Article

OBJECTIVES: To evaluate fall risk in stroke patients based on single- and
dual-task gait analyses, and to investigate the difference between 2 cognitive
tasks in the dual-task paradigm. DESIGN: Prospective cohort study. SETTING:
Rehabilitation hospitals. PARTICIPANTS: Subacute stroke patients (N=32), able to
walk without physical/manual help with or without walking aids, while performing
a verbal task. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Functional
gait measures were Functional Ambulation Categories (FAC) and use of a walking
aid. Gait measures were evaluated by an electronic walkway system under single-
and dual-task (DT) conditions. For the single-task, subjects were instructed to
walk at their usual speed. One of the DTs was a verbal fluency dual task, whereby
subjects had to walk while simultaneously enumerating as many different animals
as possible. For the other DT (counting dual task), participants had to walk
while performing serial subtractions. After inclusion, participants kept a
6-month falls diary. RESULTS: Eighteen (56.3%) of the 32 included patients fell.
Ten (31.3%) were single fallers (SFs), and 8 (25%) were multiple fallers (MFs).
Fallers (Fs) more frequently used a walking aid and more frequently needed an
observatory person for walking safely (FAC score of 3) than nonfallers (NFs). Two
gait decrement parameters in counting dual task could distinguish potential Fs
from NFs: decrement in stride length percentage (P=.043) and nonparetic step
length percentage (P=.047). Regarding the division in 3 groups (NFs, SFs, and
MFs), only MFs had a significantly higher percentage of decrement for paretic
step length (P=.023) than SFs. CONCLUSIONS: Examining the decrement of spatial
gait characteristics (stride length and paretic and nonparetic step length)
during a DT addressing working memory can identify fall-prone subacute stroke
patients.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS