Dual-tasking postural control in patients with right brain damage

Gait Posture. 2014 Jan;39(1):188-93. doi: 10.1016/j.gaitpost.2013.07.002. Epub 2013 Jul 31.

Abstract

The control of dual-tasking effects is a daily challenge in stroke neurorehabilitation. It maybe one of the reasons why there is poor functional prognosis after a stroke in the right hemisphere, which plays a dominant role in posture control. The purpose of this study was to explore cognitive motor interference in right brain-lesioned and healthy subjects maintaining a standing position while performing three different tasks: a control task, a simple attentional task and a complex attentional task. We measured the sway area of the subjects on a force platform, including the center of pressure and its displacements. Results showed that stroke patients presented a reduced postural sway compared to healthy subjects, who were able to maintain their posture while performing a concomitant attentional task in the same dual-tasking conditions. Moreover, in both groups, the postural sway decreased with the increase in attentional load from cognitive tasks. We also noticed that the stability of stroke patients in dual-tasking conditions increased together with the weight-bearing rightward deviation, especially when the attentional load of the cognitive tasks and lower limb motor impairments were high. These results suggest that stroke patients and healthy subjects adopt a similar postural regulation pattern aimed at maintaining stability in dual-tasking conditions involving a static standing position and different attention-related cognitive tasks. Our results indicate that attention processes might facilitate static postural control.

Keywords: Attentional tasks; Dual-tasking; Postural control; Standing; Stroke.

MeSH terms

  • Adult
  • Aged
  • Attention / physiology*
  • Female
  • Gait / physiology*
  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / physiopathology*
  • Gait Disorders, Neurologic / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Postural Balance / physiology*
  • Stroke / complications
  • Stroke / physiopathology*
  • Stroke Rehabilitation
  • Task Performance and Analysis