Effects Of Dual Task Training On Executive Function And Gait Of Hemiplegia Elderly With Cognitive Impairment

Objective: with the increase of age,the cognitive function of the elderly gradually degenerates;If combined with hemiplegia,the risk of cognitive impairment is higher,which has many adverse effects on the daily life of the elderly.The pace slows down,and many tasks in daily life,such as answering the phone while walking,cannot be completed smoothly.The purpose of this study is to choose a training mode close to daily life,that is,progressive resistance motor cognitive dual task training,and assist conventional rehabilitation training,and to explore the effects of conventional rehabilitation training and conventional rehabilitation training combined with progressive resistance motor cognitive dual task training on executive function and gait of the elderly with hemiplegia and cognitive impairment.Methods: according to the inclusion criteria,30 elderly patients with cognitive impairment with MOCA score less than 26 were randomly divided into experimental group and control group,with 15 patients in each group.The control group received40 minutes of routine rehabilitation training five times a week,and the experimental group received 30 minutes of progressive resistance motor cognitive dual task training five times a week on the basis of routine rehabilitation training.The executive function and gait were measured before and after the intervention.The executive function test adopts the multidimensional psychological system of Beijing Normal University to detect inhibition control,cognitive flexibility and working memory span,record the reaction time and accuracy,and calculate the standard score.The higher the score,the better the executive function.The step length test adopts the improved foot imprint method,and the step speed test adopts the 10 m walking test.Paired sample ttest was used for the comparison before and after the intervention in the group,and independent sample t-test was used for the comparison between the groups.The results represented by P < 0.05 had significant difference.Results:(1)Before the intervention,there was no significant difference in gait parameters such as age,MOCA score,executive function,inhibition control,cognitive flexibility,working memory span,step length and gait speed between the two groups(P > 0.05).(2)After the intervention,the step length,pace and inhibition control function of the control group were significantly improved(P < 0.05),and the other indexes had no significant difference compared with those before the intervention(P > 0.05).(3)After the intervention,the three subdimensions of executive function,step length and pace of the experimental group were significantly improved compared with those before the intervention(P < 0.05).(4)After the intervention,the improvement effects of inhibition control,working memory span,cognitive flexibility,step length and walking speed in the experimental group were better than those in the control group(P < 0.05).Conclusion:(1)Routine rehabilitation training and routine rehabilitation training combined with progressive resistance motor cognitive dual task training can improve the executive function and gait of elderly hemiplegic patients with cognitive impairment.(2)Progressive resistance motor cognitive dual task training can help to improve the executive function of all dimensions of elderly patients with cognitive impairment and hemiplegia,and improve their walking ability,which is better than routine rehabilitation training alone.