Multimodal training with dual-task enhances immediate and retained effects on dual-task effects of gait speed not by cognitive-motor trade-offs in stroke survivors: a randomized controlled trial

Abstract

Purpose

Individuals who have experienced stroke may benefit from dual-task related training to improve gait speed performance. Whether noted improvements reflect true effects on gait or cognitive-motor trade-offs still remains unclear. Therefore, this study aimed to investigate the effects of dual-task training on dual-task effects of both walking and cognitive domains in stroke survivors.

Materials and methods

Forty-four individuals with stroke were randomized to dual-task or single-task training groups. Both groups exercised three 60-minute sessions per week for 4 weeks. The primary outcomes were dual-task effects on gait speed and cognitive score. Outcomes were assessed before and after the intervention and 1-month follow-up.

Results

While both groups exhibited improvement in absolute gait speed under dual-task conditions, the dual-task training group demonstrated superior results by providing an additional gain on dual-task effects of gait speed. Compared to single-task training, dual-task training exhibited a significant improvement in dual-task effects of gait speed at post-treatment and follow-up. Regarding the dual-task effects on cognitive scores, no significant differences within and between groups after training were observed.

Conclusion

Dual-task training enhances immediate and retained effects on the dual-task effects of gait speed in individuals with stroke, not by cognitive-motor trade-offs.

Trial registration

URL: https://www.clinicaltrials.gov.

ClinicalTrials.gov Identifier

NCT02686515

IMPLICATIONS FOR REHABILITATION

• Dual-task interference during walking has important consequences for stroke survivors to walk safely.

• Multimodal training with dual-task enhances immediate and retained effects on the dual-task effects of gait speed in individuals with stroke, not by cognitive-motor trade-offs.

• Clinicians are encouraged to incorporate multimodal training with dual-task into the exercise routines to enhance walking under dual-task conditions in stroke survivors.

Keywords:

• Dual-task effect
• stroke
• walking
• cognition
• dual-task training

Acknowledgments

We thank Melissa Stauffer for editorial assistance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, LLC, upon reasonable request.

Additional information

Funding

This research was partially supported by the National Science and Technology Council (NSTC-111-2314-B-182-036, and 112-2314-B-182-021) and Chang Gung Memorial Hospital (CMRPD1M0841) in Taiwan.