The Effect of Dual Task-Oriented Circuit Training on Neuroplasticity and Walking Adaptability in Subacute Stroke Patients: A Pilot and Feasibility Study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 36
- 试验地点
- 1
研究概览
简要总结
This pilot study aims to assess the feasibility, safety, and initial efficacy of an integrated Dual Task-Oriented Circuit Training (DTOCT) program for individuals in the subacute phase of stroke recovery. Although numerous patients recover the capacity to walk in a regulated hospital environment, they frequently encounter difficulties with "community ambulation," the capability to traverse real-world settings while multitasking (e.g., walking while conversing or circumventing barriers). This study will examine if the integration of high-intensity circuit training with cognitive difficulties can promote neuroplasticity and enhance the patient's capacity to safely traverse intricate daily settings.
详细描述
Cognitive-Motor Interference (CMI) makes it challenging for stroke survivors to reintegrate into their communities. Walking is an automatic subcortical process in a healthy brain. After a stroke, however, the brain often has to "consciously" control walking, which takes away mental resources from other tasks. This "functional gap" is why almost 80% of survivors can walk house-hold, but only 30% can safely get around in the community. This study examines the "Golden Window" of recovery (2 weeks to 5 months post-stroke), a timeframe characterized by optimal physiological conditions for neuroplasticity. The DTOCT protocol functions as a synergistic intervention: the circuit training induces cardiovascular intensity to stimulate systemic Brain-Derived Neurotrophic Factor (BDNF) release, while concurrent cognitive tasks (e.g., memory recall or the Stroop test) focus on localized neurotrophic support within the prefrontal cortex and hippocampus. This three-arm pilot study (DTOCT vs. pure task-oriented training vs. pure dual-tasking) will give us important information about how easy it is to recruit participants, how well they stick to the plan, and how big the initial effects are. These results will constitute an essential basis for an upcoming comprehensive Randomized Controlled Trial (RCT) designed to enhance the standard of neurorehabilitation in Indonesia.
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 (Participant)
入排标准
- 年龄范围
- 40 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosed with a first-ever subacute stroke (defined as 2 weeks to 5 months post-onset) with anterior circulation involvement.
- •Diagnosis confirmed via neuroimaging (CT or MRI).
- •Men and women aged 40 to 65 years.
- •Motor recovery in the lower limbs corresponding to Brunnstrom stages 4 to
- •Functional Ambulation Category (FAC) score of at least grade
- •Ability to walk independently, with or without walking aids.
- •Montreal Cognitive Assessment Indonesian version (MoCA-INA) score of ≥20, demonstrating the capacity to collaborate and follow multi-step instructions.
- •Medically stable with controlled comorbidities.
排除标准
- •Expressive or receptive aphasia that impedes task comprehension
- •Unstable cardiovascular or medical conditions (e.g., severe hypertension, congestive heart failure) for which moderate exercise is contraindicated.
- •Moderate to severe depression, indicated by a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 15.
研究者
Farida Arisanti
MD, PMR
Universitas Padjadjaran