A study to compare two different learning methods to see which helps adult long term stroke survivors to walk better while doing a counting task

Phase 3

Not yet recruiting

Conditions: Sequelae of unspecified cerebrovascular diseases. Ayurveda Condition: PAKSHAGHATA/PAKSHAVADHAH,

Registration Number: CTRI/2025/05/086833

Lead Sponsor: All India Institute of Physical Medicine and Rehabilitation

Brief Summary: Stroke is a leading cause of adult disability worldwide, commonly resulting in motor and cognitive impairments that significantly hinder daily activities, particularly dual tasks like talking while walking. Dual-task training is essential in stroke rehabilitation as it targets both motor and cognitive challenges, improving functional independence, community participation, and quality of life. Gait training is a key rehabilitation focus, though even after regaining walking ability, patients remain vulnerable to interference during multitasking. Motor learning which is critical in stroke recovery occurs in three phases: acquisition, consolidation, and retention, with different brain regions involved in each phase. Stroke-related brain damage affects these phases differently but may be mitigated by neural compensation. Two motor learning strategies-explicit (conscious, instruction-based) and implicit (automatic, unconscious) offer tailored approaches. While both methods can improve motor tasks, it’s still unclear which is more effective for dual-task situations. There is limited research comparing these approaches in real-life tasks as most studies have been done in non clinical tasks such as serial reaction time task. This study is aims to find out which learning strategy works best for improving dual-task performance of gait cognitive dual task after stroke, helping to guide better rehabilitation.

Methodology- This is a crossover experimental study. 18 participants who meet the selection criteria will participate in the study. Convenience sampling and then random allocation will be done. Pre training dual task measurement will be done for all participants. Each group will have nine participants. Group A will receive implicit training first, followed by explicit training after 48 hours, while Group B will follow the reverse order. All participants will undergo both types of training, with the sequence depending on their group assignment. Post training dual task measurement will be done.

Statistical analysis-Statistical analysis will be conducted at a 95% confidence level, with significance set at P < 0.05. Data normality will be assessed using the Shapiro-Wilk test; if normal, a paired t-test will be used, otherwise the Wilcoxon signed-rank test will be applied.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 18

Inclusion Criteria

1.Unilateral Hemiparesis or Hemiplegia occurring for the first time after a CVA with duration of at least 6 months since onset.
2.Individuals walking independently with or without help of assistive device with speed of more than or equal to 0.4m per second.
3.Age-18-60 years.
4.Individuals with MMSE score more than 24.

Exclusion Criteria

1.Individuals having any other neurological or musculoskeletal or cardiopulmonary clinical manifestations that could affect gait performance.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Figure of 8 walking test	Baseline( Day 1), After first intervention on the same day (Day 1), After washout period of 48 hours post second intervention (Day 4)

Secondary Outcome Measures

Name	Time	Method
Not Applicable	Not Applicable

Trial Locations

Locations (1): AIIPMR,KK Marg, Haji Ali Government Colony, Mahalakshmi, Mumbai, Maharashtra, India 400034
🇮🇳
Mumbai, MAHARASHTRA, India
AIIPMR,KK Marg, Haji Ali Government Colony, Mahalakshmi, Mumbai, Maharashtra, India 400034
🇮🇳Mumbai, MAHARASHTRA, India
Dr Bhakti Somani PT
Principal investigator
9834925758
bhaktisomani07@gmail.com