TY - JOUR
T1 - Association of subsequent falls with evidence of dual-task interference while walking in community-dwelling individuals after stroke
AU - Tsang, Charlotte Sau Lan
AU - Pang, Marco Yiu Chung
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Charlotte Tsang received a full-time PhD stuentship from the Hong Kong Polytechnic University (RUNV). This study was supported by a research grant provided to Marco Pang by the Reseach Grants Council (General Research Fund; 151594/16M).
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Charlotte Tsang received a full-time PhD stuentship from the Hong Kong Polytechnic University (RUNV). This study was supported by a research grant provided to Marco Pang by the Reseach Grants Council (General Research Fund; 151594/16M).
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objective: The aim of this study was to examine the fall predictive value of single-task walking tests and extent of interference observed in dual-task walking tests in ambulatory individuals post stroke. Design: This is an observational study with prospective cohort. Setting: The study was conducted at the university laboratory. Participants: A total of 91 community-dwelling individuals with chronic stroke participated in the study. Main outcome measures: Time required to complete a 10-m walk test with and without obstacle negotiation was measured in isolation and in conjunction with performance of a verbal fluency task (category naming). Fall incidence, circumstances, and related injuries were recorded by monthly telephone calls for 12 months. Results: A total of 91 individuals (mean (SD) age = 62.7 (8.3) years; mean (SD) post-stroke duration = 8.8 (5.3) years) participated in the study; 29 (32%) of them reported at least one fall during the follow-up period, with a total of 71 fall episodes. There was a significant difference in obstacle-crossing time under single-task (mean difference = 8.3 seconds) and dual-task (mean difference = 7.4 seconds) conditions, and also the degree of interference in mobility performance (increased dual-task obstacle-crossing time relative to the single-task obstacle-crossing time; mean difference = 3.3%) between the fallers and the non-fallers (P < 0.05). After adjusting for the effects of other relevant factors, a greater degree of interference in mobility performance remained significantly associated with a decreased risk of falling (adjusted odds ratio = 0.951, 95% CI = 0.907–0.997, P = 0.037). Conclusion: The degree of mobility interference during dual-task obstacle-crossing was the most effective in predicting falls among all the single-task and dual-task walking measure parameters tested. This simple dual-task walking assessment has potential clinical utility in identifying people post stroke at high risk of future falls.
AB - Objective: The aim of this study was to examine the fall predictive value of single-task walking tests and extent of interference observed in dual-task walking tests in ambulatory individuals post stroke. Design: This is an observational study with prospective cohort. Setting: The study was conducted at the university laboratory. Participants: A total of 91 community-dwelling individuals with chronic stroke participated in the study. Main outcome measures: Time required to complete a 10-m walk test with and without obstacle negotiation was measured in isolation and in conjunction with performance of a verbal fluency task (category naming). Fall incidence, circumstances, and related injuries were recorded by monthly telephone calls for 12 months. Results: A total of 91 individuals (mean (SD) age = 62.7 (8.3) years; mean (SD) post-stroke duration = 8.8 (5.3) years) participated in the study; 29 (32%) of them reported at least one fall during the follow-up period, with a total of 71 fall episodes. There was a significant difference in obstacle-crossing time under single-task (mean difference = 8.3 seconds) and dual-task (mean difference = 7.4 seconds) conditions, and also the degree of interference in mobility performance (increased dual-task obstacle-crossing time relative to the single-task obstacle-crossing time; mean difference = 3.3%) between the fallers and the non-fallers (P < 0.05). After adjusting for the effects of other relevant factors, a greater degree of interference in mobility performance remained significantly associated with a decreased risk of falling (adjusted odds ratio = 0.951, 95% CI = 0.907–0.997, P = 0.037). Conclusion: The degree of mobility interference during dual-task obstacle-crossing was the most effective in predicting falls among all the single-task and dual-task walking measure parameters tested. This simple dual-task walking assessment has potential clinical utility in identifying people post stroke at high risk of future falls.
KW - cognition
KW - Dual-task interference
KW - falls
KW - stroke
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=85085518997&partnerID=8YFLogxK
U2 - 10.1177/0269215520923700
DO - 10.1177/0269215520923700
M3 - Journal article
C2 - 32460556
AN - SCOPUS:85085518997
SN - 0269-2155
VL - 34
SP - 971
EP - 980
JO - Clinical Rehabilitation
JF - Clinical Rehabilitation
IS - 7
ER -