Impact of Walking Speed on Risk of Fall among Stroke Patients assessed using Cognitive Motor Dual Task: A Cross-sectional Study

Abstract

Introduction: Fall is a common complication of stroke. People must use both their higher cognitive abilities and their motor skills simultaneously in everyday situations. Falling is much more likely to occur when performing multiple tasks requires continuous attention. Implementing a Cognitive Motor Dual Task (CMDT) might give more accurate information regarding how stroke survivors function throughout daily activities. Aim: To identify the walking speed in stroke patients using CMDT and to determine the impact of walking speed on risk of fall. Materials and Methods: In this cross-sectional study, 23 Middle Cerebral Artery (MCA) stroke patients with and without the risk of fall according to morse fall scale were included from Justice KS Hedge Charitable Hospital, Mangaluru, Karnataka, India from March 2023 to March 2024. After which the selected participants performed CMDT, the step count and time taken to complete the test was recorded using a pedometer and stop watch, the total and correct number of cognitive responses was recorded manually. The walking speed was calculated in m/sec. Based on the outcome measures of the present study; the statistical analysis was performed. Data collected was analysed by using the Statistical Package for the Social Sciences (SPSS) software version 29.0. To compare the data Independent sample t-test, One-way Analysis of Variance (ANOVA) was used. Results: The study participants consisted of an average age of 54.6±14.8 years. Individuals categorised as low-risk exhibited a mean walking speed of 0.238±0.014 m/sec, while those in the moderate risk group had a mean walking speed of around 0.211±0.024 m/sec and individuals at high-risk showed a lower mean walking speed of approximately 0.177±0.020 m/sec. The statistical analysis revealed a significant difference in walking speeds among the risk groups, with an F-value of 15.486 and a p-value less than 0.001. Conclusion: The study showed that walking speed will impact the risk of fall in stroke patients while performing CMDT. The time and step count are more in patients with high fall risk compared to patients with low fall risk therefore, walking speed is reduced in patients with high-risk of fall.

Keywords

• cognition
• gait
• motor activity
• pedometer
• risk assessment