Brain Activity Changes After Structured Cognitive-motor Exercise for People With Stroke

Using Functional Near-infrared Spectroscopy to Study the Changes in Brain Activity During Dual-task Walking and the Effects of Structured Cognitive-motor Exercise in Individuals With Stroke

To assess the effects of a dual-task exercise program on cognitive-motor interference during dual-task walking and the associated changes in brain activity.

Stroke is one of the leading causes of chronic disability in Hong Kong and other parts of the world. Mobility dysfunctions are among the most common impairments observed after stroke. Restoration of mobility is also a top priority in rehabilitation goal-setting by stroke patients. In daily life, functional ambulation in the community requires the ability to maintain walking balance while simultaneously engaging in other attention-demanding tasks (i.e., dual-tasking), such as walking when holding a conversation, or crossing the street while attending to traffic signals. There is increasing evidence that performing a cognitive task in conjunction with a mobility task would cause more severe degradation of one or both tasks among stroke patients when compared with age-matched able-bodied individuals. This phenomenon, termed "cognitive-motor interference", should warrant detailed study, since it has an important impact on community-living among people with stroke.

Inclusion Criteria:

• Diagnosis of stroke confirmed by brain scan reports
• Community-living
• Stroke onset ≥ 6 months
• Aged 50 years or older
• Modified Rankin scale 1-3
• Capable of following verbal instructions
• Montreal Cognitive Assessment score ≥ 22
• Ability to walk for 1 min independently with or without a walking aid
• Not receiving formal rehabilitation elsewhere

Exclusion Criteria:

• Other neurological disorders
• Pain or other comorbidities that seriously affect the ability to walk
• Contraindications to exercise (e.g., angina).