Effect of Cognitive-Motor Dual-Task Training on Postural Stability and Functional Mobility in Stroke
Effect of Cognitive-Motor Dual-Task Training on Postural Stability and Functional Mobility in Stroke Survivors
Přehled studie
Postavení
Podmínky
Detailní popis
Strokes are a leading cause of long-term disability worldwide because they frequently result in significant impairments in both cognitive and physical abilities. Traditional rehabilitation methods have primarily focused on single-task training, which targets motor or cognitive processes separately. However, the complex demands of daily tasks, which often require simultaneous cognitive and physical processing, may be too much for these approaches to handle. Cognitive-motor dual-task training (CMDT), which blends cognitive tasks with motor activities, has emerged as a promising rehabilitation method to more accurately mimic real-world scenarios. This approach blends a cognitive task, like problem-solving or attention-demanding activities, with a physical task, like walking or balancing exercises. By enhancing the brain's ability to manage multiple tasks simultaneously, CMDT aims to improve the cognitive and motor outcomes of stroke patients.
It has been demonstrated that dual-tasking increases activity in the prefrontal cortex, a region of the brain related to executive function and attention, which is crucial for managing several tasks at once. By stimulating these brain networks, CMDT may improve neuroplasticity and functional remodelling, which may lead to better postural control and mobility recovery. CMDT is based on two neurophysiological processes: enhanced synaptic plasticity and increased expression of brain-derived neurotrophic factor (BDNF). When cognitive and motor tasks are carried out simultaneously, these mechanisms support synaptogenesis and neuroprotection. Despite the growing body of evidence supporting CMDT, more research is still needed to enhance training techniques, understand the mechanisms behind its effects, and evaluate long-term outcomes. Recent meta-analyses have shown that CMDT therapies result in long-lasting cognitive improvements, including improvements in working memory, cognitive flexibility, and executive function all of which are essential for functional independence. In comparison to single-task training, recent RCTs have shown that CMDT improves quality of life while also improving upper extremity and cognitive performance. Dual-task therapies that include activities of daily living promote motivation and active engagement, leading to significant improvements in functional ability and life satisfaction.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Abrish H Abbasi, PhD* Rehab
- Telefonní číslo: 03155311799
- E-mail: abrish.habib@riphah.edu.pk
Studijní místa
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Punjab Province
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Chak One Hundred Fifty-seven, Punjab Province, Pákistán
- Family Diagnostic Center
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Kontakt:
- Abrish H Abbasi, PhD* Rehab
- Telefonní číslo: 03155311799
- E-mail: abrish.habib@riphah.edu.pk
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Kontakt:
- Arshad Nawaz Malik, PhD Rehab
- E-mail: arshad.nawaz@riphah.edu.pk
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Dílčí vyšetřovatel:
- Abrish H Abbasi, PhD* Rehab
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Vrchní vyšetřovatel:
- Muattar Hina, MS-NMPT*
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Age between 40-75 years.
- Clinically diagnosed ischemic or hemorrhagic stroke (≥3 months,post-onset).
- Ability to follow verbal commands (MMSE≥24).
- Medically stable and cleared for physical activity.
- Able to walk independently or with minimal assistance (Functional Ambulation Categories ≥3)
- Berg Balance Scale score between 21-45 (indicating moderate fall risk).
Exclusion Criteria:
- Severe aphasia or language deficits impacting task comprehension.
- Severe spasticity (modified Ashworth scale ≥2 in lower limbs).
- Visual or vestibular impairments affecting balance.
- Severe musculoskeletal conditions or orthopedic impairments that limit safe participation in balance and gait training. (e.g. recent fractures , severe arthritis).
- Diagnosed Dementia or neurodegenerative disorders
- Participation in any other structured dual-task or cognitive training program within the past 3 months
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
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Experimentální: Cognitive-motor dual-task training (CMDT) Group
Cognitive-motor dual-task training (CMDT) conducted three times weekly for 45-60 minutes with 10 repetitions each task over 6 weeks progressively challenges stroke survivors with static and dynamic tasks in weeks 1-2, anticipatory tasks in weeks 3-4, and reactive tasks in weeks 5-6, integrating cognitive challenges such as verbal fluency, Stroop tests, and auditory reactions with motor activities like walking and balance exercises
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Cognitive-motor dual-task training (CMDT) conducted three times weekly for 45-60 minutes with 10 repetitions each task over 6 weeks progressively challenges stroke survivors with static and dynamic tasks in weeks 1-2, anticipatory tasks in weeks 3-4, and reactive tasks in weeks 5-6, integrating cognitive challenges such as verbal fluency, Stroop tests, and auditory reactions with motor activities like walking and balance exercises
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Aktivní komparátor: Conventional Balance Training
Static and dynamic balance exercises without cognitive load, e.g., standing and shifting weight, conducted three times weekly for 45-60 minutes with 10 repetitions each task over 6 weeks progressively challenges stroke survivors with static and dynamic tasks in weeks 1-2, anticipatory tasks in weeks 3-4, and reactive tasks in weeks 5-6.
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Static and dynamic balance exercises without cognitive load, e.g., standing and shifting weight, conducted three times weekly for 45-60 minutes with 10 repetitions each task over 6 weeks progressively challenges stroke survivors with static and dynamic tasks in weeks 1-2, anticipatory tasks in weeks 3-4, and reactive tasks in weeks 5-6.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Berg Balance Scale(BBS)
Časové okno: 6 weeks
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A clinical tool used to assess static and dynamic balance through 14 functional tasks. Tasks include sitting, standing, reaching, turning, and single-leg stance. It evaluates a person's ability to maintain balance during common daily activities and helps determine the risk of falls, especially in stroke patients and older adults. Scoring: Each item is scored from 0 to 4 (maximum score: 56)
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6 weeks
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Timed-Up and Go Test
Časové okno: 6 weeks
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A simple test used to assess mobility, balance, walking ability, and fall risk. The participant is timed while standing up from a chair, walking 3 meters, turning around, walking back, and sitting down. Scoring: Time recorded in seconds
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6 weeks
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Postural Assessment Scale (PASS)
Časové okno: 6 weeks
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A stroke-specific tool used to assess postural control in lying, sitting, and standing positions.
It includes 12 items that evaluate the ability to maintain or change postures.
Scoring: Each item scored 0-3 (Total score: 36) Higher scores indicate better postural control.
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6 weeks
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Dual Task Cost (DTC)
Časové okno: 6 weeks
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Quantifies the impact of performing a cognitive task on motor performance (e.g., gait or balance). Calculated as: DTC(%)= Single-task performance-Dual-task performance×100 Higher DTC values indicate greater dual-task interference and poorer ability to manage simultaneous cognitive and motor demands. |
6 weeks
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Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Muattar Hina, MS-NMPT*, Riphah International Unversity
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- 02269/ Muattar Hina
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