Training Dual-Task Walking After Stroke

NCT01568957 | Completed

• 1 other identifier: 11SDG7270001
• Study Type: interventional
• Target: 37
• Locations: 1 country
• Sites: 1

Brief Summary

Community ambulation is a highly complex skill requiring the ability to adapt to increased environmental complexity and perform multiple tasks simultaneously. Deficits in dual-tasking may severely compromise the ability to participate fully in community living. Unfortunately, current rehabilitation practice for stroke fails to adequately address dual-task limitations; individuals with stroke continue to exhibit clinically significant dual-task costs on gait at discharge. As a result, many stroke survivors are living in the community with residual deficits that may increase disability in the real world and lead to falls with devastating consequences. To address this issue, the proposed study investigates the efficacy of dual-task gait training on attention allocation and locomotor performance in community-dwelling stroke survivors. Because walking in the real world often requires time-critical tasks and obstacle avoidance, the investigators will test the impact of dual-task gait training on cognitive-motor interference during walking at preferred speed and at maximal speed (Aim 1), and on locomotor control during obstacle negotiation (Aim 2). The investigators will also evaluate the effects of the intervention on community reintegration and participation (Aim 3).

Conditions

Stroke

Keywords

Gait; Dual-task; Obstacle avoidance; Attention allocation

Outcome Measures

Primary Outcomes (1)

• Dual-task cost on gait speed

  The dual-task cost represents the difference between single and dual-task walking speed.

  4 weeks

Secondary Outcomes (4)

• Executive function

  Measured at baseline, post intervention (4 weeks), 6 months post intervention

• Spontaneous physical activity

  Measured at baseline, post intervention (4 weeks), 6 months post intervention

• Kinematics of gait during obstacle crossing

  Measured at baseline, post intervention (4 weeks), 6 months post intervention

• Stroke Impact Scale

  Measured at baseline, post intervention (4 weeks), 6 months post intervention

Study Arms (2)

Dual-task gait training

EXPERIMENTAL

Gait training with simultaneous performance of cognitive tasks for 75% of training session.

Behavioral: Gait training

Single-task gait training

ACTIVE COMPARATOR

Gait training (without simultaneous cognitive task performance)

Behavioral: Gait training

Interventions

Gait training BEHAVIORAL

Twelve 30-minute sessions plus 10-minute stretching and warm up, provided 3 times per weeks for 4 weeks. Up to 6 weeks are allowed to complete the 12 sessions.

Dual-task gait training; Single-task gait training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Within 3 years of stroke onset
• Living in the community, operationally defined as living in one's own home, or the home of a friend, relative, or caregiver
• Walking speed 0.6-1.1 m/s determined during 10-meter walk test
• Walk without the assistance of another person
• Medically stable and approved for participation by study physician
• Intact global cognition indicated by score \> 23 on Montreal Cognitive Assessment
• Living in the community prior to stroke

You may not qualify if:

• Pre-existing neurological disorders (e.g., Parkinson's disease, Multiple Sclerosis, dementia, traumatic brain injury)
• Previous stroke with residual motor deficit
• Uncontrolled hypertension
• Inability to follow 3-step command
• Primary uncontrolled hearing impairment
• Severe uncontrolled visual impairment
• Any speech-language impairment affecting ability to respond verbally to auditory stimuli
• Timed Up and Go test \> 15 seconds
• Lower extremity amputation
• Any orthopedic problem affecting gait
• Concurrent participation in another clinical trial

Sponsors & Collaborators

• University of North Carolina, Chapel Hill: lead
• University of Arizona: collaborator

Study Sites (1)

University of North Carolina

Chapel Hill, North Carolina, 27599, United States

Location

Related Publications (1)

• Plummer-D'Amato P, Kyvelidou A, Sternad D, Najafi B, Villalobos RM, Zurakowski D. Training dual-task walking in community-dwelling adults within 1 year of stroke: a protocol for a single-blind randomized controlled trial. BMC Neurol. 2012 Oct 31;12:129. doi: 10.1186/1471-2377-12-129.

  PMID: 23113928 DERIVED

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Prudence Plummer, PhD

  University of North Carolina, Chapel Hill

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 25, 2012
• First Posted: April 2, 2012
• Study Start: September 1, 2011
• Primary Completion: March 29, 2017
• Study Completion: November 15, 2017
• Last Updated: December 12, 2017

Record last verified: 2017-11

Locations

US (1)