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Original Article

Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients

Osong Public Health and Research Perspectives 2021;12(5):304-313.
Published online: September 13, 2021

1Department of Occupational Therapy, Hana General Hospital, Cheongju, Korea

2Department of Occupational Therapy, College of Health and Medical Sciences, Cheongju University, Cheongju, Korea

Corresponding author: Deok-Ju Kim Department of Occupational Therapy, College of Health and Medical Sciences, Cheongju University, 298 Daeseong-ro, Cheongwon-gu, Cheongju 28503, Korea E-mail: dj7407@hanmail.net
This paper was written by revising and supplementing the first author’s master’s thesis.
• Received: July 5, 2021   • Revised: August 11, 2021   • Accepted: August 18, 2021

© 2021 Korea Disease Control and Prevention Agency

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Citations

Citations to this article as recorded by  Crossref logo
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Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients
Osong Public Health Res Perspect. 2021;12(5):304-313.   Published online September 13, 2021
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Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients
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Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients
Image
Figure 1. Flow chart of the study.K-MMSE, Korean version of the Mini-Mental State Examination; BRS, Brunnstrom Recovery Stage; MFT, Manual Function Test; DST, Digit Span Test; EFPT-K, Executive Function Performance Test Korean version; K-TMT-e B, Korean version of the Trail Making Test for the Elderly B; WHOQOL-BREF, World Health Organization Quality of Life-BREF.
Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients
Daily living activity-based task Attention task Executive function task
Climbing stairs Continuous subtraction Presenting a virtual situation
e.g., 20-3-3-3 e.g., You’re in a taxi but do not have your wallet.
Making tea/coffee Simple addition/subtraction Explaining the order of wearing clothes
e.g., 5+4, 9-6 e.g., Dress, skirt, pants, shirts, tie
Folding tops/bottoms Counting numbers forward/backward in order Talking about daily routine
e.g., Counting from 1 to 20 forwards/backwards in order e.g., Describe your daily routine for today.
Buttoning/unbuttoning Reading words backwards Making a shopping list
e.g., Hat, pencil, soap, ballpoint pen e.g., Make a shopping list for grocery shopping, pharmacy, bookstore.
Moving beans Simple word game of coming up with a word that starts with the last letter of the previous word Categorization
e.g., Standing-train-garage e.g., Types of land animals, types of drinks, colors
Characteristic Experimental group (n=15) Control group (n=15) p
Mean age (y) 65.20±12.17 65.27±12.73 0.868
Sex 0.715
 Male 8 (53.3) 7 (46.7)
 Female 7 (46.7) 8 (53.3)
Stroke type 0.464
 Infarction 8 (53.3) 6 (40.0)
 Hemorrhage 7 (46.7) 9 (60.0)
Paralyzed side 0.713
 Right 6 (40.0) 7 (46.7)
 Left 9 (60.0) 8 (53.3)
Disease duration (mo) 4.07±0.88 4.20±0.77 0.691
K-MMSE (score) 24.00±2.00 24.00±1.96 0.916
BRS (phase) 5.33±0.61 5.00±0.65 0.161
Variable Intervention with groups
Difference between groups
Before (mean±SD) After (mean±SD) Z p Mean±SD Z p
Upper extremity training
 EG 14.40±1.35 15.53±0.74 –2.724 0.006** 1.13±1.18 –0.932 0.351
 CG 14.40±1.45 15.20±1.01 –2.414 0.016* 0.80±1.14
Grip strength
 EG 5.33±0.48 5.87±0.35 –2.530 0.011* 0.67±0.48 –2.159 0.031*
 CG 5.47±0.51 5.73±0.45 –2.000 0.046* 0.27±0.45
Finger manipulation
 EG 4.60±0.91 6.20±1.08 –3.520 0.000** 1.60±0.50 –2.361 0.018*
 CG 4.60±0.82 5.53±0.99 –2.889 0.004** 0.93±0.79
Total score
 EG 24.53±1.99 27.73±1.58 –3.438 0.001** 3.20±1.52 –2.430 0.015*
 CG 24.47±2.06 26.40±1.95 –3.088 0.002** 1.93±1.79
Variable Intervention with groups
Difference between groups
Before (mean±SD) After (mean±SD) Z p Mean±SD Z p
DST-Forward
 EG 5.27±0.88 6.93±0.88 –3.542 0.000** 1.67±0.48 –3.181 0.001**
 CG 5.20±1.08 6.07±1.10 –3.127 0.002** 0.87±0.64
DST-Backward
 EG 2.60±0.73 3.93±0.45 –3.397 0.001** 1.33±0.61 –3.500 0.000**
 CG 3.00±0.75 3.40±0.73 –2.449 0.0141* 0.40±0.50
EFPT-K
 EG 12.70±2.51 9.96±1.30 –3.413 0.001** –2.74±1.29 –4.720 0.000**
 CG 12.70±2.63 11.94±2.58 –3.474 0.001** –0.77±0.19
K-TMT-e B
 EG 89.13±10.85 67.00±12.16 –3.411 0.001** –22.13±4.86 –3.199 0.001**
 CG 89.60±12.33 77.00±13.26 –3.412 0.001** –12.60±7.83
Variable Intervention with groups
Difference between groups
Before (mean±SD) After (mean±SD) Z p Mean±SD Z p
Physical health
 EG 19.47±3.50 26.00±2.59 –3.391 0.001** 6.53±2.61 –3.158 0.002**
 CG 19.93±4.14 23.60±4.18 –3.309 0.001** 3.67±2.09
Psychology
 EG 15.60±2.44 22.33±3.71 –3.423 0.001** 6.73±2.86 –3.617 0.000**
 CG 15.60±2.92 18.47±4.08 –3.196 0.001** 2.87±1.88
Social relations
 EG 8.73±2.21 10.87±1.99 –3.455 0.001** 2.13±0.99 –3.094 0.002**
 CG 8.67±1.58 9.60±1.76 –2.913 0.004** 0.93±0.88
Environment
 EG 23.53±2.64 27.93±3.15 –3.428 0.001** 4.40±1.95 –3.524 0.000**
 CG 23.73±2.28 25.20±2.65 –2.842 0.004** 1.47±1.72
Total score
 EG 68.13±8.55 86.73±9.52 –3.411 0.001** 18.60±4.05 –3.596 0.000**
 CG 66.93±9.27 76.87±11.74 –3.414 0.001** 9.93±5.68
Table 1. Dual-task training that combined attention and executive function tasks with daily activities

Perform attention tasks while performing daily living activity, or perform executive function task while performing daily living activity.

Table 2. General characteristics of the research subjects

Data are presented as mean±standard deviation or n (%).

K-MMSE, Korean version of the Mini-Mental State Examination; BRS, Brunnstrom Recovery Stage.

Table 3. Changes in Manual Function Test scores after the intervention within groups and differences between groups (n=30)

SD, standard deviation; EG, experimental group; CG, control group.

p<0.05,

p<0.01.

Table 4. Changes in the DST, EFPT-K, K-TMT-e B after the intervention within groups and differences between groups (n=30)

DST, Digit Span Test; EFPT-K, Executive Function Performance Test Korean version; K-TMT-e B, Korean version of the Trail Making Test for the Elderly B; SD, standard deviation; EG, experimental group; CG, control group.

p<0.05.

p<0.01.

Table 5. Changes in WHOQOL-BREF after the intervention within groups and differences between groups (n=30)

WHOQOL-BREF, WHO Quality of Life-BREF; SD, standard deviation; EG, experimental group; CG, control group.

p<0.01.