Our daily activities often involve the simultaneous execution of two tasks, such as walking and talking. This type of performance is defined as dual-task and it is characteristic of a functional ambulation in daily life environment that is increasingly full of stimuli. For people with stroke, these situations can be complex to manage; in fact, following a stroke, motor deficits, alterations in sensitivity and impairment of executive functions may appear. All these factors can cause an increase in cognitive-motor interference (CMI): a phenomenon in which the simultaneous execution of a motor task and a cognitive task interferes with the execution of one or both tasks. The goal of this study is to evaluate the effects of a dual-task cognitive-motor training in the treatment of stroke patients. The study was carried out in collaboration with the Degree Course in Speech Therapy; the data was collected at the SOD Clinic of Neurorehabilitation within the University Hospital of the United Hospitals of Ancona for a total period of four years (2017-2021). The study involved a total of 15 participants, including two drop-outs. During this academic year (2020-2021) two training sessions were carried out, the first with 15 sessions, the second with 9 sessions; 3 subjects were treated (of which 1 drop-out). The training involved the execution of combinations of motor and cognitive exercises, therefore performed in dual-task; each exercise was first performed in single-task. For the motor task, the time taken in execution was measured, while for the cognitive task, the errors committed and the response time were recorded. Motor and cognitive skills, social participation and dual-task performance were assessed; the latter through the calculation of the dual-task index. The assessments were carried out at the beginning and at the end of the first training session, at the follow up and at the end of the booster session. For both patience there were improvements in the following tests: Mini BESTest, 6 Minute Walk Test and Timed Up and Go Cognitive; the dual-task index also improves. The participants' endurance, walking speed and balance improved; in addition, the training led to a progressive reduction of cognitive-motor interference and had a positive effect on daily life activities and social participation.
Le nostre attività quotidiane spesso implicano l’esecuzione simultanea di due compiti, come camminare e parlare. Questo tipo di performance viene definita dual-task ed è caratteristica di un cammino funzionale in un ambiente di vita quotidiano sempre più ricco di stimoli. Per soggetti con esiti di ictus queste situazioni possono risultare complesse da gestire; a seguito di un ictus, infatti, possono comparire deficit motori, alterazioni della sensibilità e compromissione delle funzioni esecutive. Tutti questi fattori possono causare un aumento dell’interferenza cognitivo-motoria (CMI): fenomeno in cui l’esecuzione simultanea di un compito motorio e di un compito cognitivo interferisce con l’esecuzione di uno o entrambi i compiti. L’obiettivo di questo studio è quello di valutare gli effetti di un training in dual-task cognitivo-motorio nel trattamento di pazienti con esiti di ictus in fase cronica. Lo studio è stato effettuato in collaborazione con il CdL in Logopedia; i dati sono stati raccolti presso la SOD Clinica di Neuroriabilitazione all’interno dell’Azienda Ospedaliera Universitaria degli Ospedali Riuniti di Ancona per un periodo complessivo di quattro anni (2017-2021). Lo studio ha coinvolto in totale 15 partecipanti, di cui due drop-out. Durante questo anno accademico (2020-2021) sono state effettuate due sessioni di training, la prima da 15 sedute, la seconda da 9 sedute; i soggetti trattati sono stati 3 (di cui 1 drop-out). Il training ha previsto l’esecuzione di combinazioni di esercizi motori e cognitivi, eseguite quindi in dual-task; ciascun esercizio è stato prima eseguito in single-task. Per il compito motorio è stato misurato il tempo impiegato nell’esecuzione mentre per il compito cognitivo sono stati registrati gli errori commessi e il tempo di risposta. Sono state valutate le abilità motorie e cognitive, la partecipazione sociale e la performance dual-task; quest’ultima attraverso il calcolo dell’indice dual-task. Le valutazioni sono state effettuate all’inizio e alla fine della prima sessione di training, al follow up e alla fine della booster session. Per entrambi i soggetti si sono registrati miglioramenti nei seguenti test: Mini BESTest, 6 Minute Walk Test e Timed Up and Go Cognitivo; anche l’indice dual-task migliora in seguito al training. Nei partecipanti sono migliorati la resistenza, la velocità del cammino e l’equilibrio; inoltre, il training ha portato ad una progressiva riduzione dell’interferenza cognitivo-motoria ed ha avuto un effetto positivo sulle attività di vita quotidiana e sulla partecipazione sociale.
Integrazione cognitivo-motoria nella riabilitazione post ictus: risultati di un training in dual task
CESARETTI, MARIA GIULIA
2020/2021
Abstract
Our daily activities often involve the simultaneous execution of two tasks, such as walking and talking. This type of performance is defined as dual-task and it is characteristic of a functional ambulation in daily life environment that is increasingly full of stimuli. For people with stroke, these situations can be complex to manage; in fact, following a stroke, motor deficits, alterations in sensitivity and impairment of executive functions may appear. All these factors can cause an increase in cognitive-motor interference (CMI): a phenomenon in which the simultaneous execution of a motor task and a cognitive task interferes with the execution of one or both tasks. The goal of this study is to evaluate the effects of a dual-task cognitive-motor training in the treatment of stroke patients. The study was carried out in collaboration with the Degree Course in Speech Therapy; the data was collected at the SOD Clinic of Neurorehabilitation within the University Hospital of the United Hospitals of Ancona for a total period of four years (2017-2021). The study involved a total of 15 participants, including two drop-outs. During this academic year (2020-2021) two training sessions were carried out, the first with 15 sessions, the second with 9 sessions; 3 subjects were treated (of which 1 drop-out). The training involved the execution of combinations of motor and cognitive exercises, therefore performed in dual-task; each exercise was first performed in single-task. For the motor task, the time taken in execution was measured, while for the cognitive task, the errors committed and the response time were recorded. Motor and cognitive skills, social participation and dual-task performance were assessed; the latter through the calculation of the dual-task index. The assessments were carried out at the beginning and at the end of the first training session, at the follow up and at the end of the booster session. For both patience there were improvements in the following tests: Mini BESTest, 6 Minute Walk Test and Timed Up and Go Cognitive; the dual-task index also improves. The participants' endurance, walking speed and balance improved; in addition, the training led to a progressive reduction of cognitive-motor interference and had a positive effect on daily life activities and social participation.| File | Dimensione | Formato | |
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TESI Cesaretti Maria Giulia.pdf
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https://hdl.handle.net/20.500.12075/1041