Interference Between Cognition, Double-Limb Support, and Swing During Gait in Community-Dwelling Individuals Poststroke

Abstract

Background. Dual tasking can interfere with activity after stroke. Objective. The authors examined the interactions between 3 different cognitive tasks and the swing and double-limb support (DLS) components of the gait cycle in community-dwelling individuals poststroke. Methods. Acquisition of cognitive and gait data were synchronized to study the cognitive—motor interference effects during the different phases of the gait cycle. Participants performed 3 different cognitive tasks in isolation and in combination with walking as well as a single walking task. Tasks were performed continuously for 3 minutes, generating 131 ± 39 gait cycles per person for analysis for each walking trial. Data were analyzed for 8 participants 7.6 ± 4.2 months poststroke. Results. A significant increase was found in the proportion of the gait cycle spent in DLS in dual-task walking because of an increased duration of the DLS phase associated with paretic weight acceptance. There was a significant dual-task effect on nonparetic swing duration: participants reduced the amount of time in paretic single-limb stance in the 3 dual-task conditions. Temporal asymmetry of gait did not increase significantly under dual-task conditions. Reaction times were not affected by whether the stimuli were present during the swing or DLS phase of the gait cycle. Conclusions. The findings from this pilot study provide evidence that cognitive—motor interference during gait may be influenced by the phase of the gait cycle, especially DLS involving paretic weight acceptance, which may affect community ambulators with hemiparetic stroke.