ISSN 0362-1197, Human Physiology, 2012, Vol. 38, No. 4, pp. 374–382. © Pleiades Publishing, Inc., 2012.
Original Russian Text © A.V. Zharikova, L.A. Zhavoronkova, O.A. Maksakova, S.V. Kuptsova, 2012, published in Fiziologiya Cheloveka, 2012, Vol. 38, No. 4, pp. 41–50.
374
Throughout the past few decades, increasing atten-
tion in clinical rehabilitation is being given to the
search for diagnostic methods revealing the features of
maladaptation of patients to everyday activity and the
prospects of their recovery during rehabilitation. An
approach that would reveal the ability of the patient to
function in a specific environment, which can be
impaired even with formally preserved cognitive and
motor functions, is required. This approach could also
be beneficial when we select an individual rehabilita-
tion strategy, including special approaches and meth-
ods aiding in the restoration of functions necessary in
everyday activities based on the patient’s compensa-
tory capacities.
The existing methods of clinical diagnosis allow us
to reveal the features of affection of the nervous sys-
tem; however, as a rule, they provide only the probabil-
ity evaluation of a functional deficit. For example,
having pinpointed a focus in the precentral sulcus pro-
jection based on magnetic resonance imaging, we
would expect paresis in the neurological picture of the
disease; however, we cannot predict the degree of its
severity or the compensatory capacities a given patient
will have during recovery of locomotion. Therefore,
the use of methodical approaches that correlate with
everyday activities allow the prediction of the quality
of adaptation of a patient to specific conditions and
help us to elaborate the strategy of his or her rehabili-
tation on this basis [1].
Investigations using special methods for the evalu-
ation of the state of higher mental functions of patients
have made an important contribution to the solution
of this problem [2–4]. This approach enables us to
evaluate the state of the patient, to highlight the causes
of the problems of interaction with the environment
not amenable to the standard clinical examination, as
well as to predict, to a certain degree, the possibilities
and capabilities of independent functioning [5].
A number of investigations have established that
physically intact patients with traumatic brain injury
(TBI) are at high risk of falls or have an impaired
capacity for self-care at the early stages of Alzheimer’s
or Parkinson’s disease, even in the absence of a
marked motor or cognitive deficit evaluated by the
standard examination [6–8]. These patients are par-
ticularly vulnerable in situations that require simulta-
neous performance of several tasks, although healthy
people come across such situations every day (they talk
over the telephone while walking, listen to the radio
Characteristics of the Performance of a Dual Task, Voluntary
Postural Control, and Calculation by Patients with Consequences
of Traumatic Brain Injury
A. V. Zharikova
a
, L. A. Zhavoronkova
a
, O. A. Maksakova
b
, and S. V. Kuptsova
a
a
Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
b
Burdenko Institute of Neurosurgery, Russian Academy of Medical Sciences, Moscow, Russia
Received June 1, 2011
Abstract—Comprehensive clinical (MMSE, FIM and MPAI-3 and Berg scales) and stabilographic evaluation
was carried out in 14 patients (with a mean age of 25.7 ± 4.7 years) with consequences of traumatic brain
injury (TBI) in comparison with the data on 40 healthy subjects (with a mean age of 29.8 ± 2.5 years) per-
forming separate and dual tasks, including voluntary postural control and calculation. According to the clin-
ical evaluation, all the patients were divided into two groups: group 1 with a moderate deficit (eight patients)
and group 2 with a marked functional deficit (six patents). The parameters of the quality of motor and, espe-
cially, cognitive subtask performance in both separate and dual tasks were lower than the normative values in
all the patients, especially in group 2 patients. Types of dual tasks where the quality of the motor subtask per-
formance was higher than in separate tasks were revealed in healthy subjects and some group 1 patients. The
stabilographic parameters characterizing the quality of subtask performance by TBI patients were revealed.
Dual tasks could be used for diagnostic purposes such as an additional method for evaluating the adaptive
capacity of TBI patients, and certain types of dual tasks could become a promising approach for the recovery
of TBI patients at the late stages of rehabilitation.
Keywords: traumatic brain injury, voluntary postural control, stabilography, dual tasks
DOI: 10.1134/S0362119712040160