENTIONS: Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. MAIN MEASURES: A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. fNIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an fMRI sub-study used ankle-dorsiflexion to simulate walking. RESULTS: ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). fNIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). fMRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. CONCLUSION: In individual who walk slowly it may be difficult to improve dual-task walking ability. Registration: ISRCTN50586966 |
format | Online Article Text |
id | pubmed-8524683 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-85246832021-10-20 Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial Collett, Johnny Fleming, Melanie K Meester, Daan Al-Yahya, Emad Wade, Derick T Dennis, Andrea Salvan, Piergiorgio Meaney, Andrew Cockburn, Janet Dawes, Joanna Johansen-Berg, Heidi Dawes, Helen Clin Rehabil Evaluative Studies OBJECTIVE: To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability. DESIGN: A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s(−1), n = 21) and limited (walking speed <0.79 m s(−1), n = 24) capacity at baseline. SETTING: Community. SUBJECTS: Adults six-months post stroke with walking impairment. INTERVENTIONS: Twenty sessions of 30 minutes treadmill walking over 10 weeks with (DT) or without (ST) cognitive distraction. Good and limited groups were formed regardless of intervention received. MAIN MEASURES: A two-minute walk with (DT) and without (ST) a cognitive distraction assessed walking. fNIRS measured prefrontal cortex activation during treadmill walking with (DT) and without (ST) Stroop and planning tasks and an fMRI sub-study used ankle-dorsiflexion to simulate walking. RESULTS: ST walking improved in both groups (∆baseline: Good = 8.9 ± 13.4 m, limited = 5.3±8.9 m, Group × time = P < 0.151) but only the good walkers improved DT walking (∆baseline: Good = 10.4 ± 13.9 m, limited = 1.3 ± 7.7 m, Group × time = P < 0.025). fNIRS indicated increased ispilesional prefrontal cortex activation during DT walking following intervention (P = 0.021). fMRI revealed greater DT cost activation for limited walkers, and increased resting state connectivity of contralesional M1 with cortical areas associated with conscious gait control at baseline. After the intervention, resting state connectivity between ipsilesional M1 and bilateral superior parietal lobe, involved in integrating sensory and motor signals, increased in the good walkers compared with limited walkers. CONCLUSION: In individual who walk slowly it may be difficult to improve dual-task walking ability. Registration: ISRCTN50586966 SAGE Publications 2021-05-30 2021-11 /pmc/articles/PMC8524683/ /pubmed/34053250 http://dx.doi.org/10.1177/02692155211017360 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Evaluative Studies Collett, Johnny Fleming, Melanie K Meester, Daan Al-Yahya, Emad Wade, Derick T Dennis, Andrea Salvan, Piergiorgio Meaney, Andrew Cockburn, Janet Dawes, Joanna Johansen-Berg, Heidi Dawes, Helen Dual-task walking and automaticity after Stroke: Insights from a secondary analysis and imaging sub-study of a randomised controlled trial |
title | Dual-task walking and automaticity after Stroke: Insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
title_full | Dual-task walking and automaticity after Stroke: Insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
title_fullStr | Dual-task walking and automaticity after Stroke: Insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
title_full_unstemmed | Dual-task walking and automaticity after Stroke: Insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
title_short | Dual-task walking and automaticity after Stroke: Insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
title_sort | dual-task walking and automaticity after stroke: insights from a
secondary analysis and imaging sub-study of a randomised controlled
trial |
topic | Evaluative Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524683/ https://www.ncbi.nlm.nih.gov/pubmed/34053250 http://dx.doi.org/10.1177/02692155211017360 |
work_keys_str_mv | AT collettjohnny dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT flemingmelaniek dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT meesterdaan dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT alyahyaemad dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT wadederickt dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT dennisandrea dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT salvanpiergiorgio dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT meaneyandrew dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT cockburnjanet dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT dawesjoanna dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT johansenbergheidi dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial AT daweshelen dualtaskwalkingandautomaticityafterstrokeinsightsfromasecondaryanalysisandimagingsubstudyofarandomisedcontrolledtrial |