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The purpose of this study is to evaluate tDCS combined with cognitive-motor training on dual-task interference during dual-task walking, dual-task foot pedaling and the corresponding alterations of brain activity.
In China, the prevalence of stroke increased by 106.0% (93.7-118.8) between 1990 and 2019, highlighting the persistent and substantial burden of this condition. Post-stroke recovery, particularly the ability to achieve community ambulation, plays a critical role in improving health-related quality of life. Effective community ambulation in daily life requires the ability to dual-task-namely, to perform concurrent tasks requiring attentional resources while maintaining walking function and balance. Emerging evidence suggests that stroke survivors face greater challenges in walking function and dual-task balance compared to their age-matched, able-bodied counterparts. For instance, when tasked with recalling a shopping list while walking, stroke patients exhibit a more pronounced decline in both walking speed and cognitive performance relative to control groups. Given the necessity for stroke survivors to reintegrate into the community, it is imperative to thoroughly investigate this phenomenon of cognitive-motor interference.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| active tDCS combined with dual-task group | Experimental | patients receive three active tDCS and three dual motor-cognitive exercise training per week for four weeks. |
|
| sham tDCS combined with dual-task group | Active Comparator | Patients receive three sham tDCS and three dual cognitive-motor exercise training per week for four weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| active tDCS with dual-task training | Other | participants receive three 20-minute active tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Dual-task gait speed | Gait speed under dual-task condition will be recorded | Through study completion, an average of 1 year |
| Dual-task cognitive performance | Number of correct responses will be measured during dual-task conditions | Through study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Oxyhemoglobin concentration changes of the brain | Oxyhemoglobin concentration changes will be measured using functional near infra-red spectroscopy during dual-task walking | Through study completion, an average of 1 year |
| Dual-task gait performance 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Dual-task peak angular velocity | Peak angular (dorsi-plantar flexion) velocity under dual-task foot pedaling will be recorded | Through study completion, an average of 1 year |
| Dual-task cognitive performance 3 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Prof. Marco PANG | Contact | +852 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 | Hong Kong |
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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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| sham tDCS with dual-task training | Other | participants receive three 20-minute sham tDCS treatment and three 60-minute COGMOTION dual-task exercise sessions per week for four consecutive weeks. |
|
Gait cadence will be measured during dual-task walking
| Through study completion, an average of 1 year |
| Dual-task gait performance 2 | Gait cycle duration will be measured during dual-task walking | Through study completion, an average of 1 year |
| Dual-task gait performance 3 | Stride length will be measured during dual-task walking | Through study completion, an average of 1 year |
| Dual-task cognitive performance 1 | Correct reaction time under dual-task walking will be recorded | Through study completion, an average of 1 year |
| Blood oxygenation level changes of the brain | Blood oxygenation level changes will be measured using Magnetic Resonance Imaging during dual-task foot pedaling | Through study completion, an average of 1 year |
| Dual-task stride time | cadence under dual-task foot pedaling will be recorded | Through study completion, an average of 1 year |
| Dual-task cognitive performance 2 | Number of correct responses under dual-task foot pedaling will be recorded | Through study completion, an average of 1 year |
| Dual-task gait performance 4 | Step time under dual-task walking will be recorded | Through study completion, an average of 1 year |
Correct reaction time under dual-task foot pedaling will be recorded
| Through study completion, an average of 1 year |
| Single-task walking speed | 10-meter walking test will be used to assess single-task walking speed in meters per second | Through study completion, an average of 1 year |
| Balance 1 | Mini Balance Evaluation Systems Test will be used to assess postural control, with total points from 0-28. Higher points indicate better performance. | Through study completion, an average of 1 year |
| Balance 2 | 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. | Through study completion, an average of 1 year |
| Cognitive performance | Stroop color word test will be used to assess executive function | Through study completion, an average of 1 year |
| Cognitive performance 1 | 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 |
| Cognitive performance 2 | Trail Making Test will be used to assess executive function | Through study completion, an average of 1 year |
| Fall incidence | Monthly telephone interviews for recording fall incidence | Through study completion, an average of 1 year |
| dual-task walking performance at maximal speed | Walking time under dual-task walking at maximal speed will be recorded | Through study completion, an average of 1 year |
| dual-task cognitive performance at maximal speed | Accuracy under dual-task walking at maximal speed will be recorded | Through study completion, an average of 1 year |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |