The Relationship Between Dual-Task Performance and Functional Independence in Stroke Patients

Öz

Purpose: Dual-task performance have a role in independent motor functions such as gait and balance. Although walking and balance parameters are important in functional independence, the level of independence is a complex condition affected by many factors. The aim of this cross-sectional study is to investigate the relationship between dual-task performance and functional independence levels in stroke patients. Material and Methods: 26 hemiplegic patients were included in this research in a tertiary healthcare institution. The participants’ independence levels were evaluated by the functional independence mesasure(FIM). Single task performance, motor dual-task performance, and cognitive dual-task performance were evaluated by calculating walking time in a 10-meter walking test. The relationship between dual-task interference and functional independence level was examined by Spearman correlation analysis. Results: The motor dual-task interference was found as 0.7 (0.0-0.26) and the cognitive dual-task interference was found as 0.19 (0.05-0.38). There was a negative, moderate, and statistically significant correlation between the FIM score and the motor dual-task interference (r = -0.48, p = 0.01). However, no significant correlation was detected between FIM score and cognitive dual-task interference (p = 0.16). Conclusion: The level of functional independence in stroke patients is associated with motor dual-task interference. Rehabilitation programs that improve dual-task performance can increase the functional independence levels of stroke patients.

Anahtar Kelimeler

• Stroke
• Dual-task
• Functional independence measure

Kaynakça

1. Utkan, A., Karatas, G. (2022). Effect of poststroke fatigue on physical functions, depression-anxiety and dunctional independence. Journal of Physical Medicine and Rehabilitation Sciences, 25(2), 173-80. https://dx.doi.org/ 10.31609/jpmrs.2021-85191.
2. Baek, C. Y., Yoon, H. S., Kim, et al. (2021). The effect of the degree of dual-task interference on gait, dual-task cost, cognitive ability, balance, and fall efficacy in people with stroke: a cross-sectional study. Medicine, 100(24), e26275. https://dx.doi.org/ 10.1097/MD.0000000000026275.
3. Bagheri, H., Khanmohammadi, R., Olyaei, et al. (2021). Video game and motor-cognitive dual-task training could be suitable treatments to improve dual-task interference in older adults. Neuroscience Letters, 760, 136099. https://dx.doi.org/ 10.1016/j.neulet.2021.136099.
4. Cakir, T., Sarier, R. N., Doğan, Ş. K., et al. (2015). Factors affecting the functional independence measure gain of patients with stroke. Turkish Journal of Physical Medicine & Rehabilitation/Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi, 61(1), 30-5. https://dx.doi.org/ 10.5152/tftrd.2015.78045.
5. Deblock-Bellamy, A., Lamontagne, A., Blanchette, A. K. (2020). Cognitive-locomotor dual-task interference in stroke survivors and the influence of the tasks: a systematic review. Frontiers in neurology, 11, 882. https://dx.doi.org/ 10.3389/fneur.2020.00882.
6. Feigin, V. L., Stark, B. A., Johnson, C. O., et al. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20(10), 795-820. https://dx.doi.org/ 10.1016/S1474-4422(21)00252-0.
7. Feld, J. A., Plummer, P. (2020). Patterns of cognitive-motor dual-task interference post stroke: an observational inpatient study at hospital discharge. European Journal of Physical and Rehabilitation Medicine, 57(3), 327-336. https://dx.doi.org/10.23736/S1973-9087.20.06273-5.
8. Feld, J. A., Zukowski, L. A., Howard, A. G., et al. (2018). Relationship between dual-task gait speed and walking activity poststroke. Stroke, 49(5), 1296-1298. https://dx.doi.org/ 10.1161/STROKEAHA.117.019694.

9. Hall, K. M., Hamilton, B. B., Gordon, W. A., et al. (1993). Characteristics and comparisons of functional assessment indices: disability rating scale, functional independence measure, and functional assessment measure. The Journal of Head Trauma Rehabilitation, 8(2), 60-74.
10. Krishnamurthi, R. V., Ikeda, T., Feigin, V. L. (2020). Global, regional and country-specific burden of ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage: a systematic analysis of the global burden of disease study 2017. Neuroepidemiology, 54(2), 171-179. https://dx.doi.org/ 10.1159/000506396
11. Küçükdeveci, A. A., Yavuzer, G., Elhan, A. H., et al. (2001). Adaptation of the Functional Independence Measure for use in Turkey. Clinical Rehabilitation, 15(3), 311-319. https://dx.doi.org/ 10.1191/026921501676877265.
12. Lin, J.-H., Hsiao, S.-F., Chang, C.-M., et al. (2000). Factors influencing functional independence outcome in stroke patients after rehabilitation. The Kaohsiung Journal of Medical Sciences, 16(7), 351-359.
13. Muci, B., Keser, I., Meric, A., et al. (2022). What are the factors affecting dual-task gait performance in people after stroke? Physiotherapy Theory and Practice, 38(5), 621-628. https://dx.doi.org/ 10.1080/09593985.2020.1777603.
14. Murillo-Garcia, A., Villafaina, S., Collado-Mateo, D., et al. (2021). Effect of dance therapies on motor-cognitive dual-task performance in middle-aged and older adults: a systematic review and meta-analysis. Disability and Rehabilitation, 43(22), 3147-3158. https://dx.doi.org/ 10.1080/09638288.2020.1735537.
15. Park, J. (2019). Dual Task training effects on upper extremity functions and performance of daily activities of chronic stroke patients. Osong Public Health and Research Perspectives, 10(1), 2-5. https://dx.doi.org/ 0.24171/j.phrp.2019.10.1.02. Stinear, C. M., Lang, C. E., Zeiler, S., et al. (2020). Advances and challenges in stroke rehabilitation. The Lancet Neurology, 19(4), 348-360. https://dx.doi.org/10.1016/S1474-4422(19)30415-6.
16. Tisserand, R., Armand, S., Allali, G., et al. (2018). Cognitive-motor dual-task interference modulates mediolateral dynamic stability during gait in post-stroke individuals. Human Movement Science, 58, 175-184. https://dx.doi.org/ 10.1016/j.humov.2018.01.012.
17. Tsang, C. S., Miller, T., Pang, M. Y. (2022). Association between fall risk and assessments of single-task and dual-task walking among community-dwelling individuals with chronic stroke: A prospective cohort study. Gait & Posture, 93, 113-118. https://dx.doi.org/ 10.1016/j.gaitpost.2022.01.019.
18. Tsang, C. S. L., Pang, M. Y. C. (2020). Association of subsequent falls with evidence of dual-task interference while walking in community-dwelling individuals after stroke. Clinical Rehabilitation, 34(7), 971-980. https://dx.doi.org/ 10.1177/0269215520923700.
19. Yang, L., He, C., Pang, M. Y. C. (2016). Reliability and validity of dual-task mobility assessments in people with chronic stroke. PLoS One, 11(1), e0147833. https://dx.doi.org/ 10.1371/journal.pone.0147833.
20. Yun, S. M., Lee, S. Y., Sohn, M. K., et al. (2020). Factors Associated with Changes in Functional Independence after Six Months of Ischemic Stroke. Brain & NeuroRehabilitation, 13(3), e19. https://dx.doi.org/10.12786/bn.2020.13.e19.