Stroke
Conditions
Keywords
Dual-task Gait Training, Repetitive task training, Dynamic Balance, walking function, muscle strength, risk of fall
Brief summary
Chronic stroke survivors those who have had a stroke for more than six months frequently experience long-lasting, incapacitating deficits, particularly when it comes to motor task impairment. Furthermore, following a stroke, muscle coordination is frequently compromised, resulting in deficiencies in gait and balance control. Dual-task gait training involves incorporating the concept of "doing two tasks" simultaneously. Stroke survivors frequently struggle with walking and multitasking, such as juggling multiple things at once while walking. Repetitive task training (RTT) is a component of contemporary therapeutic approaches in stroke rehabilitation that entails the active practice of task-specific motor exercises. Repetitive task training strategy known as a task-oriented approach entails training a task repeatedly with an emphasis on functional performance aimed at successfully completing it. This study aims to determine the Comparative effects of Dual-task Gait Training and Repetitive task training on dynamic balance, walking function, muscle strength and risk of fall in chronic stroke patients.
Detailed description
It will be a single-blinded randomized clinical trial. Non-Probability Convenience sampling technique will be used to recruit 82 participants aged 40 to 70 years from diverse community areas in Gujrat. Through the computerized table generator method of randomization, the individuals will be randomly allocated to two groups, one undergoing Dual task gait training and the other Repetitive task training. Both the groups will perform their respective trainings for 3 days a week for 8 weeks. Tools such as Time Up and Go test (TUG) for walking function, Activity Specific Balance and Confidence ABC scale for fall risk assessment, Manual Muscle Testing (MMT) for strength, Berg Balance Scale (BBS) for balance will be used to measure outcomes. Data will be analyzed in the SPSS version 25. After normality testing of the data, the Paired sample t-test will be used for parametric data while Wilcoxon test will be used for non-parametric data in intragroup comparison, while for intergroup comparison, the independent t-test will be for parametric data and Mann-Whitney U test for non-parametric.
Interventions
OTHERDual task training
Participants will receive 45-minute individualized training sessions, 3 times a week for 8weeks. The duration and intensity will be varying. Balance training and dual task training programs will be effective in improving balance function and dual-task performance in post stroke patients respectively The balance training program will use progressive activities related to body stability (e.g., standing with eyes closed, tandem standing, and standing on compliant surfaces), to body stability plus hand manipulation (e.g., standing on foam with rapid alternating hand movement or while throwing and catching a ball, and tandem standing while holding a basket), then body transport (e.g., narrow walking, walking backward, and transferring from 1 chair to another), and finally body transport plus hand manipulation. The participants receiving dual-task training with fixed-priority instructions will practice balance tasks while simultaneously performing cognitive tasks, and will be instructed to m
Repetitive task training Participants would encouraged to perform arms and legs movement in different directions as quickly. This programme is comprised of functional tasks, embedded in routine everyday activities completed on the ward or at home. This aims to make the programme highly relevant to participants, promote 'carry over' into real life situations, and encourage self-practice. Recovery activities like: washing, dressing and eating/ drinking. Participants will be asked to practice each selected recovery activity independently for up to 20 times, twice per day. To performs RTT, the therapist selects a task relevant to the patient's daily activities-such as sit-to-stand transfers, stepping exercises, or walking-and guides the patient through high repetitions of that task. For example, a lower limb RTT session may include 3 sets of 10-15 sit-to-stand repetitions, step- ups on a low platform, or repeated 10-meter walking laps. Session time typically varies is repeated 3 times per
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
An independent assessor, who is blinded to the group allocations, will be responsible for evaluating outcomes.
Intervention model description
Randomized Clinical Trial
Eligibility
Sex/Gender
ALL
Age
40 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* The patient is between the age of 40 to 70 Male and female patients. Chronic post-stroke patients who experienced either ischemic or hemorrhagic stroke between 6 months to 1 year. Participants who have issues in balance control and walking with berg balance score \< 22 that indicates need for walking assistance and are at fall risk. Participants who reported at least one fall in the past 6 months but retain ambulatory ability with/without aid.
Exclusion criteria
* Recurrent stroke patients. Participants included in other training/study. other neurological conditions, cardiovascular condition, other serious diseases or conditions (e.g., osteoporosis) Patient with severe hypertension, congestive heart failure, unstable cardiac status, aphasia, or cognitive disabilities for which exercise is not recommended. Patients whose walking abilities are impacted by various medical conditions and neurologic illnesses that are worsening.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dynamic Balance | Baseline and post 8 weeks | Berg Balance Scale (BBS) |
| Walking function | Baseline and post 8 weeks | Time up and Go test (TUG) |
| Muscle strength | Baseline and post 8 weeks | Manual muscle testing(MMT) |
| Risk of Fall | Baseline and post 8 weeks | Activities specific Balance Confidence Scale (ABC) |
Countries
Pakistan
Contacts
CONTACTImran Amjad, PhD
PRINCIPAL_INVESTIGATORAiza Yousaf, MS-OMPT
Riphah International University
Outcome results
None listed