双任务对后循环缺血性脑卒中伴前庭症状患者步行能力的影响研究

BackgroundPosterior circulation ischemic stroke patients with vestibular symptoms usually do not present with obvious limb paralysis with certain walking ability after improvement of dizziness and vertigo symptomshowevertheir fall risk is high and clinical attention to walking ability is lacking. Functional assessment using dual-task paradigms can better detect potential gait abnormalities in patients and provide a basis for early rehabilitation intervention. ObjectiveTo investigate the effect of dual task on walking ability of posterior circulation ischemic stroke patients with vestibular symptoms. MethodsPatients diagnosed with posterior circulation ischemic stroke accompanied by vestibular symptoms and treated at Tianjin Huanhu Hospital from January 2021 to December 2022 were selected as the study subjects. Gait parameters including gait speedstep frequencystep sizeproportion of double support phase timestep durationtrunk coronal plane and sagittal plane swing angles were collected using single-task walkingmotor-motor dual-task walkingand cognitive-motor dual-task walking paradigms. The differences in gait parameters among the three task conditions and the differences in dual-task costs between the two dual-task walking. ResultsCompared to single-task walkingthe trunk coronal plane and sagittal plane swing angles weredecreased in patients during motor-motor dual-task walkingP<0.05the gait speed and step size were increasedproportion of double support phase time and trunk coronal plane swing angle were increased in patients during cognitive-motor dual-task walkingP<0.05. Compared to motor-motor dual-task walkingthe dual-task costs of cognitive-motor dual-task walking in terms of gait speed and the proportion of double support phase time were increasedP<0.05. ConclusionDual task leads to decreased gait stability in posterior circulation ischemic stroke patients with vestibular symptoms. Additionallycognitive-motor dual-task walking requires more attentional resources and is more likely to result in gait disturbances compared to motor-motor dual-task walking.