Rhythmic Auditory Stimulation and Dual-task Gait Training in Chronic Stroke

Combined Rhythmic Auditory Stimulation and Dual-task Gait Training in Individuals With Chronic Stroke: a Pre-post Study With Exploratory Age-stratified Analyses

Rhythmic auditory stimulation and dual-task gait training may improve post-stroke mobility, but evidence regarding integrated programmes and age-related differences in treatment response remains limited. The aim of the study is to evaluate changes in mobility, balance, motor dual-task performance, concern about falling, and health-related quality of life after a six-week combined programme, and to explore whether responses differed across age strata.

Study Overview

• Status: Completed
• Conditions: Stroke; Auditory Task; Dual Task; Gait Training
• Intervention / Treatment: Other: Rhythmic Auditory Stimulation and Motor Dual-Task Gait Training Programme

Detailed Description

This prospective single-group pre-post study included individuals with chronic stroke. Participants completed supervised rhythmic auditory stimulation and progressively intensified motor dual-task gait training three times weekly for six weeks. Outcomes included motor dual-task performance, Timed Up and Go, bilateral single-leg stance, Mini-BESTest, Falls Efficacy Scale-International, and SF-36. An independent assessor, unaware of previous scores and age-stratum allocation, conducted baseline and post-intervention assessments. Prespecified exploratory analyses compared changes across age strata.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Rize, Turkey (Türkiye)
    • Recep Tayyip Erdogan University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• age ≥45 years
• stroke ≥6 months previously
• ability to walk at least 10 m independently or with minimal assistance
• sufficient hearing to follow rhythmic auditory cues

Exclusion Criteria:

• advanced aphasia
• severe neglect, cognitive impairment,
• marked visual impairment,
• severe spasticity (Modified Ashworth Scale score15 ≥3)
• severe cardiopulmonary disease
• vestibular dysfunction
• an orthopaedic condition limiting walking
• progressive neurological disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Stroke Group; Participants completed a supervised six-week programme comprising three 30-minute sessions per week (18 sessions; planned dose, 540 minutes). During each session, they synchronized their steps with a metronome while performing tandem walking with progressively demanding object-carrying tasks. Participants maintained their usual walking speed and were instructed to give equal attention to gait and the concurrent motor task. Progression was designed by the research team in accordance with general motor-learning principles and involved predefined weekly increases in metronome tempo and concurrent motor-task complexity.

Other: Rhythmic Auditory Stimulation and Motor Dual-Task Gait Training Programme; The intervention combined RAS with progressively intensified motor dual-task gait training.6 Participants completed a supervised six-week programme comprising three 30-minute sessions per week (18 sessions; planned dose, 540 minutes). During each session, they synchronized their steps with a metronome while performing tandem walking with progressively demanding object-carrying tasks. Participants maintained their usual walking speed and were instructed to give equal attention to gait and the concurrent motor task. Progression was designed by the research team in accordance with general motor-learning principles and involved predefined weekly increases in metronome tempo and concurrent motor-task complexity. provided that the preceding stage had been completed safely. All sessions were delivered individually by the same licensed physiotherapist experienced in neurology.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motor dual-task performance	Participants completed a 10-m walk at their comfortable speed under single-task and motor dual-task conditions. In the dual-task condition, they carried a ball while walking and were instructed to give equal attention to both tasks. Three trials were performed under each condition, and mean completion time was used in the analysis. Positive values indicated greater dual-task interference.	at baseline and after the six-week programme
Functional mobility	Functional mobility was assessed using the Timed Up and Go test, with shorter completion times indicating better performance. One familiarization trial preceded the timed assessment.	at baseline and after the six-week programme
Balance	Dynamic balance was assessed using the 14-item Mini-BESTest, which evaluates anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait. Total scores range from 0 to 28, with higher scores indicating better balance. Static balance was assessed bilaterally using the Single-Leg Stance Test. Two trials were performed on each side, and the longest duration before foot contact, stance-foot movement, or loss of balance was recorded.	at baseline and after the six-week programme

Collaborators and Investigators

• Sponsor: Recep Tayyip Erdogan University
• Collaborators: İstanbul Yeni Yüzyıl Üniversitesi

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 2026
• Primary Completion (Actual): May 15, 2026
• Study Completion (Actual): May 15, 2026

Study Registration Dates

• First Submitted: July 11, 2026
• First Submitted That Met QC Criteria: July 11, 2026
• First Posted (Actual): July 16, 2026

Study Record Updates

• Last Update Posted (Actual): July 16, 2026
• Last Update Submitted That Met QC Criteria: July 11, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: 2026/01-1781

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: I do not prefer.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No