Name: Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients (Video) | JoVE Journal
Uploaded: 2021-03-11T15:00:00.000+00:00
Duration: 5 min 23 s
Description: Learn motor dual-task gait analysis for post-stroke rehabilitation using 3D kinematic assessment and DTC calculations. This protocol evaluates trunk and pelvic rotation changes to improve clinical diagnosis and targeted rehabilitation strategies.

ai_agent_IP

ai_agent

maintenance

instantTrialDurationMinutes

isBiopharma

enableNewMyJoveSectionDesign

educationFeatures

seoMetaApi

ai_copilot_institution_blacklist

ai_chat_institution_blacklist

freeAccessWindow

ssoRoleCapture

scheduledMaintenanceBanner

joveLabsFeatures

disable_autoplay_for_bots

extended_trial_duration

5 minutes

We thank Anniwaer Yilifate for proofreading our manuscript. This study was supported by the National Science Foundation under Grant No. 81902281 and No. 82072544, the General Guidance Project of Guangzhou Health and Family Planning Commission under Grant No. 20191A011091 and No. 20211A011106, the Guangzhou Key Laboratory Fund under Grant No. 201905010004 and Guangdong Basic and Applied Basic Research Foundation under Grant No.2020A1515010578.

NOTE: The clinical study was approved by the Medical Ethics Association of the Fifth Affiliated Hospital of Guangzhou Medical University (NO. KY01-2019-02-27) and has been registered at the China Clinical Trial Registration Center (No. ChiCTR1800017487 and entitled, &#34;The multiple modal tasks on gait control and motor cognition after stroke&#34;).
1. Recruitment
<ol>
	<li>Recruit stroke patients with the following inclusion criteria: patients meeting the diagnostic criteria for cerebrovascular disease of the Neurological Branch of the Chinese Medical Association (2005); cerebral infarction confirmed by computed tomography or magnetic resonance imaging; damage to the unilateral cortex or with a subcortical lesion; ability to walk independently, Brunnstrom stage &#8805; 4 stages; Modified Ashworth Scale11&#160;&#8804; 2 points; meeting the requirements of three-dimensional (3D) gait analysis and the ability to tolerate the whole process; and the ability to give informed consent.</li>
	<li>Ensure the following exclusion criteria are met: congestive heart failure, deep vein thrombosis of the lower extremities, malignant progressive hypertension, respiratory failure or other diseases, and serious risk of falling.</li>
	<li>Obtain written informed consent from all patients before beginning the study.</li>
</ol>
2. Clinical evaluation
<ol>
	<li>Record the demographic characteristics of the patient including the name, gender, date of birth, level of education, chief complaint, current medical history, past history, medical treatment, and current medications.</li>
	<li>Cognitive function assessment
	<ol>
		<li>Ask the patient to complete the Mini-Mental State Examination (MMSE)12 record the patient&#39;s responses to a 30-question scale with a total score of 30 points for cognition evaluation, which involves the following seven aspects: time orientation, position orientation, instant memory, attention and computing power, delayed memory, language, and visual space. 
		&#8203;NOTE: The scores of MMSE are closely related to the level of education. The normal cognitive standard is illiteracy &#62; 17 points, primary school &#62; 20 points, and junior high school &#62; 24 points13.</li>
		<li>Ask the patient to complete the Montreal Cognitive Assessment (MoCA)14 record the patient&#39;s responses to an 11-question scale with a total score of 30 points for cognition evaluation, which involves the following eight aspects: attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation, and orientation. 
		&#8203;NOTE: The normal cognitive standard is &#8805; 26 points. If the subject has been educated for less than 12 years, they should add 1 point to the score15.</li>
	</ol>
	</li>
	<li>Walking ability assessment
	<ol>
		<li>Conduct the 10-m walk test (10 MWT)16. Ask the patient to perform three consecutive trials at a self-selected pace for safety, comfort, and higher speed, respectively. Record the time taken to walk to the middle 6 m in each trial (to exclude acceleration and deceleration effects).</li>
		<li>Conduct the timed up and go test (TUGT)17. Ask the patient to perform three consecutive TUG trials (stand up, walk 3 m, turn, walk back, and sit down) at a self-selected pace for safety and comfort18.</li>
	</ol>
	</li>
</ol>
3. 3D gait analysis
<ol>
	<li>Patient preparation
	<ol>
		<li>Inform the patient about the precautions and the purpose of the experiment.</li>
		<li>Ask the patient to wear tight underwear to fully expose the neck, shoulders, waist, and lower limbs.</li>
		<li>Record the values of various anthropometric indicators including height, weight, bilateral width of the ankle joints, bilateral knee diameter, pelvic width, bilateral pelvic depth, and bilateral leg length.</li>
		<li>Place 22 markers on key points of the patient based on the Davis protocol19: three markers on the trunk (7th cervical vertebrae, shoulders on both sides); three markers on the pelvis (both sides of the anterior superior iliac spine&#160;and ankle joint); six markers on the thigh (bilateral femoral greater trochanter, femoral condyle, and middle point of femoral greater trochanter and femoral condyle on the same side); six markers on the calf (bilateral humeral head, lateral ankle joint, and middle point of humeral head and lateral ankle joint on the same side); four markers on the foot (the fifth metatarsal head and the heel on both sides) (Figure 1).</li>
		<li>Click on the Start button of the 3D gait analysis system, and make a new profile for the patient.</li>
		<li>Enter basic patient information and previously measured parameters.</li>
	</ol>
	</li>
	<li>Standing data acquisition
	<ol>
		<li>Instruct the patient to maintain an upright position on the force plate for at least 3-5 s to gather the baseline data.</li>
		<li>Click on the Proc_Davis_Standing button to quickly check the position of the marker.</li>
	</ol>
	</li>
	<li>Walking task data acquisition
	<ol>
		<li>Determine the random order of three walking tasks by drawing lots.</li>
		<li>Ask the patient to walk on the walking pass for five trials at a self-selected comfortable speed, which is marked as Task 0 (consider the single walking task as the Baseline task).</li>
		<li>Ask the patient to walk while holding a bottle of water on the walking pass for five trials at a self-selected comfortable speed, which is marked as Task 1 (simple dual-motor task). 
		NOTE: Ask the patient to hold a 550 mL bottle of water in the unaffected hand while holding the arm position of the shoulder joint at 0&#176; and elbow flexion at 90&#176;.</li>
		<li>Ask the patient to walk across the line in the middle of the walking pass for five trials at a self-selected comfortable speed, which is marked as Task 2 (complex dual-motor task). 
		&#8203;NOTE: Place a soft ruler in the middle of the walking pass before Task 2 data acquisition.</li>
	</ol>
	</li>
</ol>
4. Data processing and analysis
<ol>
	<li>Select the middle three trials of each walking task to be processed to ensure the patient is stable.</li>
	<li>Identify each gait cycle with two consecutive heel stride points on the same side.</li>
	<li>Mark the toe-off point in each gait cycle20.</li>
	<li>Click on the Proc_DavisHeel+GI_AE button to compute the kinematic parameters of gait, as well as the computation of the Gait Performance Score (GPS) index.</li>
</ol>
5. Data extraction and statistical analysis of interest
<ol>
	<li>Select region of interest parameters from the processed data, which include special-temporary parameters (stance phase, swing phase, single stance, double stance, cadence), joint angle parameters (trunk obliquity (frontal plane), trunk tilt (sagittal plane), trunk rotation (transversal plane), pelvic obliquity (frontal plane), pelvic tilt (sagittal plane), pelvic rotation (transversal plane), hip flex-extension, hip ab-adduction, hip rotation, knee flex-extension, ankle dorsi-plantarflexion, and GPS index.</li>
	<li>Calculate DTC values based on the following formula[10]: 
	([single-task gait velocity - dual-task gait velocity]/ single-task gait velocity) &#215; 100 (1)</li>
	<li>Perform the statistical analysis (see the Table of Materials) using the methodology described previously20,21.
	<ol>
		<li>Present parametric data as means and standard deviation if normally distributed or as medians if not.</li>
		<li>Use the paired t-test to compare the differences in kinematic parameters between patients in Task 1 and Task 2 conditions.</li>
		<li>Use one-way analysis of variance to compare three different tasks (Task 0, Task 1, and Task 2) of the kinematic parameters. Set statistical significance at P &#60; 0.05.</li>
	</ol>
	</li>
</ol>

<ol><li>Cho, K. H., Kim, M. K., Lee, H. -J., Lee, W. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Virtual+reality+training+with+cognitive+load+improves+walking+function+in+chronic+stroke+patients%5BTitle%5D)+AND+%22The+Tohoku+Journal+of+Experimental+Medicine%22%5BJournal%5D)">Virtual reality training with cognitive load improves walking function in chronic stroke patients.</a> The Tohoku Journal of Experimental Medicine. 236 (4), 273-280 (2015).</li>
<li>Delavaran, H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Cognitive+function+in+stroke+survivors%3A+A+10-year+follow-up+study%5BTitle%5D)+AND+%22Acta+Neurologica+Scandinavica%22%5BJournal%5D)">Cognitive function in stroke survivors: A 10-year follow-up study.</a> Acta Neurologica Scandinavica. 136 (3), 187-194 (2017).</li>
<li>Zhang, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+effects+of+transcranial+direct+current+stimulation+versus+electroacupuncture+on+working+memory+in+healthy+subjects%5BTitle%5D)+AND+%22Journal+of+Alternative+and+Complementary+Medicine%22%5BJournal%5D)">The effects of transcranial direct current stimulation versus electroacupuncture on working memory in healthy subjects.</a> Journal of Alternative and Complementary Medicine. 25 (6), 637-642 (2019).</li>
<li>Pin-Barre, C., Laurin, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Physical+exercise+as+a+diagnostic%2C+rehabilitation%2C+and+preventive+tool%3A+influence+on+neuroplasticity+and+motor+recovery+after+stroke%5BTitle%5D)+AND+%22Neural+Plasticity%22%5BJournal%5D)">Physical exercise as a diagnostic, rehabilitation, and preventive tool: influence on neuroplasticity and motor recovery after stroke.</a> Neural Plasticity. 2015, 608581(2015).</li>
<li>Auvinet, B., Touzard, C., Montestruc, F., Delafond, A., Goeb, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Gait+disorders+in+the+elderly+and+dual+task+gait+analysis%3A+a+new+approach+for+identifying+motor+phenotypes%5BTitle%5D)+AND+%22Journal+of+Neuroengineering+and+Rehabilitation%22%5BJournal%5D)">Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.</a> Journal of Neuroengineering and Rehabilitation. 14 (1), 7(2017).</li>
<li>Tramontano, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Maintaining+gait+stability+during+dual+walking+task%3A+effects+of+age+and+neurological+disorders%5BTitle%5D)+AND+%22European+Journal+of+Physical+and+Rehabilitation+Medicine%22%5BJournal%5D)">Maintaining gait stability during dual walking task: effects of age and neurological disorders.</a> European Journal of Physical and Rehabilitation Medicine. 53 (1), 7-13 (2017).</li>
<li>Sakurai, R., Bartha, R., Montero-Odasso, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Entorhinal+cortex+volume+is+associated+with+dual-task+gait+cost+among+older+adults+with+MCI%3A+results+from+the+gait+and+brain+study%5BTitle%5D)+AND+%22The+Journals+of+Gerontology.+Series+A%2C+Biological+Sciences+and+Medical+Sciences%22%5BJournal%5D)">Entorhinal cortex volume is associated with dual-task gait cost among older adults with MCI: results from the gait and brain study.</a> The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 74 (5), 698-704 (2019).</li>
<li>Howcroft, J., Lemaire, E. D., Kofman, J., McIlroy, W. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Dual-task+elderly+gait+of+prospective+fallers+and+non-fallers%3A+a+wearable-sensor+based+analysis%5BTitle%5D)+AND+%22Sensors%22%5BJournal%5D)">Dual-task elderly gait of prospective fallers and non-fallers: a wearable-sensor based analysis.</a> Sensors. 18 (4), 1275(2018).</li>
<li>Fernandez-Gonzalez, P., Molina-Rueda, F., Cuesta-Gomez, A., Carratala-Tejada, M., Miangolarra-Page, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Instrumental+gait+analysis+in+stroke+patients%5BTitle%5D)+AND+%22Revista+de+Neurologia%22%5BJournal%5D)">Instrumental gait analysis in stroke patients.</a> Revista de Neurologia. 63 (10), 433-439 (2016).</li>
<li>Montero-Odasso, M. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Association+of+dual-task+gait+with+incident+dementia+in+mild+cognitive+impairment%3A+results+from+the+gait+and+brain+study%5BTitle%5D)+AND+%22JAMA+Neurology%22%5BJournal%5D)">Association of dual-task gait with incident dementia in mild cognitive impairment: results from the gait and brain study.</a> JAMA Neurology. 74 (7), 857-865 (2017).</li>
<li>Bohannon, R. W., Smith, M. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Interrater+reliability+of+a+modified+Ashworth+scale+of+muscle+spasticity%5BTitle%5D)+AND+%22Physical+Therapy%22%5BJournal%5D)">Interrater reliability of a modified Ashworth scale of muscle spasticity.</a> Physical Therapy. 67 (2), 206-207 (1987).</li>
<li>Llamas-Velasco, S., Llorente-Ayuso, L., Contador, I., Bermejo-Pareja, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Spanish+versions+of+the+Minimental+State+Examination+%28MMSE%29.+Questions+for+their+use+in+clinical+practice%5BTitle%5D)+AND+%22Revista+de+Neurologia%22%5BJournal%5D)">Spanish versions of the Minimental State Examination (MMSE). Questions for their use in clinical practice.</a> Revista de Neurologia. 61 (8), 363-371 (2015).</li>
<li>Yoelin, A. B., Saunders, N. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Score+disparity+between+the+MMSE+and+the+SLUMS%5BTitle%5D)+AND+%22American+Journal+of+Alzheimer%27s+Disease+and+Other+Dementias%22%5BJournal%5D)">Score disparity between the MMSE and the SLUMS.</a> American Journal of Alzheimer's Disease and Other Dementias. 32 (5), 282-288 (2017).</li>
<li>Julayanont, P., Brousseau, M., Chertkow, H., Phillips, N., Nasreddine, Z. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Montreal+Cognitive+Assessment+Memory+Index+Score+%28MoCA-MIS%29+as+a+predictor+of+conversion+from+mild+cognitive+impairment+to+Alzheimer%27s+disease%5BTitle%5D)+AND+%22Journal+of+the+American+Geriatrics+Society%22%5BJournal%5D)">Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease.</a> Journal of the American Geriatrics Society. 62 (4), 679-684 (2014).</li>
<li>Carson, N., Leach, L., Murphy, K. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+re-examination+of+Montreal+Cognitive+Assessment+%28MoCA%29+cutoff+scores%5BTitle%5D)+AND+%22International+Journal+of+Geriatric+Psychiatry%22%5BJournal%5D)">A re-examination of Montreal Cognitive Assessment (MoCA) cutoff scores.</a> International Journal of Geriatric Psychiatry. 33 (2), 379-388 (2018).</li>
<li>Peters, D. M., Fritz, S. L., Krotish, D. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Assessing+the+reliability+and+validity+of+a+shorter+walk+test+compared+with+the+10-Meter+Walk+Test+for+measurements+of+gait+speed+in+healthy%2C+older+adults%5BTitle%5D)+AND+%22Journal+of+Geriatric+Physical+Therapy%22%5BJournal%5D)">Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults.</a> Journal of Geriatric Physical Therapy. 36 (1), 24-30 (2013).</li>
<li>Podsiadlo, D., Richardson, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+timed+%22Up+%26+Go%22%3A+a+test+of+basic+functional+mobility+for+frail+elderly+persons%5BTitle%5D)+AND+%22Journal+of+the+American+Geriatrics+Society%22%5BJournal%5D)">The timed "Up & Go": a test of basic functional mobility for frail elderly persons.</a> Journal of the American Geriatrics Society. 39 (2), 142-148 (1991).</li>
<li>Lin, Q., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Quantitative+static+and+dynamic+assessment+of+balance+control+in+stroke+patients%5BTitle%5D)+AND+%22Journal+of+Visualized+Experiments%3A+JoVE%22%5BJournal%5D)">Quantitative static and dynamic assessment of balance control in stroke patients.</a> Journal of Visualized Experiments: JoVE. (159), e60884(2020).</li>
<li>Davis, R. B., Ounpuu, S., Tyburski, D., Gage, J. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+gait+analysis+data+collection+and+reduction+technique%5BTitle%5D)+AND+%22Human+Movement+Science%22%5BJournal%5D)">A gait analysis data collection and reduction technique.</a> Human Movement Science. 10 (5), 575-587 (1991).</li>
<li>Liang, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+lower+body+positive+pressure+treadmill+for+knee+osteoarthritis+rehabilitation%5BTitle%5D)+AND+%22Journal+of+Visualized+Experiments%3A+JoVE%22%5BJournal%5D)">The lower body positive pressure treadmill for knee osteoarthritis rehabilitation.</a> Journal of Visualized Experiments: JoVE. (149), e59829(2019).</li>
<li>Liang, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+effect+of+anti-gravity+treadmill+training+for+knee+osteoarthritis+rehabilitation+on+joint+pain%2C+gait%2C+and+EMG%3A+Case+report%5BTitle%5D)+AND+%22Medicine+%28Baltimore%29%22%5BJournal%5D)">The effect of anti-gravity treadmill training for knee osteoarthritis rehabilitation on joint pain, gait, and EMG: Case report.</a> Medicine (Baltimore). 98 (18), 15386(2019).</li>
<li>Balaban, B., Tok, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Gait+disturbances+in+patients+with+stroke%5BTitle%5D)+AND+%22PM+%26+R%3A+The+Journal+of+Injury%2C+Function%2C+and+Rehabilitation%22%5BJournal%5D)">Gait disturbances in patients with stroke.</a> PM & R: The Journal of Injury, Function, and Rehabilitation. 6 (7), 635-642 (2014).</li>
<li>Li, M., Xu, G., Xie, J., Chen, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((A+review%3A+Motor+rehabilitation+after+stroke+with+control+based+on+human+intent%5BTitle%5D)+AND+%22Proceedings+of+the+Institute+of+Mechanical+Engineers.+Part+H%2C+Journal+of+Engineering+in+Medicine%22%5BJournal%5D)">A review: Motor rehabilitation after stroke with control based on human intent.</a> Proceedings of the Institute of Mechanical Engineers. Part H, Journal of Engineering in Medicine. 232 (4), 344-360 (2018).</li>
<li>Bloem, B. R., Valkenburg, V. V., Slabbekoorn, M., Willemsen, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((The+Multiple+Tasks+Test%3A+development+and+normal+strategies%5BTitle%5D)+AND+%22Gait+Posture%22%5BJournal%5D)">The Multiple Tasks Test: development and normal strategies.</a> Gait Posture. 14 (3), 191-202 (2001).</li>
<li>Montero-Odasso, M., Muir, S. W., Speechley, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Dual-task+complexity+affects+gait+in+people+with+mild+cognitive+impairment%3A+the+interplay+between+gait+variability%2C+dual+tasking%2C+and+risk+of+falls%5BTitle%5D)+AND+%22Archives+of+Physical+Medicine+and+Rehabilitation%22%5BJournal%5D)">Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual tasking, and risk of falls.</a> Archives of Physical Medicine and Rehabilitation. 93 (2), 293-299 (2012).</li>
<li>Selvaraj, U. M., Poinsatte, K., Torres, V., Ortega, S. B., Stowe, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/pubmed?term=((Heterogeneity+of+B+cell+functions+in+stroke-related+risk%2C+prevention%2C+injury%2C+and+repair%5BTitle%5D)+AND+%22Neurotherapeutics%22%5BJournal%5D)">Heterogeneity of B cell functions in stroke-related risk, prevention, injury, and repair.</a> Neurotherapeutics. 13 (4), 729-747 (2016).</li>
</ol>

The authors have nothing to disclose.

This study describes a protocol for the clinical assessment of dual motor task gait analysis in stroke patients with motor control deficits. The design of this protocol was based on two main points. First, most previous studies used a single walking task to assess the gait function of stroke patients, and the related discussions on motor control were inadequate, especially because the principles of complex motor movements were rarely involved22,23. Therefore, in ...

The restoration of independent walking function is one of the requisites for the participation of post-stroke patients in community life1. The recovery of walking ability requires not only the interaction of the perception and cognitive systems, but also motor control2,3,4. Furthermore, in real community life, people require higher abilities such as performing two or more tasks at the same time (e.g., walking while holding objects or crossing obstacles). Therefore, studies have begun to focus on the interference of dual-tasks in gait performance5,6. Previous dual-task studies were mostly targeted to elderly and cognitively impaired patients owing to the difficulty in motor performance and heterogeneity in stroke patients; the gait function in stroke patients was mostly evaluated by a single walking task7,8,9. However, further research on dual-task gait analysis, especially motor dual-tasks related to motor control, is required.
This study introduces a methodology for dual motor task gait analysis and evaluation. This protocol not only includes clinical assessment of the walking ability in stroke patients, but also focuses on two dual-motor tasks: the holding-water-and-walking task (a simple dual motor task) and the crossing-obstacle walking task (a complex dual motor task). The aim of this study was to explore the effects of dual motor tasks on the gait of stroke patients and to employ the dual-task gait cost (DTC) values10 of dual-task parameters (the difference between a single task and dual-task) to exclude the heterogeneity among stroke patients. The design of the experimental tasks facilitated an in-depth discussion of the motor control function of stroke patients, which provided new ideas for the clinical diagnosis and evaluation of the gait function of stroke patients.

<table><tbody><tr><td>BTS Smart DX system</td><td>Bioengineering Technology System, Milan, Italy</td><td>1</td><td>Temporospatial data collection</td></tr><tr><td>BTS SMART-Clinic software</td><td>Bioengineering Technology System, Milan, Italy</td><td>2</td><td>Data processing</td></tr><tr><td>SPSS software (version 25.0)</td><td>IBM Crop., Armonk, NY, USA</td><td></td><td>Statistical analysis</td></tr></tbody></table>

motor dual-tasks for gait analysis and evaluation in post-stroke patients

Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients

Eighteen stroke patients were recruited for this study involving the evaluation of cognition and walking ability and multitask gait analysis. Multitask gait analysis consisted of a single walking task (Task 0), a simple motor dual-task (water-holding, Task 1), and a complex motor dual-task (crossing obstacles, Task 2). The task of crossing obstacles was considered to be equivalent to the combination of a simple walking task and a complex motor task as it involved more nervous system, skeletal movement, and cognitive resources. To eliminate heterogeneity in the results of the gait analysis of the stroke patients, the dual-task gait cost values were calculated for various kinematic parameters. The major differences were observed in the proximal joint angles, especially in the angles of the trunk, pelvis, and hip joints, which were significantly larger in the dual motor tasks than in the single walking task. This research protocol aims to provide a basis for the clinical diagnosis of gait function and an in-depth study of motor control in stroke patients with motor control deficits through the analyses of dual-motor walking tasks.

Eighteen patients with hemiplegia after stroke were recruited in this study. The average age of the participants was 51.61 ± 12.97 years; all were males. The proportion of left and right hemiplegia was 10/8; the average Brunnstrom stage was 4.50 ± 0.76. The average of MMSE and MoCA were 26.56 ± 1.67 and 20.06 ± 2.27, respectively. Other demographic characteristics (including stroke type and time of onset) are shown in Table 1. For the original data of gait dual-tasks (Task 1 and Task 2), there was no sta...

This paper presents a protocol specifically for dual motor task gait analysis in stroke patients with motor control deficits.

Eighteen stroke patients were recruited for this study involving the evaluation of cognition and walking ability and multitask gait analysis. Multitask ...

motor-dual-tasks-for-gait-analysis-evaluation-post-stroke

Research

JoVE Journal

Neuroscience

This video demonstrates modulation of reflex activity, volitional strength and ambulation through clinical and quantitative assessments in individuals with motor incomplete SCI as a result of acute oral administration of a serotonin reuptake inhibitor (SSRI).

Methods to Quantify Pharmacologically Induced Alterations in Motor Function in Human Incomplete SCI

A novel low-cost human-machine interface for interactive post-stroke balance rehabilitation system is presented in this article. The system integrates off-the-shelf low-cost sensors towards volitionally driven electrotherapy paradigm. The proof-of-concept software interface is demonstrated on healthy volunteers.

A Human-machine-interface Integrating Low-cost Sensors with a Neuromuscular Electrical Stimulation System for Post-stroke Balance Rehabilitation

Here, we present a protocol to quantify precise stepping in rodents. Cortical and the spinal central pattern generator signals are required for precise foot-placement during obstructed locomotion. We report here the novel constrained walking task that directly examines precise stepping behavior.

Asymmetric Walkway: A Novel Behavioral Assay for Studying Asymmetric Locomotion

This protocol describes the process for performing a neurophysiological assessment of the lower extremity muscles, tibialis anterior and soleus, in a standing position using TMS in people post-stroke. This position provides a greater probability of eliciting a post-stroke TMS response and allows for the use of reduced stimulator power during neurophysiological assessments.

Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke

Clinical assessment scales are notsensitive enough to cognitive dysfunction in high-functioning stroke patients. The dual-task paradigm presents advantages and potential in the assessment and cognitive training of cognitive dysfunction. The study here proposes a dual-task Stroop paradigm to identify cognitive dysfunction in high-functioning stroke patients.

Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients

Chronic stroke patients' insured rehabilitation is generally time limited. Imaging-based study of brain activity from walking-related motor tasks can lead to establishing biomarkers to measure improved outcomes and justify extending tailored therapy. A novel, magnetic resonance-compatible, variable-resistance foot motion device and a protocol for use during functional magnetic resonance imaging are presented.

Use of a Foot-Induced Digitally Controlled Resistance Device for Functional Magnetic Resonance Imaging Evaluation in Patients with Foot Paresis

The purpose of this study is to provide an important reference for the standard clinical operation of motor imagery brain-computer interface (MI-BCI) for upper limb motor dysfunction after stroke.

Motor Imagery Brain-Computer Interface in Rehabilitation of Upper Limb Motor Dysfunction After Stroke

This experimental protocol outlines the use of a dual upper limb task-oriented robotic system for stroke patients with upper limb dysfunction. The findings indicate that this system can significantly improve stroke patients' upper limb function and daily living activities.

Application of a Dual Upper Limb Task-Oriented Robotic System for the Functional Recovery of the Upper Limb in Stroke Patients

This article describes in detail a protocol to electroporate in utero the cerebral cortex and the hippocampus at E14.5 in mice. We also show that this is a valuable method to study dendrites and spines in these two cerebral regions.

Visualization and Genetic Manipulation of Dendrites and Spines in the Mouse Cerebral Cortex and Hippocampus using In utero Electroporation

In animals with large identified neurons (e.g. mollusks), analysis of motor pools is done using intracellular techniques1,2,3,4. Recently, we developed a technique to extracellularly stimulate and record individual neurons in Aplysia californica5. We now describe a protocol for using this technique to uniquely identify and characterize motor neurons within a motor pool.

Extracellularly Identifying Motor Neurons for a Muscle Motor Pool in Aplysia californica

Learn motor dual-task gait analysis for post-stroke rehabilitation using 3D kinematic assessment and DTC calculations. This protocol evaluates trunk and pelvic rotation changes to improve clinical diagnosis and targeted rehabilitation strategies.

Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients

Explore More Videos