Abstract
Cognitive-motor interference may contribute to the risk of falling in people with stroke, as may be the associated phenomenon of inappropriate task prioritization. Examining dual-task walking could provide valuable insights as to how to best evaluate and treat walking in people with stroke. This study aimed to examine the effect of different walking environments on cognitive-motor interference and task prioritization in dual-task walking in people with stroke. Using a repeated-measures design, cognitive-motor interference and task prioritization were assessed in 30 stroke survivors, while walking in a plain environment and in two challenging environments that were enriched with either stationary physical context or suddenly appearing projector-augmented context. All three walking environment conditions were performed with and without a concurrent serial-3 subtraction task. We found stronger cognitive-motor interference for the two challenging environments than for the plain walking environment. Cognitive-motor interference did not differ between challenging walking environments, but task prioritization did: motor performance was prioritized more in the environment with physical context than in the environment with projector-augmented context and vice versa for cognitive-task performance. In conclusion, walking environment strongly influenced cognitive-motor interference and task prioritization during dual-task walking in people with stroke.
Highlights
Walking is a semiautomatic activity that is often combined with talking, calling, texting, and other attentiondemanding activities
The aim of the present study was to examine the effect of walking environment on cognitive-motor interference and task prioritization in dual-task walking in people with stroke without constraining walking speed
The aim of this study was to assess the effect of walking environment on cognitive-motor interference and task prioritization in dual-task walking in people with stroke
Summary
Walking is a semiautomatic activity that is often combined with talking, calling, texting, and other attentiondemanding activities. Combining walking with concurrent cognitive tasks will typically degrade overall task performance (i.e., cognitive and motor performances combined), as evidenced by a lower walking speed, poorer walking-adaptability performance (e.g., obstacle avoidance), and/or poorer cognitive-task performance. This reduction in overall task performance during dualtask walking is called cognitive-motor interference [1,2,3]. For people with stroke this has been examined in laboratory treadmill studies, where an obstacle-avoidance task was performed with and without an attention-demanding cognitive task [8, 9]. Wooden obstacles were suddenly presented under high time-pressure demands
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