Effects Of Dual-task Walking Training On Motor And Cognitive Function In Stroke Patients

Objectives To explore the effects of dual-task walking training on motor function and cognitive function of stroke hemiplegic patients,so as to provide basis for clinical rehabilitation treatment of stroke.Methods Ninety hemiplegic patients with stroke who were hospitalized in Baoding Taihe Rehabilitation Hospital from October 2019 to October 2020 were randomly divided into control group(n=30),test group 1(n=30)and test group 2(n=30).All the patients in the three groups received routine rehabilitation training once a day,5 days a week for 4weeks.On this basis,the three groups received different ways of walking training with the same time and frequency,each training for 30 minutes,five times a week,for a total of 4weeks.Patients in the control group received walking training under a single task,patients in group 1 performed cognitive tasks from easy to difficult while walking,and patients in group 2 performed motor tasks from easy to difficult at the same time.According to the functional recovery of the patients,the difficulty of the task was gradually increased.The patients were evaluated by a professional who did not know the content of grouping and training before intervention,2 weeks after intervention and 4 weeks after intervention.The surface electromyography(s EMG)signals of rectus femoris,biceps femoris,tibialis anterior muscle and gastrocnemius muscle during isometric contraction of maximum impedance were recorded by s EMG acquisition system,and the integrated electromyogram(i EMG)and co-contraction rates(CR)of each muscle were professionally processed by the analysis system,and the balance and gait performance of patients were evaluated by performance oriented mobility assessment(POMA).The 10 m walk test(10MWT)was used to evaluate the walking speed and the cost of walking speed under single and dual tasks,and the ability of inhibition,refresh and conversion of executive function was evaluated by E-Prime software.Excel table was used to input data,and SPSS22.0statistical software was used to analyze the changes of evaluation indexes of patients in three groups before treatment,2 weeks and 4 weeks after treatment.Results 1 Before intervention,there was no significant difference in general data,motor and cognitive function among the three groups(P>0.05).2 After 2 weeks of intervention,the cost of cognitive-walking dual-task pace in group 1 was lower than that in group 2 and the control group,and the reaction time of Flanker task of patients in test groups were significantly lower than those in the control group(P<0.05).3 After 4 weeks of intervention,the i EMG value of the maximum isometric contraction of the rectus femoris in test groups was higher than that in the control group,and that of the tibialis anterior muscle in test group 2 was significantly higher than that in the test group 1 and the control group(P<0.05).The CR values of maximum isometric knee extension and ankle metatarsal flexion in test group 2 were lower than those in control group,and the CR values of maximum isometric dorsal extension in test group 2 were significantly lower than those in control group(P<0.05).The walking speed of cognitive-walking dual-task in test group 1 and 2 was higher than that in the control group,and the walking cost of exercise-walking dual-task was lower than that in the control group.The walking cost of cognitive-walking dual-task in group 1 was lower than that in group 2 and control group(P<0.05).The reaction time of Flanker task and More-odd shifting task in the test groups was shorter than that in the control group,and the reaction time of 1-back task in the test group 1 was shorter than that in the control group(P<0.05).4 Intra-group comparison of the three groups: the i EMG value and CR value of the affected lower limbs,POMA score,single-task and dual-task walking speed of 10 MWT,the reaction time of Flanker task and1-back task and More-odd shifting task in the three groups were better than those before intervention,and the differences between the two time points were statistically significant(P<0.05).The cost of dual-task speed of test group 1 and group 2 were lower than that before intervention,but the cost of dual-task speed of control group was higher than that before intervention(P<0.05).Conclusions Dual-task walking training can promote the recovery of motor and cognitive function in stroke patients with hemiplegia,and cognitive-walking dual-task training is more effective than exercise-walking dual-task training in reducing the cost of cognitive-walking dual-task walking in stroke patients.Figure 8;Table 11;Reference 162...