Article Text

Download PDFPDF
Disruption of sitting balance after stroke: influence of spoken output
  1. C Harley,
  2. J E Boyd1,
  3. J Cockburn1,
  4. C Collin2,
  5. P Haggard3,
  6. J P Wann1,
  7. D T Wade4
  1. 1University of Reading, Reading, UK
  2. 2Royal Berkshire Hospital, Reading, UK
  3. 3Institute of Cognitive Neuroscience, London, UK
  4. 4Oxford Centre for Enablement, Oxford, UK
  1. Correspondence to:
 Ms C Harley
 Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, UK; c.harley{at}


Objectives: To identify the extent of dual task interference between cognitive and motor tasks, (cognitive motor interference (CMI)) in sitting balance during recovery from stroke; to compare CMI in sitting balance between stroke and non-stroke groups; and to record any changes to CMI during sitting that correlate with functional recovery.

Method: 36 patients from stroke rehabilitation settings in three NHS trusts. Healthy control group: 21 older volunteers. Measures of seated postural sway were taken in unsupported sitting positions, alone, or concurrently with either a repetitive utterance task or an oral word category generation task. Outcome measures were variability of sway area, path length of sway, and the number of valid words generated.

Results: Stroke patients were generally less stable than controls during unsupported sitting tasks. They showed greater sway during repetitive speech compared with quiet sitting, but did not show increased instability to posture between repetitive speech and word category generation. When compared with controls, stroke patients experienced greater dual task interferences during repetitive utterance but not during word generation. Sway during repetitive speech was negatively correlated with concurrent function on the Barthel ADL index.

Conclusions: The stroke patients showed postural instability and poor word generation skills. The results of this study show that the effort of verbal utterances alone was sufficient to disturb postural control early after stroke, and the extent of this instability correlated with concomitant Barthel ADL function.

  • postural control
  • stroke rehabilitation
  • dual task costs
  • speech production

Statistics from


  • Funding: this research was funded by the EPSRC EQPAL initiative; grant number GR/R26979/01.

  • Competing interests: none declared

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.