Effect of Executive Dysfunction on Posture Control and Gait after Stroke

Abstract

Objective. The purpose of the study was to observe the effects of executive dysfunction (ED) on gait and postural control during walking after stroke. Methods. In this study, 34 subjects with stroke and ED (8 women and 26 men; age, 55.41 ± 7.89 years; time since stroke onset, 1.3 ± 0.12 months) were recruited. Stroop color-word test (SCWT), 10-meter walk test (10MWT), timed-up-and-go test (TUGT), and gait analysis were evaluated. The correlation among the correct number of Stroop tasks (SCWT-C), the number of time-consuming tasks (SCWT-T), the amount of interference (SIE-M and SIE-T) and posture control, and gait-related parameters was analyzed. Results. The results indicated that SCWT-C was negatively correlated with 10MWT, TUGT, and bilateral symmetry ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> </a:math> &lt; 0.05). However, there was no significant correlation between SCWT-C and stride ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> </c:math> &gt; 0.05). A significant negative correlation was seen between SCWT-C and bilateral symmetry ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> </e:math> &lt; 0.05). There was no significant correlation between SCWT-T and stride ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>P</g:mi> </g:math> &gt; 0.05). SCWT-T was positively correlated with TUGT, 10MWT, and bilateral symmetry ( <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mi>P</i:mi> </i:math> &lt; 0.05). SIE-T was positively correlated with TUGT and bilateral symmetry ( <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>P</k:mi> </k:math> &lt; 0.05). There was no significant correlation between SIE-T and 10MWT or stride ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>P</m:mi> </m:math> &gt; 0.05). SIE-M was positively correlated with TUGT and bilateral symmetry ( <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mi>P</o:mi> </o:math> &lt; 0.05). There was no significant correlation between SIE-T and 10MWT or stride ( <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>P</q:mi> </q:math> &gt; 0.05). Conclusions. ED is closely related to the decline in postural control and the occurrence of falls. In the early phases of stroke rehabilitation, physiotherapists should focus on the patients’ executive function to accelerate the recovery of postural control.