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

Persistent Link:
http://hdl.handle.net/10150/610064
Title:
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, 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
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
Keywords:
Stroke; Gait; Dual-task; Attention; Cognition; Rehabilitation; Obstacle avoidance; Participation; Physical therapy
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2377/12/129

Full metadata record

DC FieldValue Language
dc.contributor.authorPlummer-D'Amato, Prudenceen
dc.contributor.authorKyvelidou, Anastasiaen
dc.contributor.authorSternad, Dagmaren
dc.contributor.authorNajafi, Bijanen
dc.contributor.authorVillalobos, Raymonden
dc.contributor.authorZurakowski, Daviden
dc.date.accessioned2016-05-20T08:57:44Z-
dc.date.available2016-05-20T08:57:44Z-
dc.date.issued2012en
dc.identifier.citationPlummer-D’Amato et al. BMC Neurology 2012, 12:129 http://www.biomedcentral.com/1471-2377/12/129en
dc.identifier.doi10.1186/1471-2377-12-129en
dc.identifier.urihttp://hdl.handle.net/10150/610064-
dc.description.abstractBACKGROUND: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 protocolen
dc.description.abstractthe 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 NCT01568957en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2377/12/129en
dc.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)en
dc.subjectStrokeen
dc.subjectGaiten
dc.subjectDual-tasken
dc.subjectAttentionen
dc.subjectCognitionen
dc.subjectRehabilitationen
dc.subjectObstacle avoidanceen
dc.subjectParticipationen
dc.subjectPhysical therapyen
dc.titleTraining dual-task walking in community-dwelling adults within 1 year of stroke: a protocol for a single-blind randomized controlled trialen
dc.typeArticleen
dc.identifier.eissn1471-2377en
dc.contributor.departmentDepartment of Physical Therapy, Northeastern University, 360 Huntington Ave, 6 Robinson Hall, Boston, MA, USAen
dc.contributor.departmentDepartment of Biology, Northeastern University, Boston, MA, 02115, USAen
dc.contributor.departmentDepartments of Biology, Electrical and Computer Engineering, and Physics, Northeastern University, Boston, MA, 02115, USAen
dc.contributor.departmentDepartment of Surgery, University of Arizona, Tucson, AZ, 85724, USAen
dc.contributor.departmentArizona Center on Aging, University of Arizona, Tucson, AZ, 85724, USAen
dc.contributor.departmentNew England Rehabilitation Hospital, Woburn, MA, 01801, USAen
dc.contributor.departmentDepartments of Anesthesia and Surgery, Children’s Hospital, Boston, MA, 02115, USAen
dc.contributor.departmentDepartments of Anesthesia and Biostatistics, Harvard Medical School, Boston, MA, 02115, USAen
dc.identifier.journalBMC Neurologyen
dc.description.collectioninformationThis 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.en
dc.eprint.versionFinal published versionen
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