Comparative Effects of Dual Task Training and Repetitive Task Training in Chronic Stroke

Official title

Comparative Effects of Dual-task Gait Training and Repetitive Task Training on Dynamic Balance, Walking Function, Muscle Strength and Risk of Fall in Chronic Stroke

Overview

Chronic stroke survivors those who have had a stroke for more than six months frequently experience long-lasting, incapacitating deficits, particularly when it comes to motor task impairment. Furthermore, following a stroke, muscle coordination is frequently compromised, resulting in deficiencies in gait and balance control. Dual-task gait training involves incorporating the concept of "doing two tasks" simultaneously. Stroke survivors frequently struggle with walking and multitasking, such as juggling multiple things at once while walking. Repetitive task training (RTT) is a component of contemporary therapeutic approaches in stroke rehabilitation that entails the active practice of task-specific motor exercises. Repetitive task training strategy known as a task-oriented approach entails training a task repeatedly with an emphasis on functional performance aimed at successfully completing it. This study aims to determine the Comparative effects of Dual-task Gait Training and Repetitive task training on dynamic balance, walking function, muscle strength and risk of fall in chronic stroke patients.

Detailed description

It will be a single-blinded randomized clinical trial. Non-Probability Convenience sampling technique will be used to recruit 82 participants aged 40 to 70 years from diverse community areas in Gujrat. Through the computerized table generator method of randomization, the individuals will be randomly allocated to two groups, one undergoing Dual task gait training and the other Repetitive task training. Both the groups will perform their respective trainings for 3 days a week for 8 weeks. Tools such as Time Up and Go test (TUG) for walking function, Activity Specific Balance and Confidence ABC scale for fall risk assessment, Manual Muscle Testing (MMT) for strength, Berg Balance Scale (BBS) for balance will be used to measure outcomes. Data will be analyzed in the SPSS version 25. After normality testing of the data, the Paired sample t-test will be used for parametric data while Wilcoxon test will be used for non-parametric data in intragroup comparison, while for intergroup comparison, the independent t-test will be for parametric data and Mann-Whitney U test for non-parametric.

Interventions

• Other Dual task training
  Participants will receive 45-minute individualized training sessions, 3 times a week for 8weeks. The duration and intensity will be varying. Balance training and dual task training programs will be effective in improving balance function and dual-task performance in post stroke patients respectively The balance training program will use progressive activities related to body stability (e.g., standing with eyes closed, tandem standing, and standing on compliant surfaces), to body stability plus h
• Other Repetitive task training
  Repetitive task training Participants would encouraged to perform arms and legs movement in different directions as quickly. This programme is comprised of functional tasks, embedded in routine everyday activities completed on the ward or at home. This aims to make the programme highly relevant to participants, promote 'carry over' into real life situations, and encourage self-practice. Recovery activities like: washing, dressing and eating/ drinking. Participants will be asked to practice each

Primary outcome measures

• Dynamic Balance [Time frame: Baseline and post 8 weeks]
• Walking function [Time frame: Baseline and post 8 weeks]
• Muscle strength [Time frame: Baseline and post 8 weeks]
• Risk of Fall [Time frame: Baseline and post 8 weeks]

Eligibility criteria

Inclusion criteria

• The patient is between the age of 40 to 70 Male and female patients. Chronic post-stroke patients who experienced either ischemic or hemorrhagic stroke between 6 months to 1 year.

Participants who have issues in balance control and walking with berg balance score < 22 that indicates need for walking assistance and are at fall risk.

Participants who reported at least one fall in the past 6 months but retain ambulatory ability with/without aid.

Exclusion criteria

• Recurrent stroke patients. Participants included in other training/study. other neurological conditions, cardiovascular condition, other serious diseases or conditions (e.g., osteoporosis) Patient with severe hypertension, congestive heart failure, unstable cardiac status, aphasia, or cognitive disabilities for which exercise is not recommended.

Patients whose walking abilities are impacted by various medical conditions and neurologic illnesses that are worsening.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Other

Study locations

Pakistan · 1 center

• Amin Welfare & Teaching Hospital — Sialkot

Identifiers

NCT: NCT07726017 · REC/RCR & AHS/25/0239

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗