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Task Switching After Stroke

PS Pohl, PT, PhD, is Associate Professor, Department of Physical Therapy & Rehabilitation Sciences, University of Kansas Medical Center, Mail Stop 2002, 3901 Rainbow Blvd, Kansas City, KS 66160 (USA).
JM McDowd, PhD, is Professor, Department of Occupational Therapy Education, and Associate Director for Research, Landon Center on Aging, University of Kansas Medical Center.
D Filion, PhD, is Associate Professor, Department of Psychology, University of Missouri, Kansas City, Mo.
LG Richards, PhD, OTR, is Research Health Scientist, Research Service, North Florida/South Georgia Veterans Health System, Gainesville, Fla, and Associate Professor, Occupational Therapy Department, University of Florida, Gainesville, Fla.
W Stiers, PhD, is Assistant Professor, Department of Physical Medicine and Rehabilitation, John Hopkins University, Baltimore, Md.
P Kluding, PT, PhD, is Assistant Professor, Department of Physical Therapy & Rehabilitation Sciences, University of Kansas Medical Center.

ppohl{at}kumc.edu

BACKGROUND AND PURPOSE: Task switching is a cognitive skill that may be compromised after brain damage. The purposes of this study were to examine task-switching abilities in the subacute phase after stroke, to determine whether a switching task under endogenous or internal control is more difficult than a switching task under exogenous or cued control, and to determine whether deficits in switching attenuate in the first few months after stroke.

SUBJECTS: The participants in this study were 46 adults with stroke and 38 adults without stroke.

METHODS: Subjects performed 2 computer-based switching tasks, an alternating task that relied on endogenous control and a cued task that relied on exogenous control. Testing was done in subjects' homes at 1 and 3 months after stroke and at a 2-month interval for control subjects. Switch costs, or the difference between the no-switch condition and the switch condition, were calculated for accuracy and response time.

RESULTS: Subjects in the stroke group had higher switch costs for accuracy than did subjects in the control group. The alternating task was more difficult than the cued task, with higher switch costs for accuracy and response time. The alternating task was particularly difficult for subjects in the stroke group, with high switch costs for accuracy. Both groups showed decreased response time switch costs at the second testing session.

DISCUSSION AND CONCLUSION: Task switching, particularly if under endogenous control, is impaired in adults in the subacute phase after stroke. Clinicians should be aware of performance deficits that may relate to task switching.