Training dual-task walking in community-dwelling adults within 1 year of stroke: a protocol for a single-blind randomized controlled trial
Author
Plummer-D'Amato, PrudenceKyvelidou, Anastasia
Sternad, Dagmar
Najafi, Bijan
Villalobos, Raymond
Zurakowski, David
Affiliation
Department of Physical Therapy, Northeastern University, 360 Huntington Ave, 6 Robinson Hall, Boston, MA, USADepartment 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
2012Keywords
StrokeGait
Dual-task
Attention
Cognition
Rehabilitation
Obstacle avoidance
Participation
Physical therapy
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BioMed CentralCitation
Plummer-D’Amato et al. BMC Neurology 2012, 12:129 http://www.biomedcentral.com/1471-2377/12/129Journal
BMC NeurologyRights
© 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 protocolthe 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
1471-2377Version
Final published versionAdditional Links
http://www.biomedcentral.com/1471-2377/12/129ae974a485f413a2113503eed53cd6c53
10.1186/1471-2377-12-129
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Except where otherwise noted, this item's license is described as © 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).