Training Dual-task Balance and Walking in People With Stroke

NCT02753322 | Unknown DMC

• 1 other identifier: KC/KE-15-0185/ER-3
• Study Type: interventional
• Target: 84
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is one of the most common chronic disabling conditions in Hong Kong. People after stroke may suffer from certain degree of physical impairment and disability. Resuming safe ambulation in the community appears to be a big challenge to them as it always involves the simultaneous performance of two or more tasks (dual task) such as walking and talking with someone, walking and recalling the shopping list etc. Numerous studies has demonstrated that the interference from dual tasks (dual task interference) may significantly impact the recovery of the functional walking. To date, the relevance of dual task walking to daily community is widely documented and the ability of managing dual task is therefore particularly important. Evidences supported that dual task training showed its promising effect on the balance and walking performance amongst people with neurological disorders, such as chronic stroke. In light of this, the introduction of dual task based balance and walking training into physiotherapy program for stroke patient may enhance the balance and walking performance and hence promote successful community ambulation. Yet, there is limited evidence on its effect in sub-acute stroke. Objective: To examine the effectiveness of a dual-task based balance and walking training program on performance and dual task interference in balance and walking ability, balance self-efficacy and incidence of falls in people with sub-acute stroke

Conditions

Stroke

Keywords

Dual task training; Dual task interference; Sub-acute stroke; Physiotherapy training; Community ambulation; Balance

Outcome Measures

Primary Outcomes (1)

• Degree of the dual-task interference

  It will be assessed by calculating the percentage of the difference between single task performance (2 walking tasks and 2 balance tasks) and dual task performance of the 2 walking tasks and 2 balance tasks while engaging in 3 attention demanding tasks.

  Baseline, 8 weeks, 16 weeks

Secondary Outcomes (7)

• Standing balance with eyes opened in dual task conditions

  Baseline, 8 weeks, 16 weeks

• Standing balance with eyes closed in dual task conditions

  Baseline, 8 weeks, 16 weeks

• 10 metre walk test in dual task conditions

  Baseline, 8 weeks, 16 weeks

• Obstacle crossing test in dual task conditions

  Baseline, 8 weeks, 16 weeks

• Chinese version of Activities-specific Balance Confidence (ABC) Scale

  Baseline, 8 weeks, 16 weeks

Study Arms (3)

Dual-task training group

EXPERIMENTAL

Subjects in this group will have 30 minutes of dual-task training with simultaneously performing balance and walking exercise and attention demanding tasks, and 30 minutes of stretching exercises. The training program will last for 8 weeks with frequency of 2 sessions a week.

Other: Dual task training

Single-task training group

ACTIVE COMPARATOR

Subjects in this group will have single-task training with 30 minutes of balance and walking exercise and 30 minutes of attention demanding task performed separately. The training program will last for 8 weeks with frequency of 2 sessions a week.

Other: Single-task training

Limbs exercise group

ACTIVE COMPARATOR

Subjects in this group will have stretching and strengthening exercise for 60 minutes. The training program will last for 8 weeks with frequency of 2 sessions a week.

Other: Limbs exercise

Interventions

Dual task training OTHER

Balance and walking exercises with simultaneously engaging in attention demanding tasks

Dual-task training group

Single-task training OTHER

Balance and walking exercises and and attention demanding task performed separately

Single-task training group

Limbs exercise OTHER

Stretching and strengthening exercises

Limbs exercise group

Eligibility Criteria

• Age: 50 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosis of a stroke confirmed by the individual's physician, between 1 month and 6 months post-stroke onset
• Aged ≥50
• Community-dwelling prior to stroke onset (defined as living in one's own home or the home of a relative, friend or caregiver)
• Medically stable
• Montreal Cognitive Assessment (MoCA) scored ≥21
• Ability to follow 3-step commands
• Having motor impairment in the affected lower extremity \[Chedoke McMaster Stroke Assessment (CMSA) leg and foot summative score of 4-13 out of 14)\], and upper extremity (CMSA arm and hand summative score of 4-13 out of 14)
• Having balance deficits (Mini-Balance Evaluation Systems test score \<24)
• Able to ambulate without physical assistance of another person as determined during the 10-meter walk test

You may not qualify if:

• Recurrent stroke
• Having neurological conditions other than stroke
• significant receptive and expressive aphasia
• Severe and uncorrected hearing or visual deficits
• Serious musculoskeletal (e.g. amputation) or cardiovascular conditions affecting the ability to exercise (e.g. congestive heart failure), pain experienced at rest or movement, and other serious illnesses that preclude participation.

Sponsors & Collaborators

• The Queen Elizabeth Hospital: lead
• The Hong Kong Polytechnic University: collaborator

Study Sites (1)

Queen Elizabeth Hospital

Hong Kong, China

RECRUITING

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Officials

• Margaret WY POON, MSc

  The Queen Elizabeth Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Margaret WY POON, MSc

CONTACT

852-3506 2603; pwy751@ha.org.hk

Sally PC WAN, MSc

CONTACT

852-3506 7315; wpcz01@ha.org.hk

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: PRINCIPAL INVESTIGATOR
• PI Title: Senior Physiotherapist

Study Record Dates

• First Submitted: April 24, 2016
• First Posted: April 27, 2016
• Study Start: April 1, 2016
• Primary Completion: January 1, 2018
• Study Completion: March 1, 2018
• Last Updated: April 27, 2016

Record last verified: 2016-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)