Dual-task Training Combined With tDCS on Cognitive-motor Performance and Brain Activity in Stroke Patients (dual-task tDCS)

The Effect of Dual-task Training Combined With tDCS on Cognitive-motor Interference and Related Brain Activity in Stroke Patients

The purpose of this study is to evaluate tDCS combined with cognitive-motor training on dual-task interference during dual-task walking, dual-task foot pedaling and the corresponding alterations of brain activity.

Study Overview

• Status: Recruiting
• Conditions: Stroke; Cortical Excitability
• Intervention / Treatment: Other: active tDCS with dual-task training; Other: sham tDCS with dual-task training

Detailed Description

In China, the prevalence of stroke increased by 106.0% (93.7-118.8) between 1990 and 2019, highlighting the persistent and substantial burden of this condition. Post-stroke recovery, particularly the ability to achieve community ambulation, plays a critical role in improving health-related quality of life. Effective community ambulation in daily life requires the ability to dual-task-namely, to perform concurrent tasks requiring attentional resources while maintaining walking function and balance. Emerging evidence suggests that stroke survivors face greater challenges in walking function and dual-task balance compared to their age-matched, able-bodied counterparts. For instance, when tasked with recalling a shopping list while walking, stroke patients exhibit a more pronounced decline in both walking speed and cognitive performance relative to control groups. Given the necessity for stroke survivors to reintegrate into the community, it is imperative to thoroughly investigate this phenomenon of cognitive-motor interference.

• Study Type: Interventional
• Enrollment (Estimated): 72
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Prof. Marco PANG; Phone Number: +852 2766 7156; Email: Marco.Pang@polyu.edu.hk

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Recruiting
    • The Hong Kong Polytechnic University
    • Contact: Marco Yiu-Chung Pang; Phone Number: +852 2766 7156; Email: marco.pang@polyu.edu.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• a diagnosis of stroke, stroke onset of more than 6 months,
• aged 50 or more,
• capable of following verbal and visual instructions,
• having a Montreal Cognitive Assessment score ≥ 22,
• able to walk for 10 meters with/without a mobility aid,
• community-dwelling, unilateral stroke

Exclusion Criteria:

• neurological disorders, gait-precluding pain or comorbidity,
• receiving any formal rehabilitation training,
• contraindications to exercise (e.g., unstable angina),
• contraindications to fNIRS, MRI, and tDCS (e.g., brain skin injury, pacemaker, metal implants in the brain),
• history of seizure or epilepsy,
• color blindness.
• unable to walk with/without a mobility aid while responsing stimulus by the remote control

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: active tDCS combined with dual-task group; patients receive three active tDCS and three dual motor-cognitive exercise training per week for four weeks.	Other: active tDCS with dual-task training; participants receive three 20-minute active tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks.
Active Comparator: sham tDCS combined with dual-task group; Patients receive three sham tDCS and three dual cognitive-motor exercise training per week for four weeks.	Other: sham tDCS with dual-task training; participants receive three 20-minute sham tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dual-task gait speed	Gait speed under dual-task condition will be recorded	Through study completion, an average of 1 year
Dual-task cognitive performance	Number of correct responses will be measured during dual-task conditions	Through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dual-task gait performance 1	Gait cadence will be measured during dual-task walking	Through study completion, an average of 1 year
Oxyhemoglobin concentration changes of the brain	Oxyhemoglobin concentration changes will be measured using functional near infra-red spectroscopy during dual-task walking	Through study completion, an average of 1 year
Dual-task gait performance 2	Gait cycle duration will be measured during dual-task walking	Through study completion, an average of 1 year
Dual-task gait performance 3	Stride length will be measured during dual-task walking	Through study completion, an average of 1 year
Dual-task cognitive performance 1	Correct reaction time under dual-task walking will be recorded	Through study completion, an average of 1 year
Blood oxygenation level changes of the brain	Blood oxygenation level changes will be measured using Magnetic Resonance Imaging during dual-task foot pedaling	Through study completion, an average of 1 year
Dual-task cognitive performance 2	Number of correct responses under dual-task foot pedaling will be recorded	Through study completion, an average of 1 year
Dual-task stride time	cadence under dual-task foot pedaling will be recorded	Through study completion, an average of 1 year
Dual-task gait performance 4	Step time under dual-task walking will be recorded	Through study completion, an average of 1 year

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Single-task walking speed	10-meter walking test will be used to assess single-task walking speed in meters per second	Through study completion, an average of 1 year
Balance 1	Mini Balance Evaluation Systems Test will be used to assess postural control, with total points from 0-28. Higher points indicate better performance.	Through study completion, an average of 1 year
Balance 2	Activities-specific Balance Confidence Scale will be used to assess confidence of functional balance performance, with total points from 0-100. Higher points indicate better performance.	Through study completion, an average of 1 year
Cognitive performance	Stroop color word test will be used to assess executive function	Through study completion, an average of 1 year
Fall incidence	Monthly telephone interviews for recording fall incidence	Through study completion, an average of 1 year
Dual-task peak angular velocity	Peak angular (dorsi-plantar flexion) velocity under dual-task foot pedaling will be recorded	Through study completion, an average of 1 year
Dual-task cognitive performance 3	Correct reaction time under dual-task foot pedaling will be recorded	Through study completion, an average of 1 year
Cognitive performance 1	Montreal Cognitive Assessment will be used to assess global cognition, with total points from 0-30. Higher points indicate better performance.	before the initiation of training
Cognitive performance 2	Trail Making Test will be used to assess executive function	Through study completion, an average of 1 year
dual-task walking performance at maximal speed	Walking time under dual-task walking at maximal speed will be recorded	Through study completion, an average of 1 year
dual-task cognitive performance at maximal speed	Accuracy under dual-task walking at maximal speed will be recorded	Through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: The Hong Kong Polytechnic University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2025
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: January 6, 2025
• First Submitted That Met QC Criteria: January 9, 2025
• First Posted (Actual): January 10, 2025

Study Record Updates

• Last Update Posted (Actual): February 10, 2026
• Last Update Submitted That Met QC Criteria: February 6, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: tDCS; Dual-task training; Cognitive-motor interference
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: Marco PANG_tDCS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No