Cognitive Motor Dual Task Versus Task Specific Training on Cognition and Motor Functioning in Stroke Patients

Stroke Clinical Trial

Official title:

Effects of Cognitive Motor Dual Task Versus Task Specific Training on Cognition and Motor Functioning in Stroke Patients

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT06454279
• Other study ID #: REC/MS-PT/018 Qudsia Hafeez
• Status: Active, not recruiting
• Phase: N/A
• Start date: May 30, 2024
• Est. completion date: December 5, 2024

Study information

• Verified date: June 2024
• Source: Riphah International University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study focuses on Dual Task Training as daily living involves many dual task conditions, in which a person requires to do two or more tasks at same time. without the ability to carry out these types of Dual movements. This study aims to improve the ability to do two tasks at same time, targeted to decrease the risk of fall in stroke patients. This study helps in understanding how multiple tasks simultaneously affects patients' abilities and creating effectiveness programs.

Description:

The World Health Organization (WHO) defines the stroke as a brain injury that causes rapid and noticeable changes in cerebral function, lasting 24 hours or longer, or resulting in death. Strokes can be caused by vascular issues and include cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage. Stroke is a syndrome characterized by acute neurological deficits caused by vascular injury in the central nervous system. It's a major cause of disability and mortality globally, resulting from various risk factors, diseases, and mechanisms. Dual-task training refers to the ability to simultaneously perform multiple cognitive and motor activities while maintaining postural control. Divided attention is the capacity to do more than one thing at the same time. Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. TST, or task-specific training, is a popular rehab approach that emphasizes function and is commonly used for stroke patients. It's all about targeting specific tasks to help with recovery.

RCT conducted on two groups, Dual Task Training and Task Specific training. interventions applied with a frequency of three times a week for eight weeks protocol. Participants will be divided into 2 groups. 1st group will receive Dual task training for motor and cognition simultaneously. 2nd group will receive task specific training for motor and cognition functioning.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 44
• Est. completion date: December 5, 2024
• Est. primary completion date: November 5, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 45 Years to 75 Years

Eligibility

Inclusion Criteria:

• Patients with age = 45 years' old both male and female.

• Patients with Mild cognitive impairment with MOCA score of 18-25.

• Patients with sub-acute or chronic stage of stroke and are able to sit

• independently for 30 secs.

• Patients with primary level education.

Exclusion Criteria:

• Patients with dementia that had been diagnosed by a neurologist.

• Patients with neurological, psychiatric, or medical disorders.

• Patients with auditory or visual impairments.

Related Conditions & MeSH terms

• Stroke

Intervention

Other:
• Dual Task Training
Exercise which combines cognitive task with motor task e.g Backward counting during sit ups. Calculation questions during stationary cycle for 10 mins. Sequentially perform movements on commands like normal standing (bipedal support with feet separated at shoulder width, Feet together (bipedal support with feet side by side), Semitandem stance, Tandem stance, one leg support on the dominant leg, one leg support on the nondominant leg by first laterally moving the trunk with shoulder abducted at least above 60 degree
• Task Specific Training
Wide based gait training. Auditory forward digit span: Remember as many as possible of the number/letter forward sequence, you were told Auditory backward digit span: Remember as many as possible of the number/letter back sequence, you were told Visual forward digit span: Remember as many as possible of the number forward sequence shown to you by means of cardboard Visual backward digit span: Remember as many as possible

Locations

Country	Name	City	State
Pakistan	National Institute of Rehabilitation sciences	Islamabad	Punjab

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (18)

Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, Fisher M, Pandian J, Lindsay P. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke. 2022 Jan;17(1):18-29. doi: 10.1177/17474930211065917. Erratum In: Int J Stroke. 2022 Apr;17(4):478. — View Citation

Iqbal M, Arsh A, Hammad SM, Haq IU, Darain H. Comparison of dual task specific training and conventional physical therapy in ambulation of hemiplegic stroke patients: A randomized controlled trial. J Pak Med Assoc. 2020 Jan;70(1):7-10. doi: 10.47391/JPMA.10443. — View Citation

Katz-Leurer M, Fisher I, Neeb M, Schwartz I, Carmeli E. Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disabil Rehabil. 2009;31(3):243-8. doi: 10.1080/09638280801927830. — View Citation

Kim H Yeh. Reliability, concurrent validity, and responsiveness of the FuglMeyer Assessment (FMA) for hemiplegic patients. Journal Of Physical Therapy Science. 2012; 24(9): 893.

Kim KH, Jang SH. Effects of Task-Specific Training after Cognitive Sensorimotor Exercise on Proprioception, Spasticity, and Gait Speed in Stroke Patients: A Randomized Controlled Study. Medicina (Kaunas). 2021 Oct 13;57(10):1098. doi: 10.3390/medicina57101098. — View Citation

Lam B, Middleton LE, Masellis M, Stuss DT, Harry RD, Kiss A, Black SE. Criterion and convergent validity of the Montreal cognitive assessment with screening and standardized neuropsychological testing. J Am Geriatr Soc. 2013 Dec;61(12):2181-2185. doi: 10.1111/jgs.12541. Epub 2013 Dec 9. — View Citation

Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011 May 14;377(9778):1693-702. doi: 10.1016/S0140-6736(11)60325-5. — View Citation

Marchesi G, Ballardini G, Barone L, Giannoni P, Lentino C, De Luca A, Casadio M. Modified Functional Reach Test: Upper-Body Kinematics and Muscular Activity in Chronic Stroke Survivors. Sensors (Basel). 2021 Dec 29;22(1):230. doi: 10.3390/s22010230. — View Citation

Muangpaisan W, Intalapaporn S, Assantachai P. Digit span and verbal fluency tests in patients with mild cognitive impairment and normal subjects in Thai-community. J Med Assoc Thai. 2010 Feb;93(2):224-30. — View Citation

Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine (Abingdon). 2020 Sep;48(9):561-566. doi: 10.1016/j.mpmed.2020.06.002. Epub 2020 Aug 6. — View Citation

Rost NS, Brodtmann A, Pase MP, van Veluw SJ, Biffi A, Duering M, Hinman JD, Dichgans M. Post-Stroke Cognitive Impairment and Dementia. Circ Res. 2022 Apr 15;130(8):1252-1271. doi: 10.1161/CIRCRESAHA.122.319951. Epub 2022 Apr 14. — View Citation

Scarpina F, Tagini S. The Stroop Color and Word Test. Front Psychol. 2017 Apr 12;8:557. doi: 10.3389/fpsyg.2017.00557. eCollection 2017. — View Citation

Tombaugh TN. Trail Making Test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004 Mar;19(2):203-14. doi: 10.1016/S0887-6177(03)00039-8. — View Citation

Traxler K, Schinabeck F, Baum E, Klotz E, Seebacher B. Feasibility of a specific task-oriented training versus its combination with manual therapy on balance and mobility in people post stroke at the chronic stage: study protocol for a pilot randomised controlled trial. Pilot Feasibility Stud. 2021 Jul 27;7(1):146. doi: 10.1186/s40814-021-00886-0. — View Citation

V.Rajalaxmi JA. Effects of Dual Task Training Versus PNF Pattern on Balance and Cognition in geriatrics population. International Journal of Life science and Pharma Research. 2022 July; 12(4).

Wolfe CD. The impact of stroke. Br Med Bull. 2000;56(2):275-86. doi: 10.1258/0007142001903120. — View Citation

Xiao Y, Yang T, Shang H. The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson's Disease. Brain Sci. 2023 Mar 3;13(3):437. doi: 10.3390/brainsci13030437. — View Citation

Yeh TT, Chang KC, Wang JJ, Lin WC, Wu CY. Neuroplastic Changes Associated With Hybrid Exercise-Cognitive Training in Stroke Survivors With Mild Cognitive Decline: A Randomized Controlled Trial. Neurorehabil Neural Repair. 2023 Sep;37(9):662-673. doi: 10.1177/15459683231200220. — View Citation

* Note: There are 18 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Fugl Meyer Assessment Tool	The Fugyl-Meyer scale was developed as the first quantitative evaluative instrument for measuring sensorimotor stroke recovery.	8th week
Primary	Trail Making Test A and B	The Trail Making Test (TMT) is one of the most popular neuropsychological tests and is included in most test batteries.	8 weeks
Secondary	Digit Span Test	The Digit Sequencing or Digit Span test is one of the main tools developed to measure one's verbal working memory The Digit Sequence test is one of the main tools developed to measure one's verbal working memory, overall intelligence, attention, and cognitive functioning	8 weeks
Secondary	stroop color and word test	The Stroop Color and Word Test (SCWT) is a neuropsychological test extensively used to assess the ability to inhibit cognitive interference that occurs when the processing of a specific stimulus feature impedes the simultaneous processing of a second stimulus attribute, well-known as the Stroop Effect	8 weeks
Secondary	Modified Functional Reach Test	The Modified Functional Reach Test (MFRT) is a simple and adaptive clinical assessment instrument for determining sitting balance, an important part of functional ability.	8 weeks