Disruption of sitting balance after stroke: influence of spoken output

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 77; no. 5; pp. 674 - 676
• Main Authors: Harley, C, Boyd, J E, Cockburn, J, Collin, C, Haggard, P, Wann, J P, Wade, D T
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01-05-2006; BMJ Publishing Group LTD; BMJ Group
• Subjects: Activities of Daily Living - classification; Adults; Aged; Attention - physiology; Cerebral Infarction - diagnosis; Cerebral Infarction - physiopathology; Cerebral Infarction - rehabilitation; dual task costs; Female; Health Status Indicators; Humans; Male; Memory, Short-Term - physiology; Mental Status Schedule - statistics & numerical data; Middle Aged; Neuropsychological Tests - statistics & numerical data; Older people; Phonetics; Postural Balance - physiology; postural control; Posture; Psychometrics - statistics & numerical data; Rehabilitation; Semantics; Short Report; speech production; Speech Production Measurement; Statistics as Topic; Stroke; stroke rehabilitation; Verbal Behavior - physiology; Verbal Learning - physiology; Vocabulary
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.074138

Objectives: To identify the extent of dual task interference between cognitive and motor tasks, (cognitive motor interference (CMI)) in sitting balance during recovery from stroke; to compare CMI in sitting balance between stroke and non-stroke groups; and to record any changes to CMI during sitting that correlate with functional recovery. Method: 36 patients from stroke rehabilitation settings in three NHS trusts. Healthy control group: 21 older volunteers. Measures of seated postural sway were taken in unsupported sitting positions, alone, or concurrently with either a repetitive utterance task or an oral word category generation task. Outcome measures were variability of sway area, path length of sway, and the number of valid words generated. Results: Stroke patients were generally less stable than controls during unsupported sitting tasks. They showed greater sway during repetitive speech compared with quiet sitting, but did not show increased instability to posture between repetitive speech and word category generation. When compared with controls, stroke patients experienced greater dual task interferences during repetitive utterance but not during word generation. Sway during repetitive speech was negatively correlated with concurrent function on the Barthel ADL index. Conclusions: The stroke patients showed postural instability and poor word generation skills. The results of this study show that the effort of verbal utterances alone was sufficient to disturb postural control early after stroke, and the extent of this instability correlated with concomitant Barthel ADL function.