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Cognitive-motor dual-task interference modulates mediolateral dynamic stability during gait in post-stroke individuals

Tisserand, R
Published in Human Movement Science. 2018, vol. 58, p. 175-184
Abstract Gait asymmetry and dynamic balance impairments observed in post-stroke individuals increase their risk of fall. Moreover, walking while performing a cognitive task (i.e. dual-task) disturbs the control of balance in post-stroke individuals. Here we investigated the mediolateral dynamic stability in twenty-two community-dwelling participants (12 post-strokes and 10 healthy controls) while walking in single-task (normal gait) and four different dual-tasks (cognitive-motor interference). Positions of the extrapolated center of mass and mediolateral widths of both margin of stability and base of support were extracted from 35 marker trajectories. Post-stroke participants presented larger margin of stability and base of support than controls during single-task (both p < 0.01), with a larger margin of stability on the non-paretic side than on the paretic side at ipsilateral foot-strike (p < 0.05). No significant effect of the dual-task was found between groups. In post-stroke participants, dual-task induced slight modification of the mediolateral stability strategy, as the margin of stability was not different between the two limbs at foot-strike, and significantly reduced the performance in every cognitive task. Post-stroke participants increased their dynamic stability in the frontal plane in single-task by extending their base of support and mainly relying on their non-paretic limb. Under cognitive-motor interference (dual-task), post-stroke participants prioritized dynamic stability over cognitive performance to ensure a safe locomotion. Thus, rehabilitation programs should consider both dynamic balance and dual-task training, even at a chronic delay following stroke, to reduce the risk of fall in post-stroke individuals.
Keywords Dual-taskDynamic stabilityGaitHemiparesisStroke
PMID: 29448162
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Research group Laboratoire de cinésiologie (943)
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TISSERAND, R et al. Cognitive-motor dual-task interference modulates mediolateral dynamic stability during gait in post-stroke individuals. In: Human Movement Science, 2018, vol. 58, p. 175-184. https://archive-ouverte.unige.ch/unige:103520

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Deposited on : 2018-04-13

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