Cognitive Abilities, Exercise, Motor Abilities, Stroke, Tele-rehabilitation
Conditions
Brief summary
The goal of this clinical trial is to learn if a web-based exercise and cognitive training (physical-cognitive) program works to improve movements and brain function in adults with long-term stroke. It will also learn whether the program is safe and enjoyable. The main questions it aims to answer are: Does the program improve walking, balance, strength, and reduce fall risk? Does the program improve cognitive skills such as memory, attention, and problem-solving? Researchers will compare the online exercise-and-cognitive training program to usual care to see if the program leads to greater improvements. Participants will: * Be randomly assigned to either the online training group or the usual care group * If in the training group, complete the home-based program for 12 weeks. * Take part in physical and cognitive tests before and after the program
Detailed description
The goal of this clinical trial is to evaluate whether a 12-week, web-based exercise and cognitive (physical-cognitive) training program can improve both physical abilities and brain function in adults with long-term stroke. The study will also examine whether the program is safe, practical to use at home, and enjoyable. Many people who have had a stroke continue to experience problems with movement (such as walking, balance, weakness, and risk of falling) as well as problems with cognition (such as memory, attention, and problem-solving). Traditional rehabilitation often focuses mainly on physical recovery. This study tests a program that combines physical exercises and cognitive training at the same time using interactive online "exergames" delivered through telerehabilitation. The main questions this study aims to answer are: Does the program improve motor function, walking speed, balance, muscle power, and reduce fall risk? Does the program improve cognitive abilities, including global cognitive ability, executive function, memory, and attention? Is the program enjoyable and feasible for people with chronic stroke to use at home? In this study, 52 participants will be randomly assigned to one of two groups. One group will complete the 12-week web-based physical-cognitive training program at home. Another group will continue receiving their usual care. The researchers will compare changes in physical and cognitive performance between the two groups. Participants in the training group will follow guided exercise sessions delivered online. All participants will complete physical and cognitive assessments before and after the 12-week period. The results of this study may help determine whether web-based physical-cognitive training is an effective and accessible rehabilitation option for people living with chronic stroke.
Interventions
BEHAVIORALWeb-Based Physical-Cognitive Telerehabilitation Exergaming
Perform a physical-cognitive exergame via ExerbrainCMU web-based platform at home setting for 60 min/session, 3 sessions/week for 12 weeks.
Sponsors
Chiang Mai University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
A two-arm, assessor blind, and randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* diagnosed with ischemic or hemorrhagic stroke at least 6 months before enrollment * aged between 20 and 80 years * able to walk at least 10 meters with or without assistive devices * able to perform sit-to-stand safely with or without assistive devices * can see the screen of a tablet or notebook computer at a distance of at least 60 cm * have a stable medical condition and can follow study instructions * frequent users of a mobile phone, tablet, or notebook computers
Exclusion criteria
* have medical conditions or complications that would be unsafe to exercise * have neglect, impaired communication, or uncorrected visual problems \[30\], or - have severe spasticity of the upper or lower extremities (Modified Ashworth Scale ≥ 3)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Executive function | 3 months | Trail Making Test (TMT) part B-A will be evaluated at baseline and 3 months. |
| Fall risk | 3 months | Fall risk will be assessed using the Timed Up and Go (TUG) test at baseline and 3 months. The time taken to complete TUG will be recorded in Sec. |
| Gait speed | 3 months. | 10-Meter Walk test (10MWT) will be used to assessed gait speed at baseline and 3 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global cognitive function | 3 months | Montreal Cognitive Assessment (MoCA) test will used to measured global cognitive function at baseline and 3 months.The total scores range from 0-30 points with higher scores indicating better global cognitive function. |
| Attention | 3 months | Digit Span test will be used to assess memory and attention at baseline and 3 months. |
| Motor function | 3 months | Motor Assessment Scale (MAS) will be used to evaluate motor function at baseline and 3 months. |
| Balance | 3 months | Modified Functional Reach Test (MFRT) will be used to assessed balance at baseline and 3 months. |
| Muscle strength | 3 months | Five-Time Sit to Stand will be used to evaluate lower limb muscle strength at baseline and 3 months. |
| Weight distribution | 3 months | Stance Symmetry Test (SST) will be used to assess weight distribution at baseline and 3 months. |
| Enjoyment | 3 months | Physical Activity Enjoyment Scale (PACES) will be used to assess enjoyment. |
Contacts
CONTACTPuntarik Keawtep, Ph.D., Primary investigator
CONTACTSomporn Sungkarat, PhD, Associate Professor
PRINCIPAL_INVESTIGATORPuntarik Keawtep
Chiang Mai Uiversity
Outcome results
None listed