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    Training dual-task walking in community-dwelling adults within 1 year of stroke: a protocol for a single-blind randomized controlled trial

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    Author
    Plummer-D'Amato, Prudence
    Kyvelidou, Anastasia
    Sternad, Dagmar
    Najafi, Bijan
    Villalobos, Raymond
    Zurakowski, David
    Affiliation
    Department of Physical Therapy, Northeastern University, 360 Huntington Ave, 6 Robinson Hall, Boston, MA, USA
    Department of Biology, Northeastern University, Boston, MA, 02115, USA
    Departments of Biology, Electrical and Computer Engineering, and Physics, Northeastern University, Boston, MA, 02115, USA
    Department of Surgery, University of Arizona, Tucson, AZ, 85724, USA
    Arizona Center on Aging, University of Arizona, Tucson, AZ, 85724, USA
    New England Rehabilitation Hospital, Woburn, MA, 01801, USA
    Departments of Anesthesia and Surgery, Children’s Hospital, Boston, MA, 02115, USA
    Departments of Anesthesia and Biostatistics, Harvard Medical School, Boston, MA, 02115, USA
    Issue Date
    2012
    Keywords
    Stroke
    Gait
    Dual-task
    Attention
    Cognition
    Rehabilitation
    Obstacle avoidance
    Participation
    Physical therapy
    
    Metadata
    Show full item record
    Publisher
    BioMed Central
    Citation
    Plummer-D’Amato et al. BMC Neurology 2012, 12:129 http://www.biomedcentral.com/1471-2377/12/129
    Journal
    BMC Neurology
    Rights
    © 2012 Plummer-D'Amato et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
    Collection Information
    This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
    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
    EISSN
    1471-2377
    DOI
    10.1186/1471-2377-12-129
    Version
    Final published version
    Additional Links
    http://www.biomedcentral.com/1471-2377/12/129
    ae974a485f413a2113503eed53cd6c53
    10.1186/1471-2377-12-129
    Scopus Count
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