Article

Stroke patients are at a higher risk of falling than the community-dwelling
elderly, and many falls are due to contact with an obstacle.
This study compared
the effects of the simultaneous addition of a cognitive task during obstacle
crossing between stroke patients and community-dwelling older adults (control
subjects). Participants comprised 20 stroke patients who could walk with or
without supervision and 20 control subjects matched for age and height with the
stroke patients. Participants were asked to cross a 4-cm-high obstacle while
walking at a self-selected speed. The number of failures and the spatial and
temporal parameters were compared between a single-task condition (i.e., crossing
task only) and a dual-task condition (i.e., verbal fluency task: listing
vegetables or animals). Under the dual-task condition, six stroke patients (30%)
and three community-dwelling elderly individuals (15%) failed to complete the
motor task. Task failure was only due to heel-obstacle contact after toe
clearance. In both groups, obstacle-heel distance after clearance was reduced,
and the time from heel contact to toe clearance and stride time were
significantly increased under dual-task condition versus single-task condition.
In addition, group-task interaction for the time from heel contact to toe
clearance of the obstacle was significant; this increase in time was
significantly greater under dual-task condition in stroke patients than in
control subjects. Obstacle crossing in stroke patients involved an increase in
crossing performance time and a risk of heel-obstacle contact after crossing.
These tendencies appeared stronger under the dual-task condition.

Langue : ANGLAIS