Dual Task Training Versus Single Task Training in Chronic Hemiplegic Stroke Patients

NCT07209982 | Completed DMC

• 1 other identifier: UOL/IREB/25/09/0048
• Study Type: interventional
• Target: 62
• Locations: 1 country
• Sites: 1

Brief Summary

What is this study about? This study compares two common ways of practicing walking and balance after a stroke: (1) dual-task training, where a person walks or balances while doing a second task (such as counting backward or carrying a light object), and (2) single-task training, where a person practices walking and balance without any extra task. The goal is to learn whether practicing with or without an added task is more practical and acceptable for people living with long-standing weakness on one side of the body (hemiplegia) after stroke. Why is this important? Many everyday activities-walking while talking, looking for a bus, or carrying a bag-require attention to more than one thing at a time. Some stroke survivors find this difficult. Training that safely mimics real-life multitasking may help therapists design better rehabilitation plans. Who can take part? Adults aged 45-65 years with a diagnosis of hemiplegic stroke who can walk without hands-on help may be eligible. People with other neurological conditions that affect walking, severe problems with understanding or communication, or recent serious medical/surgical issues will not be included. Additional screening will check safety for exercise. What will happen if I join? Participants are randomly assigned (like a coin toss) to one of two groups: Dual-task training group: walking/balance activities plus a simple cognitive or motor task. Single-task training group: the same walking/balance activities without any extra task. Both groups attend 60-minute sessions, three times per week, for six weeks at The University of Lahore Teaching Hospital or Sehat Medical Complex. A trained therapist supervises all sessions and adjusts difficulty gradually. Short rest breaks are provided. What will be measured? At baseline, 2 weeks, 4 weeks, and 6 weeks, an assessor who does not know the assigned group will record walking and balance using the Tinetti Performance-Oriented Mobility Assessment (POMA). Safety (such as any falls, dizziness, or discomfort) and attendance will also be recorded. What are the possible risks and benefits? Risks are similar to supervised physiotherapy: temporary muscle soreness, fatigue, or loss of balance. Therapists use safety measures (close supervision, stable equipment, and rest periods). Participants may experience the general benefits of structured rehabilitation (practice, education, and monitored activity). Taking part is voluntary, and usual care remains available. Privacy and cost Personal information is kept confidential and stored securely. There is no payment for participation. There are no charges for study-related therapy sessions. Time commitment About 18 sessions over 6 weeks, plus four short assessment visits. Contacts Study team members can answer questions at any time and will obtain written informed consent before any study procedures begin.

Conditions

Hemiplegia; Hemiplegia Following Ischemic Stroke; Stroke

Keywords

Balance; Dual-task training; Gait; Hemiplegic stroke; Rehablitation

Outcome Measures

Primary Outcomes (2)

• Change in Balance Performance (Tinetti Balance Subscore)

  The balance component of the Tinetti Performance-Oriented Mobility Assessment (POMA), scored 0-16, with higher scores indicating better balance. Used to evaluate static and dynamic balance during standing and transitional tasks.

  Baseline, 2 weeks, 4 weeks, and 6 weeks

• Change in Gait Performance (Tinetti Gait Subscore)

  The gait component of the Tinetti POMA, scored 0-12, assessing step length, symmetry, initiation, path deviation, and trunk stability during walking. Higher scores indicate better gait performance.

  Baseline, 2 weeks, 4 weeks, and 6 weeks

Study Arms (2)

Dual-Task Training (DTT)

EXPERIMENTAL

Participants receive structured gait and balance training combined with a concurrent secondary task. Secondary tasks include simple cognitive challenges (such as counting backward or naming objects) or light motor tasks (such as carrying a cup or tossing a ball). Sessions are 60 minutes, three times per week for six weeks, delivered under therapist supervision. Task difficulty is gradually increased while maintaining safety.

Behavioral: Dual-Task Training (DTT)

Single-Task Training (STT)

ACTIVE COMPARATOR

Participants receive the same dose of gait and balance training as the experimental arm, but without any concurrent secondary task. Exercises include level walking, directional changes, obstacle negotiation, and balance tasks on stable or unstable surfaces. Sessions are 60 minutes, three times per week for six weeks, supervised by a therapist. Difficulty is progressed through physical task demands only.

Behavioral: Single-Task Training (STT)

Interventions

Dual-Task Training (DTT) BEHAVIORAL

This intervention combines gait and balance practice with a simultaneous secondary task to mimic real-world multitasking demands. Participants complete 60-minute sessions, three times per week for six weeks. Secondary tasks include simple cognitive activities (such as serial subtraction, word recall, or visual scanning) or light motor tasks (such as carrying an object or tossing a ball). Task complexity is increased gradually according to participant tolerance. All sessions are supervised by a trained physiotherapist, with rest breaks and safety precautions provided.

Also known as: Cognitive-Motor Dual-Task Training (CMDT)

Dual-Task Training (DTT)

Single-Task Training (STT) BEHAVIORAL

This intervention provides gait and balance training without any added secondary tasks. Participants complete 60-minute sessions, three times per week for six weeks. Exercises include level walking, directional changes, obstacle negotiation, static and dynamic balance activities, and surface progressions (such as standing on foam). Progression is achieved by altering the physical task difficulty only. Sessions are supervised by a physiotherapist with safety measures in place and rest breaks as needed.

Single-Task Training (STT)

Eligibility Criteria

• Age: 45 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients diagnosed with hemiplegic stroke (Nam, 2023)
• Both males and females patients
• Participants ≤ 6 months poststroke (Nam, 2023)
• Participants age between 45-65(Zhou et al., 2021)
• Patients who are able to walk without assistance.(Joya, 2023) .

You may not qualify if:

• History of other neurological conditions effecting mobility (Muzio et al., 2023).
• Severe cognitive impairments or communication difficulties. (Liu et al., 2017)
• Recent acute medical/surgical conditions unrelated to stroke.(Nam, 2023)
• Other Systemic disease
• Participants with severe hemiparesis who are unable to produce movement accurately (Zhang et al., 2022).

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

The University of Lahore Teaching Hospital

Lahore, 54590, Pakistan

Location

Related Publications (1)

• Pang MYC, Yang L, Ouyang H, Lam FMH, Huang M, Jehu DA. Dual-Task Exercise Reduces Cognitive-Motor Interference in Walking and Falls After Stroke. Stroke. 2018 Dec;49(12):2990-2998. doi: 10.1161/STROKEAHA.118.022157.

  PMID: 30571419 BACKGROUND

MeSH Terms

Conditions

Hemiplegia; Stroke

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

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: Student

Study Record Dates

• First Submitted: September 29, 2025
• First Posted: October 7, 2025
• Study Start: January 15, 2025
• Primary Completion: August 19, 2025
• Study Completion: September 24, 2025
• Last Updated: October 7, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)