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
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Abrish H Abbasi, PhD* Rehab
- Numéro de téléphone: 03155311799
- E-mail: abrish.habib@riphah.edu.pk
Lieux d'étude
-
-
Punjab Province
-
Chak One Hundred Fifty-seven, Punjab Province, Pakistan
- Recrutement
- Family Diagnostic Center
-
Contact:
- Abrish H Abbasi, PhD* Rehab
- Numéro de téléphone: 03155311799
- E-mail: abrish.habib@riphah.edu.pk
-
Contact:
- Arshad Nawaz Malik, PhD Rehab
- E-mail: arshad.nawaz@riphah.edu.pk
-
Sous-enquêteur:
- Abrish H Abbasi, PhD* Rehab
-
Chercheur principal:
- Muattar Hina, MS-NMPT*
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: 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
|
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
|
|
Comparateur actif: 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.
|
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.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Berg Balance Scale(BBS)
Délai: 6 weeks
|
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)
|
6 weeks
|
|
Timed-Up and Go Test
Délai: 6 weeks
|
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
|
6 weeks
|
|
Postural Assessment Scale (PASS)
Délai: 6 weeks
|
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.
|
6 weeks
|
|
Dual Task Cost (DTC)
Délai: 6 weeks
|
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
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Muattar Hina, MS-NMPT*, Riphah International Unversity
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 02269/ Muattar Hina
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .