THE COGNITIVE PROCESSING COSTS OF STANDING AND WALKING IN INDIVIDUALS POST-STROKE

Robert Wellmon, PT, MS, NCS, Sam Pierce, PT, MS, NCS, Christine Palmer, PTA, BS, James Arnone, PT, MSPT, Christa Billerman, PT, MSPT, Kelly Lynch, PT, MSPT, Andrea Nangle, PT, MSPT. MossRehab Hospital, Philadelphia, PA and Widener University, Chester, PA.

Objective: The objective of this study was to examine the attentional or cognitive processing cost associated with standing and walking for individuals post-stroke (CVA). Design: Survey. Setting: Acute inpatient rehabilitation facility. Participants: Sixty-eight adults were assigned to four groups: left CVA (n=14), right CVA (n=18), elderly non-disabled (n=18), and young non-disabled (n=18). Subjects post-CVA achieved modified independence in ambulation. Main Outcome Measures: Voice reaction time (VRT), gait velocity, and timed get up-and-go score. Results: Non-disabled young and elderly adults had significantly faster VRT for standing and walking when compared to those post-CVA. No significant differences were found in VRT based either on the side of the lesion for the groups post-CVA or between the non-disabled young and elderly adult groups. Individuals post-CVA walked significantly slower and had significantly lower balance scores on the timed up-and-go. Conclusions: When performing functional activities, participants post-stroke incurred greater cognitive processing costs as evidenced by slower VRT when compared to non-disabled subjects. Non-disabled elderly adults evidenced similar cognitive processing abilities when standing and walking as young adults. The increase in cognitive processing time may be due in part to the effects of the central nervous system lesion. Key Words: Rehabilitation; Cerebrovascular Accident; Cognition.

Paper presented at the 78th Annual American Congress of Rehabilitation Medicine and American Society of Neurorehabilitation Meeting 2002, Philadelphia, PA.