Sitting and thinking, or just sitting?

Patients recovering from brain injuries such as strokes often experience difficulties carrying out two activities at the same time, according to researchers in the School of Psychology at the University of Reading.

Most of us can walk, cycle or drive and carry on a conversation at the same time because the combination of motor actions is so well-practised it has become automatic. However, when people have to relearn the basic postural control that enables them to sit, stand or walk safely, they need to attend to the individual components, thus limiting the attention capacity available for any other activity.

For example, if asked a question while laying the table, some patients might have to stop, answer the question, then resume laying the table.

Dr Janet Cockburn, along with her colleagues Jason Boyd, Clare Harley and Professor John Wann, has been investigating hand control, walking and sitting in people who are recovering from stroke. The research has been funded by the Engineering and Physical Sciences Research Council (EPSRC).

“We have used a method which identifies the difference between someone’s performance on a task when they devote all their attention to it and when attention is shared with another activity,” says Dr Cockburn. “The research is ongoing, but we have found that patients recovering from brain injuries show greater cognitive-motor interference (CMI) when attempting a combination of activities than do age-matched volunteers.

“However, there are quite wide differences in the extent of interference shown by individual patients. We have not yet been able to identify the most important factors influencing recovery and reduction of CMI, but performance tends to be influenced by age as well as injury.”

The researchers have now begun a study evaluating the benefits of computer-guided practice in motor control, both for recovery of motor skills and for reduction in CMI. ‘Virtual’ environments allow patients access to a range of simulations of everyday activities, matched to their needs and stage of recovery, while also providing instant feedback on performance and progress.

Dr Cockburn said: “If it proves to be successful, this adjunct to conventional therapy will increase patient autonomy and reduce demands on scarce community physiotherapy and occupational therapy resources.”