NIH Grant Supports Interdisciplinary Research on Walking in the Real World After Stroke

Dr. Prudence Plummer, Assistant Professor, has received a NIH R21 grant to fund “Real-world assessment of dual-task performance after stroke,” an interdisciplinary endeavor involving researchers in physical therapy, biomedical engineering, and psycholinguistics. The grant will provide $275,000 in direct costs over two years.

NIH Grant Supports Interdisciplinary Research on Walking in the Real World After Stroke click to enlarge Dr. Prue Plummer (back left) and Human Movement Science PhD student Ilana Levin (right) monitor a research participant as she navigates the “real-world” environment of the UNC Women’s Hospital lobby.

Dr. Plummer and the project’s co-investigators, Drs. Carol Giuliani (UNC), Lori Altmann (University of Florida), and Bijan Najafi (University of Arizona) will examine how stroke survivors’ ability to walk in a real-world environment compares to their ability to walk in the research lab, and how that ability is affected by concurrent cognitive tasks, such as conversing.

“Being able to comfortably and confidently walk in public settings is a key determinant of community integration and participation, yet very little is known about the impact of the environment on gait after stroke,” said Plummer.  “This research will provide new information about gait recovery after stroke and will help us to develop interventions to improve locomotor adaptability and safety.”
The study will involve 30 adults with stroke and 30 age and gender-matched healthy adults.  Each participant will be assessed in single and three different variable-priority dual-task conditions (no-priority, gait-priority, cognitive-priority) in the laboratory and a real-world context (hospital lobby), and in two different dual-task combinations (walking while talking, walking while performing an executive function task).

Investigators will examine how gait with and without a concurrent cognitive task differs between the research lab and the real-world setting and whether individuals with stroke are able to flexibly prioritize their attention between gait and a simultaneous cognitive task in the lab and the real world.  Additionally, researchers will establish estimates of minimal clinically important differences in dual-task interference on gait, which will enable them to identify the individuals with stroke that are most susceptible to clinically significant mobility disability in the real world.

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