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 cerebrovas...

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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 border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<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

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 &#177; 12.97 years; all were males. The proportion of left and right hemiplegia was 10/8; the average Brunnstrom stage was 4.50 &#177; 0.76. The average of MMSE and MoCA were 26.56 &#177; 1.67 and 20.06 &#177; 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 ...

Watch this Scientific Journal Video about Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients at JoVE.com

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

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 ...

The design of this experimental tasks facilitated a in-depth discussion of motor control function of stroke patients which provides new ideas for clinical diagnosis and evaluation of the gait function of stroke patients. Through dual-motor working tasks and the calculation of dual-task gait cost values, this research protocol aims to provide a basis for the clinical diagnosis of gait function and the in-depth study of motor control in stroke patients. Demonstrating the procedure will be Doctor Shijuan Lang and graduate student Biyi Zhao and Yongchun Jiang from my laboratory.To begin, recruit stroke patients and obtain written informed consent from all patients before beginning the study. Record the patient's demographic characteristics including name, gender, date of birth, level of education, chief complaint, current medical history, past history, medical treatment, and current medications. Then ask the patient to complete the mini mental state examination in Montreal Cognitive Assessment.Next, conduct a 10 meter walk test by asking 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 six meters in each trial. Next, conduct the timed Up and Go"test by asking the patient to perform three consecutive trials at a self-selected pace for safety and comfort.Before performing the 3D Gait Analysis, inform the patient about the precautions and the purpose of the experiment. Then, 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. Next place, twenty-two markers on key points of the patient with three markers on the trunk, three markers on the pelvis, six markers on the thigh six markers on the calf, and four markers on the foot.Instruct the patient to maintain an upright position on the force plate for at least three to five seconds to gather the baseline data. Then, 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. Next, ask the patient to walk while holding a bottle of water on the walking pass for five trials at a self-selected, comfortable speed.and mark this as Task 1"Finally, ask the patient to walk across the line in the middle of the walking pass for five trials at a self-selected comfortable speed and mark this as Task 2"The demographic characteristics of 18 patients recruited in this study with hemiplegia after stroke are shown here for the original data of Simple Motor dual-task, called Task 1"and Complex Motor dual-Task, called Task 2"there was no statistical difference in the spatiotemporal parameters. However, in the joint angle parameters, the bilateral trunk rotation and the bilateral pelvic rotation in the transversal plane were significantly larger in Task 2 than in Task 1. For the DTC values of Gait dual tasks, the bilateral trunk obliquity in the frontal plane and the bilateral pelvic rotation in the transversal plane were higher in Task 2 than in Task 1.At the same time, the right cadence in the right GPS were significantly increased in Task 2, relative to that in Task 1. In this study, in addition to the single walking task as the baseline, we mainly focus on comparing two dual tasks of motor performance and walking, including the task of water holding and the task of coursing obstacles. This study aimed explore the effect of dual modal task on the gait of stroke patients and employ DTC values of dual modal parameters to accrue the heterogeneity among stroke patients.This results suggest that DTC values have an advantage in assessing dual task gait in stroke patients.

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JoVE Journal

Neuroscience

2.2K visualizações.  The Fifth Affiliated Hospital of Guangzhou Medical University. O delineamento dessas tarefas experimentais facilitou uma discussão aprofundada da função de controle motor de pacientes com AVE, o que fornece novas ideias para o diagnóstico clínico e avaliação da função da marcha de pacientes com AVE. Por meio de tarefas de trabalho bimotor e do cálculo de valores de custo da marcha com dupla tarefa, este protocolo de pesquisa visa fornecer uma base para o diagnóstico clínico da função da marcha e o estudo aprofundado do controle motor em pac...