Effects of Dual Task-Oriented Circuit Training on Walking Recovery in Sub-acute Stroke

NCT07494357 | Not Yet Recruiting DMC

• 1 other identifier: IKFR-202603.01
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot study aims to assess the feasibility, safety, and initial efficacy of an integrated Dual Task-Oriented Circuit Training (DTOCT) program for individuals in the subacute phase of stroke recovery. Although numerous patients recover the capacity to walk in a regulated hospital environment, they frequently encounter difficulties with "community ambulation," the capability to traverse real-world settings while multitasking (e.g., walking while conversing or circumventing barriers). This study will examine if the integration of high-intensity circuit training with cognitive difficulties can promote neuroplasticity and enhance the patient's capacity to safely traverse intricate daily settings.

Conditions

Stroke, Cerebrovascular

Outcome Measures

Primary Outcomes (6)

• Adherence Rate

  Description: Percentage of attended sessions (out of 12) during the 4-week intervention period.

  4 weeks

• Retention Rate

  Proportion of participants who complete the full 4-week protocol and follow-up assessments

  4 weeks

• Incidence of Adverse Events

  Frequency of falls or medical adverse events documented during the training sessions.

  4 weeks

• Mean Exercise Heart Rate

  Evaluation of cardiovascular demand and tolerability during the circuit training stations. Measured using a digital heart rate monitor. Unit of Measure: Beats per minute (bpm)

  During each of the 12 training sessions (4 weeks)

• Mean Systolic and Diastolic Blood Pressure

  Monitoring of hemodynamic stability to ensure the high-intensity circuit training is safe for subacute stroke patients Unit of Measure: Millimeters of mercury (mmHg)

  Pre-and post-each training session (4 weeks)

• Mean Borg Rating of Perceived Exertion (RPE) Score

  Assessment of subjective physical effort and tolerability. The scale ranges from 6 to 20 (or 0-10 depending on the version used), where higher scores indicate greater perceived exertion. Unit of Measure: Units on a scale

  At the end of each circuit station during all 12 sessions (4 weeks)

Secondary Outcomes (6)

• Change from Baseline in 6-Minute Walk Test (6MWT)

  Baseline and 4 weeks

• Change from Baseline in 10-Meter Walk Test (10MWT)

  Baseline and 4 weeks

• Change from Baseline of Completion Time in Standardized Walking Obstacle Course (SWOC)

  Baseline and 4 weeks

• Change from Baseline in Standardized Walking Obstacle Course (SWOC) Step Count

  Baseline and 4 weeks

• Change of number of errors in Standardized Walking Obstacle Course (SWOC)

  Baseline and 4 weeks (Post-intervention)

Study Arms (3)

Dual Task Oriented Circuit Training (DTOCT)

EXPERIMENTAL

Experimental: DTOCT Behavioral: Dual Task-Oriented Circuit Training. Participants engage in 5 circuit stations (e.g., obstacle walking, stair navigation) while performing secondary cognitive tasks (e.g., backward counting, object naming). 3 sessions/week for 4 weeks.

Behavioral: Dual task oriented circuit training

Task Oriented Circuit Training (TOCT)

ACTIVE COMPARATOR

Behavioral: Task-Oriented Circuit Training. Focuses on high-intensity motor repetition using circuit stations (e.g., sit-to-stand, stepping) without added cognitive load.

Behavioral: Dual task training

Dual Task Training (DTT)

ACTIVE COMPARATOR

Behavioral: Pure Dual-Task Training. Participants practice walking under cognitive load (e.g., Stroop task) in a standard non-circuit format.

Behavioral: Task Oriented Circuit Training

Interventions

Dual task oriented circuit training BEHAVIORAL

1\. Experimental Arm: Dual Task-Oriented Circuit Training (DTOCT) Intervention Name: Behavioral: Dual Task-Oriented Circuit Training (DTOCT) Description: Participants will undergo an integrated 60-minute rehabilitation session, 3 times per week for 4 weeks (total 12 sessions). Each session includes 25-50 minutes of active circuit training across five specialized stations: Dual-Task Walking: Straight walking (3-8m) while performing forward/backward number sequencing. Obstacle Walking: Stepping over cone or hurdle obstacles (5-14cm) while naming object categories from long-term memory. Stair Navigation: Ascending/descending stairs (10-17cm step height) while identifying colors and shapes. Walking with Navigation: Navigating an oval path (3-8m) while performing an incongruent Stroop color-word task. ADL Stimulation: Walking while carrying a cup of liquid or a shopping bag to train executive function and working memory. Training intensity and cognitive difficulty are progressed weekly

Also known as: DTOCT

Dual Task Oriented Circuit Training (DTOCT)

Task Oriented Circuit Training BEHAVIORAL

2\. Active Comparator Arm: Task-Oriented Circuit Training (TOCT) Intervention Name: Behavioral: Task-Oriented Circuit Training (TOCT) Description: Participants will focus exclusively on functional motor relearning and cardiovascular endurance through 6 circuit-based stations: Standing and Reaching: Multidirectional reaching to targets while standing. Sit-to-Stand: Transitions using chairs of various heights to strengthen extensors. Anterior/Posterior Stepping: Stepping onto blocks of various heights. Lateral Stepping: Side-stepping for lateral stability. Forward Step-Up: Strengthening for stair climbing mechanics. Heel Raise: Improving gait push-off mechanics. Each station is performed for 2.5 to 5 minutes with 1-minute rest periods. Training is conducted 3 times per week for 4 weeks (total 12 sessions), with each session lasting 60 minutes including warm-up and cool-down. No explicit secondary cognitive tasks are added.

Also known as: TOCT

Dual Task Training (DTT)

Dual task training BEHAVIORAL

3\. Active Comparator Arm: Pure Dual-Task Training (DT) Intervention Name: Behavioral: Pure Dual-Task Training (DT) Description: Participants will perform standard, non-circuit walking at a self-selected comfortable speed while executing simultaneous cognitive demands. The protocol includes: Backward Counting: Continuous subtraction from a random 3-digit number. Stroop Task: Identifying font colors or semantic meanings of incongruent words. Memory Tasks: Sequential recall of shopping lists (3-5 items) and reverse word recall (2-4 words). Verbal Fluency: Generating word chains or category naming. Each session consists of two 15-minute sets of core dual-task training (30 minutes total activity) within a 60-minute therapist-supervised visit. Training is conducted 3 times per week for 4 weeks (total 12 sessions). Cognitive difficulty is adjusted weekly to maintain an optimal challenge.

Also known as: DTT

Task Oriented Circuit Training (TOCT)

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosed with a first-ever subacute stroke (defined as 2 weeks to 5 months post-onset) with anterior circulation involvement.
• Diagnosis confirmed via neuroimaging (CT or MRI).
• Men and women aged 40 to 65 years.
• Motor recovery in the lower limbs corresponding to Brunnstrom stages 4 to
• Functional Ambulation Category (FAC) score of at least grade 3.
• Ability to walk independently, with or without walking aids.
• Montreal Cognitive Assessment Indonesian version (MoCA-INA) score of ≥20, demonstrating the capacity to collaborate and follow multi-step instructions.
• Medically stable with controlled comorbidities.

You may not qualify if:

• Expressive or receptive aphasia that impedes task comprehension
• Unstable cardiovascular or medical conditions (e.g., severe hypertension, congestive heart failure) for which moderate exercise is contraindicated.
• Moderate to severe depression, indicated by a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 15.

Sponsors & Collaborators

• Universitas Padjadjaran: lead

Study Sites (1)

RS Dustira Bandung

Bandung, West Java, 40131, Indonesia

Location

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Officials

• Farida Arisanti, MD, PMR

  Faculty of Medicine Universitas Padjadjaran

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Farida Arisanti, MD, PMR

CONTACT

+62-85351111946; farida.arisanti@unpad.ac.id

Vitriana Biben, Prof., MD, PMR

CONTACT

+628156262733; vitriana@unpad.ac.id

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, PMR

Model Details: Parallel asgnment

Study Record Dates

• First Submitted: March 14, 2026
• First Posted: March 27, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): July 30, 2026
• Study Completion (Estimated): August 30, 2026
• Last Updated: March 27, 2026

Record last verified: 2026-03

Locations

ID (1)