Ann Rehabil Med.  2019 Feb;43(1):1-10. 10.5535/arm.2019.43.1.1.

Effect of Task-Specific Lower Extremity Training on Cognitive and Gait Function in Stroke Patients: A Prospective Randomized Controlled Trial

• Chung SH
• Kim JH
• Yong SY
• Lee YH
• Park JM
• Kim SH
• Lee HC

• KMID: 2440946
• DOI: http://doi.org/10.5535/arm.2019.43.1.1

Abstract

OBJECTIVE
To elucidate the effect of task-specific lower extremity training (TSLET) on cognitive and gait function in stroke patients.
METHODS
Thirty-eight patients were assigned to either the TSLET group or the control group. The individuals of TSLET group went through a TSLET plus conventional physical therapy. The control group received two sessions of conventional physical therapy. The primary outcome involved the assessment with visual and auditory digit span test. The secondary outcome was evaluated by the Korean version of Mini-Mental State Examination (K-MMSE) and Global Deterioration Scale (GDS) for cognitive function, Berg Balance Scale (BBS), Time Up and Go Test (TUG), 10 meters Walking Test (10mWT), 6 minutes Walking Test (6MWT), and Korean version of Modified Barthel Index (K-MBI) for gait, balance, and functional ability.
RESULTS
After intervention (3 weeks) and 2 weeks of follow-up, the TSLET group showed statistically significant improvement in the visual digit span test backwards compared with the control group. In secondary outcome, a significant improvement was observed in GDS, BBS, TUG, and 10mWT in the TSLET group. There was no significant difference between the two groups concerning visual digit span test forward, auditory forward and backward digit span tests, K-MMSE, 6MWT, and K-MBI.
CONCLUSION
TSLET could be a useful alternative strategy for improving cognitive and gait function in stroke patients.

Keyword

Stroke rehabilitation; Cognition; Lower extremity; Balance; Gait

MeSH Terms

Cognition
Follow-Up Studies
Gait*
Humans
Lower Extremity*
Prospective Studies*
Stroke*
Walking

Figure

• 

  Fig. 1. Task-specific lower extremity training machine. (A) It consists of a balance board, a sensor, a computer system, and a screen. To prevent falling down, a harness and safety bar is used. (B) This figure shows ‘fruit picking game’. The catching cursor moves up and down according to the flexion and extension of the knee joint and moves the cursor in the left and right direction through the weight shifting.

• 

  Fig. 2. Flowchart represents the process of the study. Three of 38 patients dropped out, 1 from the TSLET group, and 2 from the control group due to follow-up loss. TSLET, task-specific lower extremity training.

• 

  Fig. 3. Changes in parameters of the primary outcome (digit span test). (A) VST-F, (B) VST-B, (C) AST-F, and (D) AST-B. In the TSLET group, a significant time versus group interaction was observed for VST-B improvement (p=0.031). TSLET, task-specific lower extremity training; VST-F, visual digit span test forward; VST-B, visual digit span test backward; AST-F, auditory digit span test forward; AST-B, auditory digit span test backward.

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