Clinical trial NCT01568957: Training Dual-Task Walking After Stroke
Official title: Training Dual-Task Walking After Stroke: Effects on Attentional and Locomotor Control
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Stroke
Keywords: Gait
Dual-task
Obstacle avoidance
Attention allocation
Lead sponsor: University of North Carolina, Chapel Hill
Sponsor class: OTHER
Collaborators: name: University of Arizona
First posted: 2012-04-02
Enrollment: 37
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Community ambulation is a highly complex skill requiring the ability to adapt to increased environmental complexity and perform multiple tasks simultaneously. Deficits in dual-tasking may severely compromise the ability to participate fully in community living. Unfortunately, current rehabilitation practice for stroke fails to adequately address dual-task limitations; individuals with stroke continue to exhibit clinically significant dual-task costs on gait at discharge. As a result, many stroke survivors are living in the community with residual deficits that may increase disability in the real world and lead to falls with devastating consequences. To address this issue, the proposed study investigates the efficacy of dual-task gait training on attention allocation and locomotor performance in community-dwelling stroke survivors. Because walking in the real world often requires time-critical tasks and obstacle avoidance, the investigators will test the impact of dual-task gait training on cognitive-motor interference during walking at preferred speed and at maximal speed (Aim 1), and on locomotor control during obstacle negotiation (Aim 2). The investigators will also evaluate the effects of the intervention on community reintegration and participation (Aim 3).


Eligibility criteria: Inclusion Criteria:

* Within 3 years of stroke onset
* Living in the community, operationally defined as living in one's own home, or the home of a friend, relative, or caregiver
* Walking speed 0.6-1.1 m/s determined during 10-meter walk test
* Walk without the assistance of another person
* Medically stable and approved for participation by study physician
* Intact global cognition indicated by score \> 23 on Montreal Cognitive Assessment
* Living in the community prior to stroke

Exclusion Criteria:

* Pre-existing neurological disorders (e.g., Parkinson's disease, Multiple Sclerosis, dementia, traumatic brain injury)
* Previous stroke with residual motor deficit
* Uncontrolled hypertension
* Inability to follow 3-step command
* Primary uncontrolled hearing impairment
* Severe uncontrolled visual impairment
* Any speech-language impairment affecting ability to respond verbally to auditory stimuli
* Timed Up and Go test \> 15 seconds
* Lower extremity amputation
* Any orthopedic problem affecting gait
* Concurrent participation in another clinical trial

Primary outcomes:
measure: Dual-task cost on gait speed
timeFrame: 4 weeks
Secondary outcomes:
measure: Executive function
timeFrame: Measured at baseline, post intervention (4 weeks), 6 months post intervention
measure: Spontaneous physical activity
timeFrame: Measured at baseline, post intervention (4 weeks), 6 months post intervention
measure: Kinematics of gait during obstacle crossing
timeFrame: Measured at baseline, post intervention (4 weeks), 6 months post intervention
measure: Stroke Impact Scale
timeFrame: Measured at baseline, post intervention (4 weeks), 6 months post intervention
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: University of North Carolina
state: North Carolina
Study officials:
affiliation: University of North Carolina, Chapel Hill
name: Prudence Plummer, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Plummer-D'Amato P, Kyvelidou A, Sternad D, Najafi B, Villalobos RM, Zurakowski D. Training dual-task walking in community-dwelling adults within 1 year of stroke: a protocol for a single-blind randomized controlled trial. BMC Neurol. 2012 Oct 31;12:129. doi: 10.1186/1471-2377-12-129.