Reading material on improving patient communication

During the assessment of gait with an additional task, several areas can be sensitive to cross-cultural communication: 

1.Communicating information to the patient and issuing instructions during the course of the study:  

During gait assessments with an additional task, the identification of the strategy used to allocate attention between the tasks is crucial. It is essential to evaluate whether gait, the additional task, or both are affected. When explaining the purpose and process of the assessment to the participant and providing instructions, it’s important not to suggest that one of the tasks is more important than the other (Maclean et al., 2017). Additionally, care should be taken to avoid situations that may evoke emotional responses in the participant, as emotions can also influence the assessment results (Gross et al., 2012). 

This approach ensures that the participant does not feel pressured or anxious about the tasks and can perform them as naturally as possible, which is essential for obtaining accurate results during gait assessments with an additional task. 

2. Selection of an Additional Task 

Current scientific research results do not provide an answer to the question of which additional task is the best choice during gait assessments with an additional task. 

Culture, understood as the entirety of material and spiritual heritage handed down from generation to generation, has a significant impact on human development, the type of information acquired, and competencies. Most of the additional tasks used are based on the participant’s skills and knowledge, which can influence the results obtained. For example, if the task involves naming animals starting with a given letter (differently in single and dual tasks), the task’s effectiveness, measured by the number of named animals and average reaction time, depends on the participant’s knowledge. Their knowledge may be related to their education, hobbies, upbringing in various cultural contexts, and language. In different languages, both the number of animal names starting with a particular letter and the time to pronounce them differ. Therefore, when selecting an additional task and interpreting the results obtained, caution is necessary. It is advisable to choose tasks that do not pertain to areas of knowledge or skills that are particularly developed or limited in the participant (e.g., backward counting is not recommended for individuals with dyscalculia or accountants, and naming animals is not suitable for biologists). It’s also important to remember that each additional task places a different burden on the nervous system. Therefore, results obtained from assessments using different additional tasks are not directly comparable. 

In our own research, to avoid cognitive tasks related to the participant’s knowledge and skills, we use the computer program DIVA-gait. When employing this tool, the type of alphabet typically used by the participant in their daily life should be considered (a cultural factor). While the Latin alphabet is commonly used, the DIVA-gait program can be applied to all alphabets that include uppercase and lowercase letters. 

3. Selection of Research Method with Respect to the Client’s Cultural Needs 

Religious beliefs and individual sensitivity can make gait assessments challenging when using systems that require exposure of significant areas of the body. The consequence may be a refusal to participate in the study or a high level of stress that could affect the results. Having various measurement systems facilitates the optimal adjustment of the study conditions to the patient’s needs.