Stroke Clinical Trial
Official title:
Training Dual-task Balance and Walking in People With Stroke: a Randomized Controlled Trial
Stroke is one of the most common chronic disabling conditions in Hong Kong. People after
stroke may suffer from certain degree of physical impairment and disability. Resuming safe
ambulation in the community appears to be a big challenge to them as it always involves the
simultaneous performance of two or more tasks (dual task) such as walking and talking with
someone, walking and recalling the shopping list etc. Numerous studies has demonstrated that
the interference from dual tasks (dual task interference) may significantly impact the
recovery of the functional walking. To date, the relevance of dual task walking to daily
community is widely documented and the ability of managing dual task is therefore
particularly important. Evidences supported that dual task training showed its promising
effect on the balance and walking performance amongst people with neurological disorders,
such as chronic stroke. In light of this, the introduction of dual task based balance and
walking training into physiotherapy program for stroke patient may enhance the balance and
walking performance and hence promote successful community ambulation. Yet, there is limited
evidence on its effect in sub-acute stroke.
Objective: To examine the effectiveness of a dual-task based balance and walking training
program on performance and dual task interference in balance and walking ability, balance
self-efficacy and incidence of falls in people with sub-acute stroke
An assessor-blind, randomized control trial will be conducted. Eighty-four people with
sub-acute stroke and fulfill the eligibility criteria will be recruited from the medical
wards of the Queen Elizabeth Hospital (QEH) or from the Physiotherapy Department of the QEH.
Subjects will be randomly allocated into either dual-task training (DT) group (n=28) or
single-task training (ST) group (n=28) or Control (C) group (n=28) by 1:1:1 randomization
sequence after baseline evaluation. All subjects will receive usual physiotherapy training.
Subjects in the DT group will undergo 30 minutes of dual task training with simultaneously
performing balance and walking exercise and attention demanding tasks, and 30 minutes of
stretching exercises whereas those in the ST group will undergo single task training with 30
minutes of balance and walking exercise and 30 minutes of attention demanding task performed
separately. Subjects in the control group will receive stretching and strengthening exercise
only. The training program will last for 8 weeks with frequency of 2 sessions a week and
duration of 60 minutes per session.
The degree of the dual-task interference, the balance and walking performance in dual task
conditions will be evaluated at three time points: (1) Baseline (within one week before the
intervention (2) within one week after completion of training (3) 8 weeks after the
completion of training by blinded assessors. Also, the subjects will have monthly telephone
follow up on the fall incidence for 6 months after completion of the program.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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