Dual Task Training Versus Single Task Training in Chronic Hemiplegic Stroke Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 62
- 试验地点
- 1
- 主要终点
- Change in Gait Performance (Tinetti Gait Subscore)
研究概览
简要总结
What is this study about? This study compares two common ways of practicing walking and balance after a stroke: (1) dual-task training, where a person walks or balances while doing a second task (such as counting backward or carrying a light object), and (2) single-task training, where a person practices walking and balance without any extra task. The goal is to learn whether practicing with or without an added task is more practical and acceptable for people living with long-standing weakness on one side of the body (hemiplegia) after stroke.
Why is this important? Many everyday activities-walking while talking, looking for a bus, or carrying a bag-require attention to more than one thing at a time. Some stroke survivors find this difficult. Training that safely mimics real-life multitasking may help therapists design better rehabilitation plans.
Who can take part? Adults aged 45-65 years with a diagnosis of hemiplegic stroke who can walk without hands-on help may be eligible. People with other neurological conditions that affect walking, severe problems with understanding or communication, or recent serious medical/surgical issues will not be included. Additional screening will check safety for exercise.
What will happen if I join?
Participants are randomly assigned (like a coin toss) to one of two groups:
Dual-task training group: walking/balance activities plus a simple cognitive or motor task.
Single-task training group: the same walking/balance activities without any extra task.
Both groups attend 60-minute sessions, three times per week, for six weeks at The University of Lahore Teaching Hospital or Sehat Medical Complex. A trained therapist supervises all sessions and adjusts difficulty gradually. Short rest breaks are provided.
What will be measured? At baseline, 2 weeks, 4 weeks, and 6 weeks, an assessor who does not know the assigned group will record walking and balance using the Tinetti Performance-Oriented Mobility Assessment (POMA). Safety (such as any falls, dizziness, or discomfort) and attendance will also be recorded.
What are the possible risks and benefits? Risks are similar to supervised physiotherapy: temporary muscle soreness, fatigue, or loss of balance. Therapists use safety measures (close supervision, stable equipment, and rest periods). Participants may experience the general benefits of structured rehabilitation (practice, education, and monitored activity). Taking part is voluntary, and usual care remains available.
Privacy and cost Personal information is kept confidential and stored securely. There is no payment for participation. There are no charges for study-related therapy sessions.
Time commitment About 18 sessions over 6 weeks, plus four short assessment visits.
Contacts Study team members can answer questions at any time and will obtain written informed consent before any study procedures begin.
详细描述
Study design and setting Single-center, parallel-group, randomized, single-blind controlled trial conducted at the University Institute of Physical Therapy (UIPT), Faculty of Allied Health Sciences, The University of Lahore, with sessions delivered at the University of Lahore Teaching Hospital and Sehat Medical Complex.
Rationale After stroke, many individuals report difficulty walking when attention is divided. Rehabilitation programs often use either single-task practice or add a concurrent cognitive or motor task to approximate everyday demands. A standardized comparison of these two approaches over a fixed dose of therapy can inform practical rehabilitation planning.
Participants
Target population: Adults (45-65 years) with hemiplegic stroke who can ambulate without physical assistance.
Key inclusion criteria: clinical diagnosis of hemiplegic stroke; able to follow instructions; ambulatory (with or without an assistive device but without hands-on help).
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
- 45 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients diagnosed with hemiplegic stroke (Nam, 2023)
- •Both males and females patients
- •Participants ≤ 6 months poststroke (Nam, 2023)
- •Participants age between 45-65(Zhou et al., 2021)
- •Patients who are able to walk without assistance.(Joya, 2023) .
排除标准
- •History of other neurological conditions effecting mobility (Muzio et al., 2023).
- •Severe cognitive impairments or communication difficulties. (Liu et al., 2017)
- •Recent acute medical/surgical conditions unrelated to stroke.(Nam, 2023)
- •Other Systemic disease
- •Participants with severe hemiparesis who are unable to produce movement accurately (Zhang et al., 2022).
研究组 & 干预措施
Dual-Task Training (DTT)
Participants receive structured gait and balance training combined with a concurrent secondary task. Secondary tasks include simple cognitive challenges (such as counting backward or naming objects) or light motor tasks (such as carrying a cup or tossing a ball). Sessions are 60 minutes, three times per week for six weeks, delivered under therapist supervision. Task difficulty is gradually increased while maintaining safety.
干预措施: Dual-Task Training (DTT) (Behavioral)
Single-Task Training (STT)
Participants receive the same dose of gait and balance training as the experimental arm, but without any concurrent secondary task. Exercises include level walking, directional changes, obstacle negotiation, and balance tasks on stable or unstable surfaces. Sessions are 60 minutes, three times per week for six weeks, supervised by a therapist. Difficulty is progressed through physical task demands only.
干预措施: Single-Task Training (STT) (Behavioral)
结局指标
主要结局
Change in Gait Performance (Tinetti Gait Subscore)
时间窗: Baseline, 2 weeks, 4 weeks, and 6 weeks
The gait component of the Tinetti POMA, scored 0-12, assessing step length, symmetry, initiation, path deviation, and trunk stability during walking. Higher scores indicate better gait performance.
Change in Balance Performance (Tinetti Balance Subscore)
时间窗: Baseline, 2 weeks, 4 weeks, and 6 weeks
The balance component of the Tinetti Performance-Oriented Mobility Assessment (POMA), scored 0-16, with higher scores indicating better balance. Used to evaluate static and dynamic balance during standing and transitional tasks.
次要结局
未报告次要终点
研究者
Rabiya Sadaf
Student
University of Lahore