In Switzerland, approximately 20'000 persons suffer a stroke each year. Despite carefully considered rehabilitation programs, full recovery is achieved only in a small proportion of stroke survivors (www.swissheart.ch). Studies suggest that motor-cognitive trainings can improve gait, balance, and mobility in chronic stoke survivors. However, little is known about the effect of motor-cognitive trainings on cognitive functioning in chronic stroke. The aim of this study is to evaluate the effects of a motor-cognitive training added to usual care compared to usual care alone on cognitive functions, single- and dual-task mobility, gait and health-related quality of life. In this single-blind RCT, 38 participants will be allocated randomly to either the intervention group (usual care + motor-cognitive training by means of an exergame for 12 weeks, 2x/week for 30-40 minutes) or the control group (usual care only). Both groups will attend three assessments, at baseline, post-intervention (12 weeks after baseline), and at follow-up (24 weeks after baseline). Global cognitive functioning will be the primary endpoint and a linear mixed model will be used for analysis. Motor-cognitive trainings, especially exergames, bear the potential for further development of innovative long-term rehabilitation solutions for chronic stroke survivors. Cognitive deficits are a common unmet need restricting daily activities mentioned by chronic stroke survivors. Exergame training following personally tailored progression to generate optimal training load may help addressing this unmet need. Therefore, this study will contribute to the on-going research objective on how to improve the long-term care of stroke patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
38
12 weeks, two times per week for 30-40min
Kantonsspital Winterthur
Winterthur, Canton of Zurich, Switzerland
Ambulante Reha Triemli Zürich
Zurich, Switzerland
University Hospital Zürich
Zurich, Switzerland
Change of Montreal Cognitive Assessment Score
Widely used screening tool and cognitive outcome in neurological patients including stroke
Time frame: week 0, week 12 and week 24
Change of Stroke Impact Scale 3.0 Score
Stroke-specific measurement tool assessing patient-reported health-related quality of life
Time frame: week 0, week 12 and week 24
Change of Simple Reaction Test Parameters
Widely used reliable and valid neuropsychological test assessing alertness
Time frame: week 0, week 12 and week 24
Change of Trail Making Test A & B Parameters
Widely used reliable and valid neuropsychological test assessing processing speed and executive functions
Time frame: week 0, week 12 and week 24
Change of Stroop Interference Test Parameters
Widely used reliable and valid neuropsychological test assessing the ability to inhibit the reaction to a more dominant stimulus in favour of the inquired reaction to a less dominant stimulus
Time frame: week 0, week 12 and week 24
Change of N-back test Parameters
Widely used reliable and valid neuropsychological test assessing working memory and related cognitive functions
Time frame: week 0, week 12 and week 24
Change of Mental Rotation Test Parameters
Measures the ability to mentally rotate abstract objects
Time frame: week 0, week 12 and week 24
Change in Single- and cognitive Dual-Task Timed Up and Go Test Parameters and motor/cognitive dual task costs
Widely used, reliable and valid test of mobility and dual-task ability in various populations including stroke.
Time frame: week 0, week 12 and week 24
Change of 10 meter walk test Gait Parameters
Widely used test to assess gait speed and spatiotemporal gait parameters.
Time frame: week 0, week 12 and week 24
Change of Outdoor Gait Parameters
Assesses walking endurance and spatiotemporal gait parameters under daily-life conditions.
Time frame: week 0, week 12 and week 24
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