Cortical Excitability, Stroke
Conditions
Keywords
Dual-task training, Cognitive-motor interference, tDCS
Brief summary
This study aims to evaluate the effects of tDCS combined with cognitive-motor training on dual-task interference during walking and foot pedaling, alongside corresponding alterations in brain activity assessed via fNIRS. Additionally, an fMRI component was conducted as a nested sub-study for deep mechanistic exploration.
Detailed description
In China, the prevalence of stroke increased by 106.0% (93.7-118.8) between 1990 and 2019, highlighting the persistent and substantial burden of this condition. Post-stroke recovery, particularly the ability to achieve community ambulation, plays a critical role in improving health-related quality of life. Effective community ambulation in daily life requires the ability to dual-task-namely, to perform concurrent tasks requiring attentional resources while maintaining walking function and balance. Emerging evidence suggests that stroke survivors face greater challenges in walking function and dual-task balance compared to their age-matched, able-bodied counterparts. For instance, when tasked with recalling a shopping list while walking, stroke patients exhibit a more pronounced decline in both walking speed and cognitive performance relative to control groups. Given the necessity for stroke survivors to reintegrate into the community, it is imperative to thoroughly investigate this phenomenon of cognitive-motor interference.
Interventions
OTHERactive tDCS with dual-task training
participants receive three 20-minute active tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks.
OTHERsham tDCS with dual-task training
participants receive three 20-minute sham tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks.
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* a diagnosis of stroke, stroke onset of more than 6 months, * aged 50 or more, * capable of following verbal and visual instructions, * having a Montreal Cognitive Assessment score ≥ 22, * able to walk for 10 meters with/without a mobility aid, * community-dwelling, unilateral stroke
Exclusion criteria
* neurological disorders, gait-precluding pain or comorbidity, * receiving any formal rehabilitation training, * contraindications to exercise (e.g., unstable angina), * contraindications to fNIRS, MRI, and tDCS (e.g., brain skin injury, pacemaker, metal implants in the brain), * history of seizure or epilepsy, * color blindness. * unable to walk with/without a mobility aid while responsing stimulus by the remote control
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dual-task self-paced walking--gait speed | Through study completion, an average of 1 year | Gait speed under dual-task walking condition will be recorded |
| Dual-task self-paced walking--cognitive performance | Through study completion, an average of 1 year | Number of correct responses will be measured during dual-task conditions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dual-task self-paced walking--gait performance 1 | Through study completion, an average of 1 year | Gait cadence will be measured during dual-task walking |
| Dual-task self-paced walking--gait performance 2 | Through study completion, an average of 1 year | Stride length will be measured during dual-task walking |
| Dual-task self-paced walking--gait performance 3 | Through study completion, an average of 1 year | Dor-Plantar Range under dual-task walking will be recorded |
| Dual-task self-paced walking--cognitive performance 1 | Through study completion, an average of 1 year | Correct reaction time under dual-task walking will be recorded |
| Oxyhemoglobin concentration changes of the brain | Through study completion, an average of 1 year | Oxyhemoglobin concentration changes will be measured using functional near infra-red spectroscopy during dual-task walking |
| Dual-task pedaling--cadence | Through study completion, an average of 1 year | cadence under dual-task foot pedaling will be recorded |
| Dual-task pedaling--cognitive performance 1 | Through study completion, an average of 1 year | Number of correct responses under dual-task foot pedaling will be recorded |
| Blood oxygenation level changes of the brain | Through study completion, an average of 1 year | Blood oxygenation level changes will be measured using Magnetic Resonance Imaging during dual-task foot pedaling |
| tDCS adverse event | Through study completion, an average of 1 year | number of patients who report an adverse event will be recorded. |
Countries
Hong Kong
Contacts
CONTACTProf. Marco PANG
Outcome results
None listed