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Post-stroke cognitive impairment is common in stroke survivors. Cognitive function is related to walking ability. The dual task walking is required for daily activities, however, such ability is even more challenging than single walking for people with stroke. The purpose of present study is to investigate the effects of combining cognitive and treadmill training on cognitive function and dual task walking performance in chronic stroke patients with cognitive impairment.
This is a single-blinded, randomized controlled trial with pre- and post-measurements. 24 subjects will be recruited, and randomly assigned to one of two groups: cognitive training during treadmill training group (experimental group) and treadmill training group (control group). The intervention for both group will be 30 minutes per session, 3 sessions per week for a total of 4 weeks. Statistical data analysis will use the SPSS 25.0. Baseline characteristics will be analyzed using independent t-test or Chi-square test. Repeated measures two-way analysis of variance (ANOVA) with Tukey's post-hoc analysis will be used to compare between time and groups. The significant level is set at 0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cognitive training during treadmill training group | Experimental | Cognitive training combine treadmill training is an intervention that can challenge participants by practicing different tasks simultaneously. |
|
| treadmill training group | Active Comparator | Treadmill training as an active control. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cognitive training combine treadmill training | Other | Treadmill training includes warming up for 3 minutes, training for 25 minutes, and relaxing for 2 minutes. The speed of the treadmill during the warm-up and relaxation period is based on the participant's Borg's rating of perceived exertion (RPE) 7-9 points (very slight to very slight), and the RPE during the training period does not exceed 10~12 points (slight), and ensures that patients can be cognitively trained at the same time. The cognitive training tasks will be projected on the screen and the participant have to answer the task orders during treadmill training simultaneously. |
| Measure | Description | Time Frame |
|---|---|---|
| Trail-making test A&B | executive function (s) | 8 minutes |
| Stroop test | attention (number) | 10 minutes |
| Digit span test | memory (number) | 8 minutes |
| Clock drawing test | visuospatial function (score 1-10) | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Single walking performance- speed (cm/s) | walking speed in centimeters per second will be calculated during the single walking by using the GaitRite system | 3 minutes |
| Single walking performance-step length (cm) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ray-Yau Wang, professor | National Yang Ming Chiao Tung University | Principal Investigator |
| Yun-Hsien Liu | National Yang Ming Chiao Tung University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Yang-Ming University | Taipei | Beitou District | 112 | Taiwan |
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|
| Treadmill training | Other | Treadmill training includes warming up for 3 minutes, training for 25 minutes, and relaxing for 2 minutes. The speed of the treadmill during the warm-up and relaxation period is based on the participant's Borg's rating of perceived exertion (RPE) 7-9 points (very slight to very slight), and the RPE during the training period does not exceed 10~12 points (slight). |
|
step length in centimeters will be calculated during the single walking by using the GaitRite system
| 3 minutes |
| Single walking performance-step time (s) | step time in seconds will be calculated during the single walking by using the GaitRite system | 3 minutes |
| Single walking performance-cadence (steps/min) | cadence in steps per minute will be calculated during the single walking by using the GaitRite system | 3 minutes |
| Cognitive dual task walking performance-speed (cm/s) | walking speed in centimeters per second will be calculated during the cognitive dual task walking by using the GaitRite system | 3 minutes |
| Cognitive dual task walking performance-step length (cm) | step length in centimeters will be calculated during the cognitive dual task walking by using the GaitRite system | 3 minutes |
| Cognitive dual task walking performance-step time (s) | step time in seconds will be calculated during the cognitive dual task walking by using the GaitRite system | 3 minutes |
| Cognitive dual task walking performance-cadence (steps/min) | cadence in steps per minute will be calculated during the cognitive dual task walking by using the GaitRite system | 3 minutes |
| Cognitive dual task walking performance-dual task cost (%) | dual task cost (%) will be calculated with the following formula: [(dual-task performance-single task performance) / single task performance] × 100% | 3 minutes |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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