Zhongguo quanke yixue (Nov 2023)
Effect of Dual Task on Walking Ability in Posterior Circulation Ischemic Stroke Patients with Vestibular Symptoms
Abstract
Background Posterior circulation ischemic stroke patients with vestibular symptoms usually do not present with obvious limb paralysis with certain walking ability after improvement of dizziness and vertigo symptoms, however, their fall risk is high and clinical attention to walking ability is lacking. Functional assessment using dual-task paradigms can better detect potential gait abnormalities in patients and provide a basis for early rehabilitation intervention. Objective To investigate the effect of dual task on walking ability of posterior circulation ischemic stroke patients with vestibular symptoms. Methods Forty patients diagnosed with posterior circulation ischemic stroke accompanied by vestibular symptoms and treated at Tianjin Huanhu Hospital from 2021 to 2022 were selected as the study subjects. Gait parameters including gait speed, step frequency, step size, proportion of double support phase time, step duration, trunk coronal plane and sagittal plane swing angles were collected using single-task walking, motor-motor dual-task walking, and cognitive-motor dual-task walking paradigms. The differences in gait parameters among the three task conditions and the differences in dual-task costs between the two dual-task walking. Results Compared to single-task walking, the trunk coronal plane and sagittal plane swing angles were decreased in patients during motor-motor dual-task walking (P<0.05) ; the gait speed was increased, proportion of double support phase time and trunk coronal plane swing angle were increased in patients during cognitive-motor dual-task walking (P<0.05). Compared to motor-motor dual-task walking, the dual-task costs of cognitive-motor dual-task walking in terms of gait speed, step size and the proportion of double support phase time were increased (P<0.05) . Conclusion Dual task leads to decreased gait stability in posterior circulation ischemic stroke patients with vestibular symptoms. Additionally, cognitive-motor dual-task walking requires more attentional resources and is more likely to result in gait disturbances compared to motor-motor dual-task walking.
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