COMPARATIVE ANALYSIS OF DUAL-TASK COGNITIVE-MOTOR TRAINING AND ACTION OBSERVATION THERAPY ON UPPER LIMB FUNCTIONAL RECOVERY AND HAND DEXTERITY IN PATIENTS WITH SUBACUTE STROKE

November 8, 2026 updated by: Ibadat International University, Islamabad

This randomized controlled trial aims to compare the effects of dual-task cognitive-motor training and action observation therapy on upper limb functional recovery and hand dexterity in patients with subacute stroke.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
48

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

40 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • First-ever ischemic or hemorrhagic stroke (confirmed by CT/MRI).
  • Subacute stage of stroke 3-6 months
  • Age 40-75 years, male andfemale..
  • Mini Mental State Examination (MMSE) >24.
  • Manual muscle testing (MMT) > 3.

Exclusion Criteria:

  • Bilateral stroke or brainstem stroke.
  • Severe neglect, apraxia, or global aphasia.
  • Severe visual field defects such as hemianopia.
  • Uncontrolled hypertension, unstable cardiac issues, and uncontrolled diabetes.
  • Neurological disorders (Parkinson's, MS, and Alzheimer's).
  • Fractures or contracture (Modified Ashworth Scale < 2).
  • Pre-existing musculoskeletal Issues in the upper limb

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Group A (Dual-Task Cognitive-Motor Training)

Dual-Task Cognitive-Motor Training
Other: Dual-Task Cognitive-Motor Training

Week 1: Simple Cognitive + Motor Tasks Motor Tasks

  • Reaching
  • Ball transfer
  • Cone stacking
  • Block moving Cognitive Tasks Performed simultaneously
  • Counting forward
  • Naming colors
  • Saying weekdays
  • Simple word recall Week 2: Moderate Cognitive Loading Motor Tasks
  • up stacking
  • Object sorting
  • Arm elevation tasks Cognitive Tasks
  • Counting backward
  • Simple calculations
  • Memory recall Progression
  • Increase movement repetitions
  • Reduce rest periods Week 3: Functional Dual Tasks

Motor Tasks ADL-based:

  • Folding towel
  • Carrying objects
  • Simulated feeding Cognitive Tasks
  • Responding to questions
  • Word generation
  • Sequencing activities Week 4: Complex Real-Life Dual Tasks

Motor Tasks Complex upper limb activities:

  • Tray carrying
  • Multi-step object transfer
  • Kitchen simulation
  • Dressing simulation Cognitive Tasks
  • Serial subtraction
  • Problem solving
  • Delayed recall
  • Following multistep commands
Active Comparator: Group B (Action Observation Therapy)

Action Observation Therapy
Other: Action Observation Therapy

Week 1: Basic Gross Motor Tasks

Observation Tasks Patient watches videos or therapist demonstrations of:

  • shoulder flexion
  • elbow flexion/extension
  • reaching movements
  • grasp and release activities Execution Patient imitates observed movements using affected upper limb. Functional Tasks
  • Reaching cone
  • Picking up cup
  • Moving blocks
  • Table wiping Week 2: Bilateral Functional Activities Observation
  • Bilateral reaching
  • Holding objects
  • Cup transfer
  • Folding towel Execution Patient repeats observed activities. Progression
  • Increase repetitions
  • Add object manipulation
  • Encourage movement accuracy Week 3: Fine Motor and Dexterity Tasks Observation
  • Peg placement
  • Buttoning
  • Spoon use
  • Writing simulation
  • Coin transfer Execution Focused practice after each observation clip. Progression
  • Faster task completion
  • Reduced verbal cueing
  • More affected side involvement Week 4: Complex Functional ADL Tasks Observation
  • Drinking from glass
  • Opening container
  • Dressing-relate

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Barthel Index (BI)
Time Frame: Baseline, 2nd week, 4th week

It measures independence in daily activities. Test-retest reliability: ICC = 0.89 (High stability)
Baseline, 2nd week, 4th week
Fugl-Meyer Assessment Upper Extremity (FMA-UE)
Time Frame: Baseline, 2nd week, 4th week

It is a stroke-specific, performance-based outcome measure used to assess upper limb motor recovery following a stroke. The FMA-UE consists of 33 items evaluating reflex activity, voluntary movement within and out of synergy, wrist and hand function, and coordination/speed. Each item is scored on a 3-point ordinal scale (0 = cannot perform, 1 = performs partially, 2 = performs fully), with a maximum score of 66 indicating optimal motor function.
Baseline, 2nd week, 4th week
Box and Block Test (BBT)
Time Frame: Baseline, 2nd week, 4th week

It measures gross manual dexterity / hand function. Concurrent validity: r = 0.801 (Strong correlation)
Baseline, 2nd week, 4th week
Trail Making Test Part B
Time Frame: Baseline, 2nd week, 4th week

It measures attention shifting, processing speed, and executive function. ICC = 0.93 Excellent test-retest reliability
Baseline, 2nd week, 4th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Ibadat International University, Islamabad

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Nazish Rafique, Ibadat International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • 1. Alvarez-Rodríguez M., López-Dolado, E., Salas-Monedero, M., Lozano-Berrio, V., Ceruelo-Abajo, S., Gil-Agudo, A., & de los Reyes-Guzmán, A. (2020). Concurrent validity of a virtual version of Box and Block Test for patients with neurological disorders. World Journal of Neuroscience, 10(1), 79-89. 2. An H. S., & Kim, D. J. (2021). Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients. Osong Public Health and Research Perspectives, 12(5), 304-313. 3.Borges, L. R. D. M., Fernandes, A. B. G. S., Oliveira dos Passos, J., Rego, I. A. O., & Campos, T. F. (2022). Action observation for upper limb rehabilitation after stroke. Cochrane Database of Systematic Reviews, 2022(8), CD011887. 4. GB 2021 Stroke Risk Factor Collaborators. (2024). Global, regional, and national burden of stroke and its risk factors, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet Neurology, 23(10), 973-1003. 5.Han, C., Wang, Q., Meng, P. P., & Qi, M. Z. (2013). Effects of intensity of arm training on hemiplegic upper extremity motor recovery in stroke patients: A randomized controlled trial. Clinical Rehabilitation, 27(1), 75-81. 6.Khalid, Z., Gulalai, Qamar, K., Khan, M., Afridi, A., & Rahat, A. (2024). Effects of action observation exercises with complex tasks on upper limb function in acute stroke. Journal of Health and Rehabilitation Research, 4(1), 318-324. 7.Mancuso, M., Di Tondo, S., Costantini, E., Damora, A., Sale, P., & Abbruzzese, L. (2021). Action Observation Therapy for upper limb recovery in patients with stroke: A randomized controlled pilot study. Brain Sciences, 11(3), 290. 8.Milani, G., Baroni, A., Galluccio, M., Fadiga, L., & Rossettini, G. (2025). Action Observation Training for upper limb stroke rehabilitation: A pilot study on the role of attention. Journal of Clinical Medicine, 14(18), 6618. Page, S. J., Hade, E., & Persch, A. (2015). Psycho

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 9, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 18, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 30, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 13, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 13, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
November 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • IIUI/RERC/ADT/2026/07/380

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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