Training Dual-Task Walking After Stroke
- Conditions
- Stroke
- Interventions
- Behavioral: Gait training
- Registration Number
- NCT01568957
- Lead Sponsor
- University of North Carolina, Chapel Hill
- Brief Summary
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).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 37
- 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
- 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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Dual-task gait training Gait training Gait training with simultaneous performance of cognitive tasks for 75% of training session. Single-task gait training Gait training Gait training (without simultaneous cognitive task performance)
- Primary Outcome Measures
Name Time Method Dual-task cost on gait speed 4 weeks The dual-task cost represents the difference between single and dual-task walking speed.
- Secondary Outcome Measures
Name Time Method 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 A computerized version of the Stroop task will be used to assess changes in executive function.
Spontaneous physical activity Measured at baseline, post intervention (4 weeks), 6 months post intervention Spontaneous physical activity will be assessed with an activity monitor (PAMSys) worn for two consecutive days at each assessment timepoint.
Trial Locations
- Locations (1)
University of North Carolina
🇺🇸Chapel Hill, North Carolina, United States