What are the factors affecting dual-task gait performance in people after stroke?

BACKGROUND: People after stroke have difficulties when they undertaking two tasks simultaneously. PURPOSES: To investigate the relationships between dual-task performance and factors such as motor function, balance, cognitive state, and fatigue, to identify factors that have an impact on dual-task performance after a stroke. METHODS: Thirty-seven people with stroke and 38 healthy participants were assessed with 10-m walking test in different performances which were single-task-based, motor dual-task-based and cognitive dual-task-based. Results were evaluated according to the Rivermead Motor Assessment, the Static balance index, the Mini-Mental State Examination, and the Fatigue Severity Scale. RESULTS: Participants with stroke were slower compared to the control group with the following mean speed values for single-task (M = 0.73 m/s, t = -7.612, p < .001), motor dual-task (M = 0.70 m/s, t = -8.232, p < .001), cognitive dual-task (M = 0.59 m/s, t = -7.944, p < .001). For people after stroke, motor dual-task performance was significantly affected by the total motor function scores (r = 0.648, p < .001), static balance (r = -0.499, p < .05), and fatigue rates (r = -0.349, p < .05). Furthermore, cognitive dual-task performance was affected by the total motor function score (r = 0.537, p < .05) static balance (r = -0.541, p < .05) and fatigue rates (r = -0.350), p < .05). Multivariate factor analysis indicated that impairment in the gross function influenced motor dual-task performance (B = 0.086, p = .031) and cognitive dual-task performance (B = 0.083, p = .010). Cognitive dual-task performance was affected by leg-trunk function (B = 0.063, p = .015) and age (B = -0.006, p = .009). CONCLUSION: The present study indicated that dual-task performance was related to motor function, balance, and fatigue, whereas gross motor function was the unique determinant of dual-task performance.

The Effect of Virtual Reality Exercises on Pain, Functionality, Cardiopulmonary Capacity, and Quality of Life in Fibromyalgia Syndrome: A Randomized Controlled Study.

Objective: To investigate the effect of motion-controlled videogames on pain, functionality, cardiopulmonary capacity, and quality of life in women with fibromyalgia. Materials and Methods: Forty women with fibromyalgia were randomized into virtual reality group (VRG) and conventional training group (CTG). The CTG performed aerobic exercise (cycling, 3 days per week, 20 minutes per day) and conventional exercises (muscle strengthening, balance, and flexibility, 3 days per week, 15 minutes per day) for 4 weeks. The VRG performed virtual reality exercise (volleyball, Microsoft Xbox Kinect®, 3 days per week, 15 minutes per day) together with cycling exercise for 4 weeks. After the exercise program, both groups received the same home exercise program for 4 weeks. All patients were evaluated at baseline, fourth, and eighth weeks. Primary outcome measure was Fibromyalgia Impact Questionnaire. Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale, Fatigue Severity Scale (FSS), Symptom Severity Scale, EuroQol-Five Dimensions Index Scale/Visual Analogue Scale (EQ-5D-index/VAS) and Six Minute Walk Test (6MWT) were used as secondary outcome measures. Results: Thirty-four patients (17 VRG, 17 CTG) were evaluated at the eighth week. After 4 weeks, all outcome measures improved significantly in both groups (P < 0.05). However, there was no statistically significant difference in all outcome measures between fourth and eighth weeks. Group and time interactions for 6MWT (P = 0.043), FSS (P = 0.026), EQ-5D-Index Scale (P = 0.014), and EQ-5D-VAS (P = 0.049) were significant only for the VRG. In addition, median individual's satisfaction was significantly higher in the VRG (P < 0.001). Conclusion: Virtual reality exercises along with aerobic exercise increase cardiopulmonary capacity and quality of life in fibromyalgia syndrome. In addition, they increase patient satisfaction and may improve patient compliance to exercise.