Abstract
Descending stairs demands attention and neuromuscular control, especially with dual-tasking. Studies have demonstrated that stroke often degrades a survivor's ability to descend stairs. Tai Chi has been shown to improve dual-tasking performance of healthy older adults, but no such study has been conducted in stroke survivors. This study investigated the effect of Tai Chi training on dual-tasking performance that involved stepping down and compared it with that of conventional exercise among stroke survivors. Subjects were randomized into Tai Chi (n = 9), conventional exercise (n = 8), and control (n = 9) groups. Those in the former two groups received 12-week training. Assessments included auditory Stroop test, stepping down test, and dual-tasking test involving both simultaneously. They were evaluated before training (time-1), after training (time-2), and one month after training (time-3). Tai Chi group showed significant improvement in the auditory Stroop test from time-1 to time-3 and the performance was significantly better than that of the conventional exercise group in time-3. No significant effect was found in the stepping down task or dual-tasking in the control group. These results suggest a beneficial effect of Tai Chi training on cognition among stroke survivors without compromising physical task performance in dual-tasking. The effect was better than the conventional exercise group. Nevertheless, further research with a larger sample is warranted.
Highlights
Falling on the stairs, especially in descending, could result in severe injuries [1, 2] or even death [3]
Three of the subjects in the conventional exercise group proved unable to perform the stepping down test due to fear of falling (n = 2) or knee pain (n = 1) during the assessment, so there were only five subjects in that group
The stroke survivors showed a significant increase in their average composite score on the cognitive task in dual-tasking after 12 weeks of Tai Chi training
Summary
Especially in descending, could result in severe injuries [1, 2] or even death [3]. It involves cognition and attention to evaluate the configuration of the stairs and to integrate information from various sensory systems [1, 2, 4]. A previous study has demonstrated altered foot clearance when stepping down among healthy older adults using a Stroop test [5]. Another study found that, when compared with single-tasking, older adults made more errors in an auditory Stroop test when stepping down [6]. It has been suggested that attentional distraction is one of the most common situations in which stair-related falls occur [7]
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