Cognitive-motor interference (CMI) is evident when simultaneous performance of a cognitive task and a motor task results in deterioration in performance in one or both of the tasks, relative to performance of each task separately. The purpose of this review is to present a framework for categorizing patterns of CMI and to examine the specific patterns of CMI evident in published studies comparing single-task and dual-task performance of cognitive and motor tasks during gait and balance activities after stroke. We also examine the literature for associations between patterns of CMI and a history of falls, as well as evidence for the effects of rehabilitation on CMI after stroke. Overall, this review suggests that during gait activities with an added cognitive task, people with stroke are likely to demonstrate significant decrements in motor performance only (cognitive-related motor interference), or decrements in both motor and cognitive performance (mutual interference). In contrast, patterns of CMI were variable among studies examining balance activities. Comparing people poststroke with and without a history of falls, patterns and magnitude of CMI were similar for fallers and nonfallers. Longitudinal studies suggest that conventional rehabilitation has minimal effects on CMI during gait or balance activities. However, early-phase pilot studies suggest that dual-task interventions may reduce CMI during gait performance in community-dwelling stroke survivors. It is our hope that this innovative and critical examination of the existing literature will highlight the limitations in current experimental designs and inform improvements in the design and reporting of dual-task studies in stroke.

译文

:当同时执行一项认知任务和一项运动任务导致一项或两项任务的绩效相对于每项任务的绩效下降时,认知运动干扰(CMI)显而易见。这篇综述的目的是提供一个用于对CMI模式进行分类的框架,并检查已发表的研究中明显的CMI特定模式,该研究比较了中风后步态和平衡活动期间认知和运动任务的单任务和双任务表现。我们还检查了CMI模式与跌倒历史之间的关联的文献,以及中风后CMI康复的影响的证据。总的来说,这项研究表明,在具有额外认知任务的步态活动中,中风患者可能仅表现出运动能力的显着下降(与认知有关的运动干扰),或者运动和认知能力的下降(相互干扰)。相反,在研究平衡活动的研究中,CMI的模式是可变的。比较有或没有跌倒历史的人的中风后,跌倒者和非跌倒者的CMI模式和强度相似。纵向研究表明,传统的康复在步态或平衡活动期间对CMI的影响最小。但是,早期阶段的初步研究表明,双任务干预可能会降低社区居民卒中幸存者步态表现期间的CMI。我们希望对现有文献进行的创新和批判性检查将凸显当前实验设计的局限性,并为中风双重任务研究的设计和报告提供改进的信息。

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