Dual-Task Demands of Hand Movements for Adults with Stroke: A Pilot Study

Abstract

For adults with stroke, walking while performing a cognitive task can be challenging, resulting in slower walking, poorer cognitive performance, or decreased performance on both tasks. It is not known if dual-task deficits are also present for upper limb movements for adults with stroke. Purpose: To determine if unilateral movements of the affected and less affected hand are compromised when walking or talking. Methods: Nineteen community-dwelling adults with stroke were video- and audiotaped while performing in single- and dual-task conditions. Tasks included repeated, rhythmic hand movements with the affected and less affected hand, walking a narrow pathway, and speaking. For dual-task conditions, movements of each hand were done while walking and while talking. The rate of hand movement, cadence, and speech rate were analyzed using repeated measures analyses of variance. Results: Affected hand movement rate was the same for single- and dual-task conditions. The rate of less affected hand movement was affected by dual-task conditions; this was due to an increase in hand movement rate while talking. Examination of cadence and speech rates revealed that cadence was decreased when moving the affected hand. Speech rate increased when accompanied by hand movements, but post hoc analyses were not significant. Conclusion: For those with stroke, dual-task deficits are seen with slower walking while moving the affected hand. In contrast, hand movements while speaking may have a more complex relationship, with possible faster speech rates in dual-task conditions.