Training Dual-Task Walking After Stroke: Effects on Attentional and Locomotor Control
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 37
- 试验地点
- 1
- 主要终点
- Dual-task cost on gait speed
研究概览
简要总结
Community ambulation is a highly complex skill requiring the ability to adapt to increased environmental complexity and perform multiple tasks simultaneously. Deficits in dual-tasking may severely compromise the ability to participate fully in community living. Unfortunately, current rehabilitation practice for stroke fails to adequately address dual-task limitations; individuals with stroke continue to exhibit clinically significant dual-task costs on gait at discharge. As a result, many stroke survivors are living in the community with residual deficits that may increase disability in the real world and lead to falls with devastating consequences. To address this issue, the proposed study investigates the efficacy of dual-task gait training on attention allocation and locomotor performance in community-dwelling stroke survivors. Because walking in the real world often requires time-critical tasks and obstacle avoidance, the investigators will test the impact of dual-task gait training on cognitive-motor interference during walking at preferred speed and at maximal speed (Aim 1), and on locomotor control during obstacle negotiation (Aim 2). The investigators will also evaluate the effects of the intervention on community reintegration and participation (Aim 3).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Within 3 years of stroke onset
- •Living in the community, operationally defined as living in one's own home, or the home of a friend, relative, or caregiver
- •Walking speed 0.6-1.1 m/s determined during 10-meter walk test
- •Walk without the assistance of another person
- •Medically stable and approved for participation by study physician
- •Intact global cognition indicated by score > 23 on Montreal Cognitive Assessment
- •Living in the community prior to stroke
排除标准
- •Pre-existing neurological disorders (e.g., Parkinson's disease, Multiple Sclerosis, dementia, traumatic brain injury)
- •Previous stroke with residual motor deficit
- •Uncontrolled hypertension
- •Inability to follow 3-step command
- •Primary uncontrolled hearing impairment
- •Severe uncontrolled visual impairment
- •Any speech-language impairment affecting ability to respond verbally to auditory stimuli
- •Timed Up and Go test > 15 seconds
- •Lower extremity amputation
- •Any orthopedic problem affecting gait
- •Concurrent participation in another clinical trial
研究组 & 干预措施
Dual-task gait training
Gait training with simultaneous performance of cognitive tasks for 75% of training session.
干预措施: Gait training (Behavioral)
Single-task gait training
Gait training (without simultaneous cognitive task performance)
干预措施: Gait training (Behavioral)
结局指标
主要结局
Dual-task cost on gait speed
时间窗: 4 weeks
The dual-task cost represents the difference between single and dual-task walking speed.
次要结局
- Stroke Impact Scale(Measured at baseline, post intervention (4 weeks), 6 months post intervention)
- Kinematics of gait during obstacle crossing(Measured at baseline, post intervention (4 weeks), 6 months post intervention)
- Executive function(Measured at baseline, post intervention (4 weeks), 6 months post intervention)
- Spontaneous physical activity(Measured at baseline, post intervention (4 weeks), 6 months post intervention)