Quantitative Analysis of Dual-Task Rehabilitation

BACKGROUNDDual-task impairment severely limits functional recovery post-stroke. This diagnostic accuracy study aimed to develop an eye-tracking-based system for objectively quantifying ankle-cognitive integration deficits in stroke survivors. METHODSThis diagnostic accuracy study was conducted from January 2022 to October 2023 at Tsinghua Changgung Hospital in Beijing. A total of 20 healthy adults (mean age 53.15{+/-}6.26 years) participated in the study. In addition, 30 patients with a history of stroke (mean age 64.13{+/-}8.16 years, 8 females, disease duration 9.12{+/-}6.60 weeks) participated in a standardised dual-task evaluation. The novel system utilised 17 parameters, encompassing ankle kinematics (range of motion, velocity) and eye tracking (gaze duration, sweep latency), which were measured simultaneously during the cognitive motor task. Reliability was assessed by intragroup correlation coefficients (ICC), while criterion validity was assessed using 12 clinical evaluation metrics, including Spearman correlation with Montreal Cognitive Assessment (MOCA) scores and dual-task cost (DTC) percentages. RESULTSThe system demonstrated that 88.2% of the evaluation parameters exhibited high consistency, with 55.8% showing a moderate correlation with clinical benchmark scales (p<0.05). Notably, MOCA, DTC%, and TUG-subtraction task duration were identified as key indicators of dual-task ability (P<0.05), while the Self-Rating Anxiety Scale showed lower sensitivity. Furthermore, ankle motion parameters exhibited a strong correlation with balance and fall risk (P<0.05), effectively serving as predictors of motor function recovery and fall risk in stroke patients. CONCLUSIONSThis multimodal system reliably quantifies post-stroke dual-task deficits, with ankle kinematics and eye-tracking metrics serving as sensitive biomarkers for balance recovery and fall risk stratification. Findings advocate integrating objective dual-task metrics into neurorehabilitation protocols to optimize functional outcomes. (ChiCTR2300067640; URL: https://www.chictr.org.cn/showproj.html?proj=188211).