Functional Balance and Motor Impairment Correlations with Gait Parameters during Timed Up and Go Test across Three Attentional Loading Conditions in Stroke Survivors
The aim of this study was to determine whether stroke survivor’s gait performance during dual-task Timed Up and Go (TUG) test is correlated with the level of functional balance and motor impairment. Thirty stroke survivors (22 men, 8 women) were recruited for this study. The level of functional balance (Berg Balance Scale) and motor impairment (Fugl-Meyer assessment lower extremity) were assessed prior to the TUG test. TUG test was conducted under three attentional loading conditions (single, dual motor, and dual-cognitive). The time and number of steps were used to quantify gait parameters. The Spearmen’s rank correlation coefficient was used to evaluate the relationship between these variables. There was moderate to strong negative correlation between functional balance and gait parameters (range ？0.53 to ？0.73, ). There was a weak negative correlation observed between the time taken to complete the single task and motor impairment ( ; ) dual motor task and motor impairment ( ; ). However, there were no significant correlations between lower limb motor impairment and the number of steps in all conditions. These findings suggest that functional balance may be an influential domain of successful dual-task TUG in stroke. 1. Introduction The incidence of falls is one of the most common consequences of stroke, especially when it involves walking in the community or outdoors [1, 2]. Walking outdoors is a challenging task for stroke survivors because they need to overcome obstacles and change direction (turning) under the presence of many distractions [3] and at the same time perform multiple tasks simultaneously [4]. In order to be able to adapt to this challenging environment, stroke survivors may be required to learn highly complex skills [4] such as walking and turning as well as performing dual task such as walking while carrying objects or answering phone calls. Skilled turning has been identified as one of the influential factors for safe functional ambulation [5–7]. Turning sequence involves slowing down the walking speed as well as reorientation of the body segments toward the new direction [8, 9]. It is postulated that stroke survivors with impaired sensorimotor, balance, and cognitive or attentional function may have difficulty performing safe turning task. The Timed Up and Go test (TUG), which is a clinical assessment for the balance and mobility performance [10], has been highly used in a clinical setting to represent functional balance by measuring the time taken for an individual to stand up from a chair, walk 3 meters, turn around, walk 3
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