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The purpose of this study is to evaluate a cognitive-motor exercise on dual-task interference during dual-task ankle movement and the corresponding alterations of brain activity.
The prevalence rate of stroke increased by 106.0% (93.7-118.8) from 1990 to 2019 in China, and stroke burden is still severe. Community ambulation is an important factor that influences health-related quality of life after a stroke.In daily living, effective community ambulation requires the ability to maintain balance and walking function while engaging in other tasks that demand attentional resources simultaneously (i.e., dual-tasking). Increasing evidence has shown that stroke patients have more problems with dual-task balance and walking function than their age-matched able-bodied peers. stroke individuals were found to have more reduction in both the walking speed and cognitive recall than control group during walking with remembering a shopping list. Hence, since stroke victims must reintegrate into community, this kind of cognitive-motor interference needs to be thoroughly studied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| dual-task group | Experimental | patients receive three dual motor-cognitive exercise training per week for six weeks. |
|
| single-task group | Active Comparator | Patients receive three separate cognitive and mobility exercises per week for six weeks. |
|
| control group | Active Comparator | Patients receive three upper limb muscle strengthening exercise with muscle stretching per week for six weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dual-task training | Behavioral | participants receive three 60-minute COGMOTION dual-task exercise sessions per week for six consecutive weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Dual-task step frequency | step frequency under dual-task condition will be recorded | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task cognitive performance accuracy | Number of correct responses will be measured during dual-task conditions | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Measure | Description | Time Frame |
|---|---|---|
| Blood oxygenation level changes of the brain | Blood oxygenation level changes will be measured using Magnetic Resonance Imaging during dual-task conditions | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task No.steps |
| Measure | Description | Time Frame |
|---|---|---|
| Single-task walking speed | 10-meter walking test will be used to assess single-task walking speed in meters per second | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task walking performance |
Inclusion Criteria
Clinical diagnosis of stroke, Stroke onset of more than 6 months Aged 50 or more Capable of following verbal instructions Having a Montreal Cognitive Assessment score≥22, Able to walk for 1 minute without physical assistance Not receiving any formal rehabilitation training Having a Fugl-Meyer Ankle dorsiflexion-standing position score≥1
Exclusion Criteria
Contraindications to exercise (e.g., unstable angina) Contraindications to MRI (e.g., pacemaker) Color blindness Neurological disorders Gait-precluding pain Comorbidity
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marco Yiu Chung PANG, PhD | Contact | +852 2766-7156 | 2766-7156 | Marco.Pang@polyu.edu.hk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Hong Kong Polytechnic University | Recruiting | Hong Kong | 000000 | China |
The study data can be provided via contacting the Principal Investigator
From Dec 2026 onwards
By contacting the Principal Investigator (Prof. Marco PANG): Marco.Pang@polyu.edu.hk
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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After stratification according to gender and walking speed, the participants will be randomly allocated to one of three groups: (1) dual-task training, (2) single-task training, and (3) control intervention, using a 1:1:1 allocation ratio.
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This will be a single-blinded randomized controlled trial . The assessor will be blinded during assessments. The participants and investigators (trainers) are not possible to be blinded as it is an exercise intervention.
| Single-task training | Behavioral | participants receive 30-minute single motor tasks with 30-minute single cognitive tasks three times per week for six consecutive weeks.The cognitive and mobility exercises will be the same as those in the dual-task group, but they will be performed separately. |
|
| Upper limb strengthening exercise | Behavioral | participants receive upper limb strengthening exercise for 30 minutes and flexibility exercises for 30 minutes three times per week for six consecutive weeks. The training is performed in sitting or standing position and no cognitive load will be added. |
|
No.steps under dual-task condition will be recorded |
| before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task correct reaction time | Correct reaction time under dual-task condition will be recorded | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task amplitude of ankle movement | Amplitude of ankle movement under dual-task condition will be recorded | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
1 min Forward Walking with Serial 3 subtractions will be used to assess motor and cognitive performance during dual-task walking.
| before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Mini Balance Evaluation Systems Test | Mini Balance Evaluation Systems Test will be used to assess postural control and balance, with total points from 0-28. Higher points indicate better performance. | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Activities-specific Balance Confidence Scale | Activities-specific Balance Confidence Scale will be used to assess confidence of functional balance performance, with total points from 0-100. Higher points indicate better performance. | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Trail Making Test | Trail Making Test will be used to assess executive function | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Digit Span Test | Digit Span Test will be used to assess working memory | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Montreal Cognitive Assessment | Montreal Cognitive Assessment will be used to assess global cognition, with total points from 0-30. Higher points indicate better performance. | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Fall incidence | Monthly telephone interviews for recording fall incidence | before the initiation of training, 6 months after training |
| Dual-task ankle movement degree | Ankle movement degree under dual-task condition will be recorded | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| Dual-task cognitive performance time | Time of correct responses under dual-task condition will be measured during dual-task conditions | before the initiation of training,after 6 weeks of training, 6 weeks after termination of the training |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |