title: Cognitive-motor interference during functional mobility after stroke: state of the science and implications for future research.
abstract: 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.
authors: Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: prue.plummer@gmail.com.
authors: Prudence
authors: P
authors: Plummer
authors: Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Gail
authors: G
authors: Eskes
authors: Department of Speech Language Pathology, Duquesne University, Pittsburgh, PA.
authors: Sarah
authors: S
authors: Wallace
authors: Department of Occupational Therapy, Rush University Medical Center, Chicago, IL.
authors: Clare
authors: C
authors: Giuffrida
authors: Department of Communication Sciences and Disorders, Western Washington University, Bellingham, WA.
authors: Michael
authors: M
authors: Fraas
authors: School of Nursing, University of Pittsburgh, Pittsburgh, PA.
authors: Grace
authors: G
authors: Campbell
authors: Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Kerry-Lee
authors: KL
authors: Clifton
authors: Departments of Occupational Therapy and Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
authors: Elizabeth R
authors: ER
authors: Skidmore
mesh_terms: D003072:Cognition Disorders / Q000503:physiopathology*; D020233:Gait Disorders, Neurologic / Q000503:physiopathology; D006801:Humans; D019957:Motor Skills Disorders / Q000503:physiopathology*; D009483:Neuropsychological Tests; D004856:Postural Balance / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation
keywords: CMI; Cognition; Gait; Postural balance; Rehabilitation; cognitive-motor interference
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