Functional Recovery And Corticospinal Tract Changes In Stroke Patients After Dual Task Training

Objectives:(1)A clinical randomized controlled trial of dual-task training and single-task training for patients with subacute stroke,comparing the improvement of cognitive,balance,and motor functions of the two groups of patients.(2)Fiber assignment continuous tracking was used to reconstruct the bilateral corticospinal Fiber bundles of patients in the two groups.Quantitative analysis of corticospinal tract before and after dual-task training to evaluate fractional anisotropy,mean diffusivity,axial diffusivity,radial diffusivity,changes in the length and number of CST.Methods:A total of 30 patients with subacute stroke who were eligible for inpatient and outpatient department in the rehabilitation and medical department of the Second Affiliated Hospital of Kunming Medical University from April 2018 to January 2020 were collected for 3 weeks of training and randomly assigned to the experimental group 15 cases Two-task rehabilitation training was performed,and 15 patients in the control group underwent single-task rehabilitation training and corresponding clinical function assessment.Diffusion Tensor Imaging scans were performed on 8 patients with stroke in the experimental group before and after dual task rehabilitation.Seven patients in the control group underwent DTI scans before and after single task training.The main assessment scales include:Mini-Mental State Examination(MMSE),Berg Balance Scale(BBS),Fug-Meyer assessment(FMA),and improvement Subjects were assessed by the Modified Barthel Index(MBI)and the Hamilton Depression Scale(HAMD).DTI is used to describe the changes in CST before and after treatment of subjects,and valuable information about subject's functional recovery is provided through multiple DTI parameters and clinical function assessment scores.Results:1.After 3 weeks of dual-task training,compared with before and after treatment,the cognitive,balance,motor function,living ability,and depression were significantly improved(p<0.05).Compared with the control group,the balance function of the experimental group was significantly improved after dual-task training(p<0.001),the improvement of motor function and living ability was statistically significant(p<0.05),and the improvement of cognitive function and depression level was not statistically significant Significance(p>0.05).2.The five subjects in the experimental group had statistically significant balance function,motor function,living ability,and depression level before treatment(p<0.05),and no significant change in cognitive function(p>0.05).CST's DTI data results are displayed.Before treatment and after treatment,the FA value of the healthy side and the affected side,the length and number of CST were significantly different(p<0.05),and the MD,AD and RD values of the healthy side and the affected side were There was no statistical significance before and afier treatment(p>0.05).The differences in the length and number of corticospinal fiber in the affected side after treatment were statistically significant(p<0.05),while the differences in FA,MD,AD and RD in the healthy side and the affected side after treatment were not statistically significant(p>0.05).Conclusions:1.Dual task training for patients with subacute stroke can effectively improve the patients' balance,exercise and daily activities.and the effect is better than single task training.2.Dual-task training has caused plastic changes in the corticospinal tract of patients with subacute stroke.Long-term follow-up requires dynamic observation to conclude.