Comparative Effects of Dual Task Training and Repetitive Task Training in Chronic Stroke

Comparative Effects of Dual-task Gait Training and Repetitive Task Training on Dynamic Balance, Walking Function, Muscle Strength and Risk of Fall in Chronic Stroke

Chronic stroke survivors those who have had a stroke for more than six months frequently experience long-lasting, incapacitating deficits, particularly when it comes to motor task impairment. Furthermore, following a stroke, muscle coordination is frequently compromised, resulting in deficiencies in gait and balance control. Dual-task gait training involves incorporating the concept of "doing two tasks" simultaneously. Stroke survivors frequently struggle with walking and multitasking, such as juggling multiple things at once while walking. Repetitive task training (RTT) is a component of contemporary therapeutic approaches in stroke rehabilitation that entails the active practice of task-specific motor exercises. Repetitive task training strategy known as a task-oriented approach entails training a task repeatedly with an emphasis on functional performance aimed at successfully completing it. This study aims to determine the Comparative effects of Dual-task Gait Training and Repetitive task training on dynamic balance, walking function, muscle strength and risk of fall in chronic stroke patients.

Study Overview

• Status: Recruiting
• Conditions: Stroke
• Intervention / Treatment: Other: Dual task training; Other: Repetitive task training

Detailed Description

It will be a single-blinded randomized clinical trial. Non-Probability Convenience sampling technique will be used to recruit 82 participants aged 40 to 70 years from diverse community areas in Gujrat. Through the computerized table generator method of randomization, the individuals will be randomly allocated to two groups, one undergoing Dual task gait training and the other Repetitive task training. Both the groups will perform their respective trainings for 3 days a week for 8 weeks. Tools such as Time Up and Go test (TUG) for walking function, Activity Specific Balance and Confidence ABC scale for fall risk assessment, Manual Muscle Testing (MMT) for strength, Berg Balance Scale (BBS) for balance will be used to measure outcomes. Data will be analyzed in the SPSS version 25. After normality testing of the data, the Paired sample t-test will be used for parametric data while Wilcoxon test will be used for non-parametric data in intragroup comparison, while for intergroup comparison, the independent t-test will be for parametric data and Mann-Whitney U test for non-parametric.

• Study Type: Interventional
• Enrollment (Estimated): 82
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad, PhD; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk

Study Locations

• Pakistan
  • Sialkot, Pakistan
    • Recruiting
    • Amin Welfare & Teaching Hospital
    • Contact: Dr. Aqsa Gulzar Ahmed; Phone Number: 03484071699; Email: aqsachodhary504@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• The patient is between the age of 40 to 70 Male and female patients. Chronic post-stroke patients who experienced either ischemic or hemorrhagic stroke between 6 months to 1 year.

Participants who have issues in balance control and walking with berg balance score < 22 that indicates need for walking assistance and are at fall risk.

Participants who reported at least one fall in the past 6 months but retain ambulatory ability with/without aid.

Exclusion Criteria:

• Recurrent stroke patients. Participants included in other training/study. other neurological conditions, cardiovascular condition, other serious diseases or conditions (e.g., osteoporosis) Patient with severe hypertension, congestive heart failure, unstable cardiac status, aphasia, or cognitive disabilities for which exercise is not recommended.

Patients whose walking abilities are impacted by various medical conditions and neurologic illnesses that are worsening.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Dual task training group A; Participants will receive 45-minute individualized training sessions, 3 times a week for 8weeks. The duration and intensity will be varying. Balance training and dual task training programs will be effective in improving balance function and dual-task performance in post stroke patients respectively The balance training program will use progressive activities related to body stability (e.g., standing with eyes closed, tandem standing, and standing on compliant surfaces), to body stability plus hand manipulation (e.g., standing on foam with rapid alternating hand movement or while throwing and catching a ball, and tandem standing while holding a basket), then body transport (e.g., narrow walking, walking backward, and transferring from 1 chair to another), and finally body transport plus hand manipulation. The participants receiving dual-task training with fixed-priority instructions will practice balance tasks while simultaneously performing cognitive tasks, and will be instructed to	Other: Dual task training; Participants will receive 45-minute individualized training sessions, 3 times a week for 8weeks. The duration and intensity will be varying. Balance training and dual task training programs will be effective in improving balance function and dual-task performance in post stroke patients respectively The balance training program will use progressive activities related to body stability (e.g., standing with eyes closed, tandem standing, and standing on compliant surfaces), to body stability plus hand manipulation (e.g., standing on foam with rapid alternating hand movement or while throwing and catching a ball, and tandem standing while holding a basket), then body transport (e.g., narrow walking, walking backward, and transferring from 1 chair to another), and finally body transport plus hand manipulation. The participants receiving dual-task training with fixed-priority instructions will practice balance tasks while simultaneously performing cognitive tasks, and will be instructed to m
Active Comparator: Repetitive task training group B; While for Repetitive task training Participants would encouraged to perform arms and legs movement in different directions as quickly. This programme is comprised of functional tasks, embedded in routine everyday activities completed on the ward or at home. This aims to make the programme highly relevant to participants, promote 'carry over' into real life situations, and encourage self-practice. Recovery activities like: washing, dressing and eating/ drinking. Participants will be asked to practice each selected recovery activity independently for up to 20 times, twice per day. To performs RTT, the therapist selects a task relevant to the patient's daily activities-such as sit-to-stand transfers, stepping exercises, or walking-and guides the patient through high repetitions of that task. For example, a lower limb RTT session may include 3 sets of 10-15 sit-to-stand repetitions, step- ups on a low platform, or repeated 10-meter walking laps. Session time typically varies is repeated 3	Other: Repetitive task training; Repetitive task training Participants would encouraged to perform arms and legs movement in different directions as quickly. This programme is comprised of functional tasks, embedded in routine everyday activities completed on the ward or at home. This aims to make the programme highly relevant to participants, promote 'carry over' into real life situations, and encourage self-practice. Recovery activities like: washing, dressing and eating/ drinking. Participants will be asked to practice each selected recovery activity independently for up to 20 times, twice per day. To performs RTT, the therapist selects a task relevant to the patient's daily activities-such as sit-to-stand transfers, stepping exercises, or walking-and guides the patient through high repetitions of that task. For example, a lower limb RTT session may include 3 sets of 10-15 sit-to-stand repetitions, step- ups on a low platform, or repeated 10-meter walking laps. Session time typically varies is repeated 3 times per

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dynamic Balance	Berg Balance Scale (BBS)	Baseline and post 8 weeks
Walking function	Time up and Go test (TUG)	Baseline and post 8 weeks
Muscle strength	Manual muscle testing(MMT)	Baseline and post 8 weeks
Risk of Fall	Activities specific Balance Confidence Scale (ABC)	Baseline and post 8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Aiza Yousaf, MS-OMPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2025
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): August 2, 2026

Study Registration Dates

• First Submitted: July 21, 2026
• First Submitted That Met QC Criteria: July 21, 2026
• First Posted (Actual): July 24, 2026

Study Record Updates

• Last Update Posted (Actual): July 24, 2026
• Last Update Submitted That Met QC Criteria: July 21, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: muscle strength; walking function; Dynamic Balance; risk of fall; Dual-task Gait Training; Repetitive task training
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: REC/RCR & AHS/25/0239

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