The effect of different dual task practies on activities of daily living in stroke individuals

Introduction: The motor, sensory, and cognitive impairments experienced by stroke survivors significantly impede their ability to engage in activities of daily living (ADLs) and constrain their participation in societal routines. In the course of daily activities, individuals frequently encounter the necessity to concurrently execute multiple tasks, rather than singular ones. Aim: Our study aims to assess the efficacy of various dual-task interventions integrated into neurodevelopmental treatment regimens, with a focus on their impact on the performance of ADLs among stroke patients. Methods: 32 stroke-diagnosed cases meeting the inclusion criteria were randomly divided into two groups. The mean age of the cases was 65.42 ± 13.35, with 14 females and 15 males. Among them, 9 were in the acute phase, 9 in the subacute phase, and 11 in the chronic phase of stroke. The Motor Dual-Task group (MDG) received motor and motor dual-task exercises alongside neurodevelopmental treatment, while the Cognitive Dual-Task group (CDG) underwent motor and cognitive dual-task exercises. These interventions were administered in the hospital, under the supervision of a physiotherapist, five days/week for six weeks, with each session lasting approximately 45 minutes. Pre- and post-treatment evaluations were conducted utilizing various assessment tools, including the Modified Barthel Index, Nottingham Extended Activities of Daily Living Scale, Stroke Impact Scale 3.0, 10 Meter Walk Test, Timed Up and Go Test, Berg Balance Scale (BBS), Motor Activity Log-28, and Montreal Cognitive Assessment Scale. Statistical analysis was performed using SPSS Version 20.0. A significance level of p<0.05 was adopted for all analyses. Findings: Based on the analysis conducted with data from 29 cases, significant enhancements were noted across all assessment parameters in both groups (p<0.05). Following the treatment period, it was observed that only the perceived level of stroke recovery score exhibited a notable increase within the CDG (p=0.040), while the remaining scores showed no significant differences (p>0.05). Furthermore, upon comparison between the groups, a significant discrepancy was identified in the BBS scores, favoring the MDG (p=0.037). Conclusion: Within rehabilitation protocols designed to enhance ADL independence and participation among stroke patients, the incorporation of motor and cognitive dual-task exercises may serve as a viable alternative to motor-motor dual-task interventions.