Training dual-task walking in community-dwelling adults within 1 year of stroke

a protocol for a single-blind randomized controlled trial

Prudence Plummer-D'Amato, Anastasia Kyvelidou, Dagmar Sternad, Bijan Najafi, Raymond M. Villalobos, David Zurakowski

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Community ambulation is a highly complex skill requiring the ability to adapt to increased environmental complexity and perform multiple tasks simultaneously. After stroke, individuals demonstrate a diminished ability to perform dual-tasks. Current evidence suggests that conventional rehabilitation does not adequately address gait-related dual-task impairments after stroke, which may be contributing to low levels of participation and physical inactivity in community-dwelling stroke survivors. The objective of this study is to investigate the efficacy of dual-task gait training in community-dwelling adults within 1 year of stroke. Specifically, we will compare the effects of dual-task gait training and single-task gait training on cognitive-motor interference during walking at preferred speed and at fastest comfortable speed (Aim 1), locomotor control during obstacle negotiation (Aim 2), and spontaneous physical activity (Aim 3).Methods/Design: This single-blind randomized controlled trial will involve 44 individuals within 12 months of stroke. Following baseline evaluation, participants will be randomly allocated to single- or dual-task gait training. Both groups will receive 12, 30-minute sessions provided one-on-one over 4-6 weeks in an outpatient therapy setting. Single-task gait training involves practice of gait activities incorporating motor relearning principles. Dual-task gait training involves an identical gait training protocol; the critical difference being that the dual-task gait training group will practice the gait activities while simultaneously performing a cognitive task for 75% of the repetitions. Blinded assessors will measure outcomes at baseline, post-intervention, and 6 months after completion of the intervention. The primary outcome measure will be dual-task effects on gait speed and cognition during unobstructed walking. Secondary outcomes include spatiotemporal and kinetic gait parameters during unobstructed single- and dual-task walking at preferred and fastest comfortable walking speeds, gait parameters during high and low obstacle crossing, spontaneous physical activity, executive function, lower extremity motor function, Timed Up and Go, balance self-efficacy, number of falls, and stroke-related disability. Hypotheses for each aim will be tested using an intention-to-treat analysis with repeated measures ANOVA design.Discussion: This trial will provide evidence to help clinicians make decisions about the types of activities to include in rehabilitation to improve dual-task walking after stroke.Trial registration: ClinicalTrials.gov NCT01568957.

Original languageEnglish (US)
Article number129
JournalBMC Neurology
Volume12
DOIs
StatePublished - Oct 31 2012
Externally publishedYes

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Independent Living
Gait
Walking
Randomized Controlled Trials
Stroke
Aptitude
Rehabilitation
Outcome Assessment (Health Care)
Exercise
Intention to Treat Analysis
Executive Function
Negotiating
Self Efficacy
Cognition
Survivors

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Training dual-task walking in community-dwelling adults within 1 year of stroke : a protocol for a single-blind randomized controlled trial. / Plummer-D'Amato, Prudence; Kyvelidou, Anastasia; Sternad, Dagmar; Najafi, Bijan; Villalobos, Raymond M.; Zurakowski, David.

In: BMC Neurology, Vol. 12, 129, 31.10.2012.

Research output: Contribution to journalArticle

Plummer-D'Amato, Prudence ; Kyvelidou, Anastasia ; Sternad, Dagmar ; Najafi, Bijan ; Villalobos, Raymond M. ; Zurakowski, David. / Training dual-task walking in community-dwelling adults within 1 year of stroke : a protocol for a single-blind randomized controlled trial. In: BMC Neurology. 2012 ; Vol. 12.
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