Subacute Stroke
Conditions
Keywords
Subacute Stroke, BFR, Dual Task Training, Gait, Balance, Muscle Strength, Falls Efficacy
Brief summary
This study aims to evaluate the effects of individualized blood flow restriction (BFR) training combined with cognitive-motor dual task intervention on lower limb muscle strength, gait ability, and fall stability in patients with subacute stroke. A total of 28 participants will be randomly assigned to either the experimental group (BFR + dual task training) or the control group (dual task only). The intervention will last for 5 weeks, with training sessions conducted three times per week, each lasting 40 minutes. The primary outcome is lower limb strength measured by the Five Times Sit-to-Stand Test. Secondary outcomes include gait ability (10-Meter Walk Test and Functional Gait Assessment) and fall stability (Timed Up and Go Test and Korean version of the Falls Efficacy Scale-International). This study seeks to verify whether combining low-pressure BFR training (40% of arterial occlusion pressure) with dual task training can be a clinically effective strategy for improving motor and cognitive function in individuals with subacute stroke.
Detailed description
Subacute stroke is defined as the period between 7 days and 6 months after stroke onset, a critical window during which neuroplasticity and functional recovery are highly active. During this phase, individualized and task-specific interventions can enhance motor recovery. Blood flow restriction (BFR) training is a promising low-load exercise modality that induces physiological effects similar to high-intensity training by restricting venous return using a proximal cuff. Studies suggest that BFR training at 40% of arterial occlusion pressure (AOP) can safely stimulate muscle hypertrophy and strength, particularly in populations with limited exercise capacity, such as stroke survivors. Additionally, dual task training, which combines motor and cognitive tasks, has been shown to improve executive function and gait performance by increasing prefrontal cortex activity. While each approach has independent benefits, the combination of peripheral muscle activation through BFR and central stimulation via cognitive-motor dual tasks may provide synergistic effects on functional recovery. This randomized controlled trial will compare an intervention group receiving BFR training (40% AOP) with concurrent dual task gait training to a control group performing the same cognitive-motor dual tasks without BFR. Both groups will train three times per week for 5 weeks. Outcome measures will assess changes in lower limb strength, gait ability, and fall stability before and after the intervention. The study also addresses safety and standardization concerns in BFR application by using pulse oximeter-based AOP measurement protocols. By providing evidence on the efficacy and safety of combining BFR and dual-task training in subacute stroke rehabilitation, this study aims to contribute to the development of individualized, clinically applicable intervention strategies.
Interventions
BEHAVIORALBlood Flow Restriction + Dual Task Training
Participants will undergo lower limb resistance and gait training while wearing blood flow restriction cuffs at 40% of their individualized arterial occlusion pressure. Tasks include walking, sit-to-stand, and obstacle crossing combined with verbal fluency or serial subtraction. Training is performed 3 times per week for 5 weeks.
BEHAVIORALDual Task Training Only
Participants will perform the same cognitive-motor dual task training without blood flow restriction. Tasks include forward walking, obstacle crossing, and sit-to-stand exercises with concurrent cognitive tasks such as verbal fluency or serial subtraction. Training is performed 3 times per week for 5 weeks.
Sponsors
Sahmyook University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with subacute stroke within 1 to 6 months after onset * Able to walk at least 10 meters, with or without assistive devices * Modified Ashworth Scale score less than 1 * Korean Mini-Mental State Examination (K-MMSE) score of 24 or higher
Exclusion criteria
* History of psychiatric disorders or cognitive impairment * Presence of peripheral neuropathy * Resting systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg despite medication * Diagnosis of heart failure or unstable angina * History of bypass surgery within the past 3 months * Serious musculoskeletal disorders affecting gait (e.g., amputation, fracture)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 5 Times Sit-to-Stand Test (5STS) | Baseline and after 5 weeks of intervention | Lower limb strength will be assessed using the Five Times Sit-to-Stand Test. A shorter time indicates better performance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 10-Meter Walk Test (10MWT) | Baseline and after 5 weeks of intervention | Walking speed (m/s) will be measured over a middle 10-meter segment of a 14-meter walking path. Higher values indicate better performance. |
| Timed Up and Go Test (TUG) | Baseline and after 5 weeks of intervention | Shorter completion time on the TUG indicates improved functional balance and mobility. |
| Korean Version of Falls Efficacy Scale - International (KFES-I) | Baseline and after 5 weeks of intervention | KFES-I assesses confidence in avoiding falls during daily activities. Lower scores indicate higher confidence. |
| Functional Gait Assessment (FGA) | Baseline and after 5 weeks of intervention | The FGA is a 10-item test that assesses postural stability during various walking tasks. Higher scores indicate better functional gait and balance. |
Countries
South Korea
Outcome results
None listed