Charlotte Sau-Lan Tsang1, Shuting Wang2, Tiev Miller1, Marco Yiu-Chung Pang3. 1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. 2. School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong. 3. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. Electronic address: marco.pang@polyu.edu.hk.
Abstract
QUESTIONS: What are the degree and pattern of dual-task interference during walking in people after stroke? How do these vary with disease chronicity and different component tasks in people after stroke? How does dual-task interference differ between people after stroke and people without stroke? DESIGN: Systematic review with meta-analysis of studies reporting gait-related dual-task interference. PARTICIPANTS: People after stroke and people without stroke. OUTCOME MEASURES: Measures of walking and secondary (cognitive or manual) task performance under dual-task conditions relative to those under single-task conditions. RESULTS: Seventy-six studies (2,425 people after stroke and 492 people without stroke) were included. Manual and mental tracking tasks imposed the greatest dual-task interference on gait speed, although there was substantial uncertainty in these estimates. Among mental tracking tasks, the apparently least-complex task (serial 1 subtractions) induced the greatest dual-task interference (-0.17 m/s, 95% CI -0.24 to -0.10) on gait speed, although there was substantial uncertainty in these estimates. Mutual interference (decrement in both walking and secondary component task performances during dual-tasking) was the most common dual-task interference pattern. The results of the sensitivity analyses for studies involving people with chronic stroke were similar to the results of the primary analyses. The amount of dual-task interference from a mental tracking or manual task during walking was similar between people with or without stroke. CONCLUSIONS: The degree and pattern of dual-task interference vary with the choice of component tasks. When evaluating limitations to functional mobility during dual-tasking conditions and in planning interventions accordingly, clinicians should select dual-task assessments that correspond to the daily habits and physical demands of people after stroke. REGISTRATION: CRD42017059004.
QUESTIONS: What are the degree and pattern of dual-task interference during walking in people after stroke? How do these vary with disease chronicity and different component tasks in people after stroke? How does dual-task interference differ between people after stroke and people without stroke? DESIGN: Systematic review with meta-analysis of studies reporting gait-related dual-task interference. PARTICIPANTS: People after stroke and people without stroke. OUTCOME MEASURES: Measures of walking and secondary (cognitive or manual) task performance under dual-task conditions relative to those under single-task conditions. RESULTS: Seventy-six studies (2,425 people after stroke and 492 people without stroke) were included. Manual and mental tracking tasks imposed the greatest dual-task interference on gait speed, although there was substantial uncertainty in these estimates. Among mental tracking tasks, the apparently least-complex task (serial 1 subtractions) induced the greatest dual-task interference (-0.17 m/s, 95% CI -0.24 to -0.10) on gait speed, although there was substantial uncertainty in these estimates. Mutual interference (decrement in both walking and secondary component task performances during dual-tasking) was the most common dual-task interference pattern. The results of the sensitivity analyses for studies involving people with chronic stroke were similar to the results of the primary analyses. The amount of dual-task interference from a mental tracking or manual task during walking was similar between people with or without stroke. CONCLUSIONS: The degree and pattern of dual-task interference vary with the choice of component tasks. When evaluating limitations to functional mobility during dual-tasking conditions and in planning interventions accordingly, clinicians should select dual-task assessments that correspond to the daily habits and physical demands of people after stroke. REGISTRATION: CRD42017059004.