Araştırma Makalesi
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The Efficacy of Dual Task Activity In Stroke Patients

Yıl 2020, Cilt: 15 Sayı: 3, 60 - 68, 16.10.2020
https://doi.org/10.17517/ksutfd.743895

Öz

Purpose: To investigate the effect of dual task activity on function and quality of life in stroke patients
Material and Methods: 20 years and older forty (n=40) stroke patients were included in the study. Group 1 (n:20) patients were given conventional exercise therapy (static, dynamic balance exercises and gait training) 45 minutes a week for 4 weeks. Group 2 (n: 20) patients were given conventional exercise and verbal fluency and mathematics problems were applied concurrently. The demographic data of the patients were recorded and 6-minute walk test, functional ambulatory scale (FAS), Rivermead mobility index, mini-mental test, stroke-specific quality of life scale, National Institutes of Health Stroke Scale (NIHSS) was evaluated before and after 4 weeks of rehabilitation program.
Results: There was statistically significant difference in the study group (group 2); after rehabilitation; upper (p<0.01), hand (p<0.01), lower (p<0.01) extremity Brunnstrom staging, stroke quality of life (p<0.01), FAS (p=0.02), Rivermead mobility index (p<0.01), 6 min walking distance (p<0.01) and mini mental test (p<0.01) were statistically significant. In the control group after rehabilitation; there was statistically significant difference in upper (p=0.01), hand (p=0.01), lower (p<0.01) extremity Brunnstrom staging, stroke quality of life (p=0.01), NIHHS (p=0.01), Rivermead mobility index (p<0.01), 6 min walking distance (p<0.01) and minimental test (p=0.04). In the study and control groups all parameters compared before and after the treatment and results were similar. Results of both groups were similar after the treatment program.
Conclusion: Dual task exercise has a positive effect on functional level, quality of life and mental status in stroke patients and has no superiority over conventional treatments. It may be preferred for neurorehabilitation in stroke patients.

Kaynakça

  • Beyazova M, Kutsal YG, Aydın G, Çapacı K, Göğüş F, Gündüz H ve ark. Fiziksel Tıp ve Rehabilitasyon 2. Basım, cilt 2, Güneş Tıp Kitapevi, Ankara, 2011, s:2761-87
  • Alawieha A, Zhaod J, Feng W. Actors affecting post-stroke motor recovery: Implications on neurotherapy after brain injury. Behav Brain Res. 2018;340:94–101.
  • Frontera WR, Delisa JA, Gans BM, Walsh NE, Robınson LR. Delısa Fiziksel Tıp ve Rehabilitasyon İlkeler ve Uygulamalar (çev:Arasıl T, Eskiyurt N), Güneş Tıp Kitabevi, Ankara, 2014, s:551-71,
  • Silpupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under single and dual-task conditions in older adults with balance impairment. Phys Ther. 2006; 86:269-81.
  • Kim HD, Brunt D. The effect of a dual-task on obstacle crossing in healthy elderly and young adults. Arch Phys Med Rehabil 2007;88:1309-13.
  • Martın IB. Current tanı ve tedavi Fiziksel Tıp ve Rehabilitasyon (Çev: Ketenci A, Evcik D, Çetin A, Şendur ÖF), Ema Tıp Kitapevi, İstanbul, 2016, s:209-36
  • Debbie Rand; Daniel Gottlieb; Patrice L. (Tamar) Weiss. Recovery of Patients with a Combined Motor and Proprioception Deficit During the First Six Weeks of Post Stroke Rehabilitation. Physical & Occupational Therapy In Geriatrics 2001;18(3):69 – 87
  • Tacchino A, Veldkamp R, Coninx K, Brulmans J, Palmaers S, Hämäläinen P, et al. Design, Development, and Testing of an App for Dual-Task Assessment and Training Regarding Cognitive-Motor Interference (CMI-APP) in People With Multiple Sclerosis: Multicenter Pilot Study. JMIR Mhealth Uhealth. 2020;8(4):e15344. doi: 10.2196/15344.
  • Batum M, Ak AK, Yılmaz H. The Relationship of Stroke and Sleep- A Review. Journal of Turkish Sleep Medicine 2017;4:95-103
  • Oğuz H, Dursun E, Dursun N. Tıbbı Rehabilitasyon.1. basım, Nobel Tıp Kitapevi, İstanbul, 2004, s: 589-617
  • Akın. B, Emiroğlu O. N. Rivermead mobilite indeksi (RM) Türkçe formunun yaşlılarda geçerlilik ve güvenliliği Turk Jour Geriatr 2007;10(3):124-13
  • Patomella AH, Mälstam E, Eriksson C, Bergström A, Åkesson E, Kottorp A, et al. Primary prevention of stroke: randomised controlled pilot trial protocol on engaging every day activities promoting health. BMJ Open 2019; 9:e031984. doi:10.1136/bmjopen-2019- 031984
  • Tamam B, Taşdemir N, Tamam Y. İnme sonrası demans: sıklığı ve risk faktörleri Türk Psik Derg 2008;19(1):46-56
  • Topçu S, Oğuz S. Efficacy and quality of life after stroke Journal of Human Sciences 2017;14(2):1388-1396.
  • Akdeniz D, Em S, Çağlayan M, Bozkurt M, Oktayoğlu P, Karakoç M ve ark. İnmeli hastalarda uyku kalitesi ve ilişkili faktörlerin değerlendirilmesi Fırat Tıp Derg 2015;20(2):86-91
  • Cüngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini MentalTest’in Türk Toplumunda Hafif Demans Tanısında Geçerlik ve Güvenirliliği. Turk Psik Derg 2002; 13(4):273-281
  • Ünver E, Alpan ŞC. Ergenlik Öncesi Erkek Çocuklarda Fiziksel Aktivite Düzeyinin 6 Dakika Yürüme Testi İle İlişkisi Hacettepe Spor Bilim Derg 2017;28(4):194–204.
  • Park JH. Dual Task Training Effects on Upper Extremity Functions and Performance of Daily Activities of Chronic Stroke Patients Osong Public Health Res Perspect 2019;10(1):2-5
  • Yang YR, Wang RY, Chen YC, Kao MJ. Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil 2007;88:1236-40.
  • Bowen A, Wenman R, Mickelborough J et al. Dual-task effects of talking while walking on velocity and balance following a stroke. Age Ageing 2001;30(4):319-23.
  • Regnaux JP, David D, Daniel O, Smail DB, Combeaud M, Bussel B.. Evidence for cognitive processes involved in the control of steady state of walking in healthy subjects and after cerebral damage. Neuro Rehabil Neural Repair 2005;19(2):125-32.
  • Pellecchia GL. Dual-task training reduce simpact of cognitive task on posturals way. J Mot Behav 2005;37(3):239-46.
  • Manaf H, Justine M, Omar M. Functional balanceand motor impairment correlations with gait parameters during time dupandgo test across three attentional loading conditions in stroke survivors. Stroke Res and Treat 2014;439304:1-9.doi: 10.1155/2014/439304
  • Yogev G, Hausdorff JM, Giladi N. The role of Executive function and attention in gait. NIH public Access 2008;23(3):329-342.
  • Pan X. L. Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident. Medicine (Baltimore) 2018;97(2):e9544
  • Yokoyama H, Okazaki K, Imai Dİ, Yamashina Y, Takeda R, Nooshin N, Ota A et all. The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial. BMC Geriatr 2015;15:60.
  • Nascimento C, Ayan C, Lirani-Silva E, Montes L, Cancela J. Physical Exercises and Functional Mobility in Single and Dual-Task in the Elderly: Relation ship with Cognitive Function. Austin Alzheimers J Parkinsons Dis 2016;3(1):1025.
  • Yang YR, Wang RY, Chen YC, Kao MJ. Dual-Task Exercise Improves Walking Ability in Chronic Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil 2007;88:1236-40.
  • Liu YC, Yang YR, Tsai YA, Wang RY. Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial . Sci Rep. 2017;7(1):4070.
  • Elhinidi E. I. M. , Ismaeel M. M. I. , and El-Saeed T. M. Effect of dual-task training on postural stability in children with infantile hemiparesi, J Phys Ther Sci 2016;28:875–880
  • Hanneke JR, Van D, Heeren A, Peters MAM, Veerbeek JM, Kwakkel G et al . Effects of Exercise Therapy on Balance Capacity in Chronic Stroke Systematic Review and Meta-Analysis Stroke 2016;47:2603-2610.

İnme Hastalarında Çift Yönlü Görev Aktivitesinin Etkinliği

Yıl 2020, Cilt: 15 Sayı: 3, 60 - 68, 16.10.2020
https://doi.org/10.17517/ksutfd.743895

Öz

Amaç: İnmeli hastalarda çift yönlü görev aktivitesinin fonksiyon ve yaşam kalitesi üzerine etkisini araştırmak.
Gereç ve Yöntem: Çalışmaya 20 yaş üzeri kırk (n=40) inmeli hasta dahil edildi. Çalışma grubu ve kontrol grubu olarak belirlendi. Grup 1 (n:20) hastalara konvansiyonel egzersiz tedavisi (statik, dinamik denge egzersizleri ve yürüme eğitimi) 4 haftalık 45'şer dakika verilirken grup 2’deki (n:20) hastalara konvansiyonel egzersiz ile eş zamanlı; sözel akıcılık ve matematik problemleri uygulandı. Hastaların demografik verileri kaydedildi ve rehabilitasyon programına başlamadan önce ve 4 haftalık rehabilitasyon programını aldıktan sonra 6 dakika yürüme testi, fonksiyonel ambulasyon skala (FAS), Rivermead mobilite indeksi, mini mental test, inmeye özgü yaşam kalitesi ölçeği, Ulusal Sağlık İnme Enstitüsü Skalası (NIHSS) inme skalası ölçeği değerlendirildi.
Bulgular: Çalışma grubundaki hastaların (grup2) tedavi sonrasında; üst (p<0.01), el (p<0.01), alt (p<0.01) ekstremite Brunnstrom evrelendirmesinde, stroke yaşam kalitesinde (p<0.01), FAS (p=0.02), Rivermead mobilite indeksi (p<0.01), 6 dk yürüme mesafesi (p<0.01) ve mini mental testte (p=0.01) istatistiksel olarak anlamlı iyileşme gözlemlenmiştir. Kontrol (grup 1) grubunda ise tedavi sonrasında; üst (p=0.01), el (0.01), alt ekstremite (p<0.01) Brunnstrom evrelendirmesinde, stroke yaşam kalitesinde (NIHSS) (p=0.01), Rivermead mobilite indeksi (p<0.01), 6 dk yürüme mesafesi (p<0.01) ve mini mental testte (p=0.04) istatistiksel olarak anlamlı farklılık gözlemlenmiştir. Çalışma ve kontrol grubu tedavi protokolü öncesi ve sonrası tüm parametreler kendi arasında karşılaştırıldığında benzer sonuçlar elde edildi. Buna göre tedavi öncesi fonksiyonel ve yaşam kalitesini gösteren parametreler her iki grupta benzerdi. Tedavi programı sonrası da her iki grup sonuçları benzer bulundu.
Sonuç: Çift yönlü görev egzersizi inmeli hastalarda fonksiyonel düzey, yaşam kalitesi ve mental duruma olumlu etkisi olup, konvansiyonel tedavilere üstünlüğü yoktur. İnmeli hastalarda nörorehabilitasyonda tercih edilebilir.

Kaynakça

  • Beyazova M, Kutsal YG, Aydın G, Çapacı K, Göğüş F, Gündüz H ve ark. Fiziksel Tıp ve Rehabilitasyon 2. Basım, cilt 2, Güneş Tıp Kitapevi, Ankara, 2011, s:2761-87
  • Alawieha A, Zhaod J, Feng W. Actors affecting post-stroke motor recovery: Implications on neurotherapy after brain injury. Behav Brain Res. 2018;340:94–101.
  • Frontera WR, Delisa JA, Gans BM, Walsh NE, Robınson LR. Delısa Fiziksel Tıp ve Rehabilitasyon İlkeler ve Uygulamalar (çev:Arasıl T, Eskiyurt N), Güneş Tıp Kitabevi, Ankara, 2014, s:551-71,
  • Silpupadol P, Siu KC, Shumway-Cook A, Woollacott MH. Training of balance under single and dual-task conditions in older adults with balance impairment. Phys Ther. 2006; 86:269-81.
  • Kim HD, Brunt D. The effect of a dual-task on obstacle crossing in healthy elderly and young adults. Arch Phys Med Rehabil 2007;88:1309-13.
  • Martın IB. Current tanı ve tedavi Fiziksel Tıp ve Rehabilitasyon (Çev: Ketenci A, Evcik D, Çetin A, Şendur ÖF), Ema Tıp Kitapevi, İstanbul, 2016, s:209-36
  • Debbie Rand; Daniel Gottlieb; Patrice L. (Tamar) Weiss. Recovery of Patients with a Combined Motor and Proprioception Deficit During the First Six Weeks of Post Stroke Rehabilitation. Physical & Occupational Therapy In Geriatrics 2001;18(3):69 – 87
  • Tacchino A, Veldkamp R, Coninx K, Brulmans J, Palmaers S, Hämäläinen P, et al. Design, Development, and Testing of an App for Dual-Task Assessment and Training Regarding Cognitive-Motor Interference (CMI-APP) in People With Multiple Sclerosis: Multicenter Pilot Study. JMIR Mhealth Uhealth. 2020;8(4):e15344. doi: 10.2196/15344.
  • Batum M, Ak AK, Yılmaz H. The Relationship of Stroke and Sleep- A Review. Journal of Turkish Sleep Medicine 2017;4:95-103
  • Oğuz H, Dursun E, Dursun N. Tıbbı Rehabilitasyon.1. basım, Nobel Tıp Kitapevi, İstanbul, 2004, s: 589-617
  • Akın. B, Emiroğlu O. N. Rivermead mobilite indeksi (RM) Türkçe formunun yaşlılarda geçerlilik ve güvenliliği Turk Jour Geriatr 2007;10(3):124-13
  • Patomella AH, Mälstam E, Eriksson C, Bergström A, Åkesson E, Kottorp A, et al. Primary prevention of stroke: randomised controlled pilot trial protocol on engaging every day activities promoting health. BMJ Open 2019; 9:e031984. doi:10.1136/bmjopen-2019- 031984
  • Tamam B, Taşdemir N, Tamam Y. İnme sonrası demans: sıklığı ve risk faktörleri Türk Psik Derg 2008;19(1):46-56
  • Topçu S, Oğuz S. Efficacy and quality of life after stroke Journal of Human Sciences 2017;14(2):1388-1396.
  • Akdeniz D, Em S, Çağlayan M, Bozkurt M, Oktayoğlu P, Karakoç M ve ark. İnmeli hastalarda uyku kalitesi ve ilişkili faktörlerin değerlendirilmesi Fırat Tıp Derg 2015;20(2):86-91
  • Cüngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini MentalTest’in Türk Toplumunda Hafif Demans Tanısında Geçerlik ve Güvenirliliği. Turk Psik Derg 2002; 13(4):273-281
  • Ünver E, Alpan ŞC. Ergenlik Öncesi Erkek Çocuklarda Fiziksel Aktivite Düzeyinin 6 Dakika Yürüme Testi İle İlişkisi Hacettepe Spor Bilim Derg 2017;28(4):194–204.
  • Park JH. Dual Task Training Effects on Upper Extremity Functions and Performance of Daily Activities of Chronic Stroke Patients Osong Public Health Res Perspect 2019;10(1):2-5
  • Yang YR, Wang RY, Chen YC, Kao MJ. Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil 2007;88:1236-40.
  • Bowen A, Wenman R, Mickelborough J et al. Dual-task effects of talking while walking on velocity and balance following a stroke. Age Ageing 2001;30(4):319-23.
  • Regnaux JP, David D, Daniel O, Smail DB, Combeaud M, Bussel B.. Evidence for cognitive processes involved in the control of steady state of walking in healthy subjects and after cerebral damage. Neuro Rehabil Neural Repair 2005;19(2):125-32.
  • Pellecchia GL. Dual-task training reduce simpact of cognitive task on posturals way. J Mot Behav 2005;37(3):239-46.
  • Manaf H, Justine M, Omar M. Functional balanceand motor impairment correlations with gait parameters during time dupandgo test across three attentional loading conditions in stroke survivors. Stroke Res and Treat 2014;439304:1-9.doi: 10.1155/2014/439304
  • Yogev G, Hausdorff JM, Giladi N. The role of Executive function and attention in gait. NIH public Access 2008;23(3):329-342.
  • Pan X. L. Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident. Medicine (Baltimore) 2018;97(2):e9544
  • Yokoyama H, Okazaki K, Imai Dİ, Yamashina Y, Takeda R, Nooshin N, Ota A et all. The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid β peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial. BMC Geriatr 2015;15:60.
  • Nascimento C, Ayan C, Lirani-Silva E, Montes L, Cancela J. Physical Exercises and Functional Mobility in Single and Dual-Task in the Elderly: Relation ship with Cognitive Function. Austin Alzheimers J Parkinsons Dis 2016;3(1):1025.
  • Yang YR, Wang RY, Chen YC, Kao MJ. Dual-Task Exercise Improves Walking Ability in Chronic Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil 2007;88:1236-40.
  • Liu YC, Yang YR, Tsai YA, Wang RY. Cognitive and motor dual task gait training improve dual task gait performance after stroke - A randomized controlled pilot trial . Sci Rep. 2017;7(1):4070.
  • Elhinidi E. I. M. , Ismaeel M. M. I. , and El-Saeed T. M. Effect of dual-task training on postural stability in children with infantile hemiparesi, J Phys Ther Sci 2016;28:875–880
  • Hanneke JR, Van D, Heeren A, Peters MAM, Veerbeek JM, Kwakkel G et al . Effects of Exercise Therapy on Balance Capacity in Chronic Stroke Systematic Review and Meta-Analysis Stroke 2016;47:2603-2610.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Derya Tuba Bal 0000-0002-1963-8368

Tuba Koca 0000-0002-4596-858X

Ejder Berk 0000-0002-0816-0960

Burhan Fatih Koçyiğit 0000-0002-6065-8002

Vedat Nacitarhan 0000-0003-1756-8615

Yayımlanma Tarihi 16 Ekim 2020
Gönderilme Tarihi 4 Haziran 2020
Kabul Tarihi 26 Haziran 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 15 Sayı: 3

Kaynak Göster

AMA Bal DT, Koca T, Berk E, Koçyiğit BF, Nacitarhan V. İnme Hastalarında Çift Yönlü Görev Aktivitesinin Etkinliği. KSÜ Tıp Fak Der. Ekim 2020;15(3):60-68. doi:10.17517/ksutfd.743895