About this trial
Everyday life requires individuals to function in complex environments and perform tasks that involve the integration of motor and cognitive abilities. However, stroke often leads to impairments in motor-cognitive interaction, which can negatively affect mobility, balance, attention, and the ability to live independently. Although motor-cognitive performance has been identified as an important rehabilitation target after stroke, limited knowledge exists regarding the underlying brain function associated with these difficulties and how rehabilitation and exercise interventions can best address them.
Improving treatment for motor-cognitive difficulties after stroke, such as dual-task walking and navigation, remains a major challenge. An important step is developing assessment methods that accurately capture these impairments in ecologically valid settings that reflect real-world mobility demands. The investigators therefore aim to explore brain function during complex walking after stroke by investigating motor-cognitive performance and its neural correlates during three walking conditions: dual-task walking, navigation, and a combination of both. Non-invasive measures of brain activity using functional near-infrared spectroscopy (fNIRS) together with advanced real-time gait analysis will be used to better understand how stroke affects motor-cognitive functioning during complex walking tasks.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
18 years or older
with a stroke ≥6 months confirmed by a clinical diagnosis
with the ability to walk with or without a walking aid for ≥ 5 min
Disqualifiers
Individuals post stroke with cognitive impairment
severe neglect
global aphasia affecting the ability to provide written informed consent
severe perceptual problems or severe freezing of gait
Trial population
We are studying complex walking in four different populations, people with stroke, healthy adults, people with Parkinson's disease and people with Multiple Sclerosis. We have during 2022-2025 completed data collection (ClinicalTrials.gov ID: NCT06906276, NCT05218213 and NCT05787704) of healthy adults, people with Parkinson's disease and people with Multiple Sclerosis. Hence, this registration concerns the stroke cohort
Trial design
Cohort
Cross-sectional
Treatments tested in this trial
No Interventions
Other interventionThis study includes assessment of brain activity with functional Near Infrared Spectrscopy (fNIRS) and behavioural assessments (motor, motor-cognitive and cognitive) during three complex walking conditions. Dual-task walking with the auditory stroop task. Navigational walking - a course consisting of a distribution of 45 and 90 degrees turns to the left and right Navigational and dual-task walking (condition 1 and 2 together)
Treatment groups
Trial outcomes
Primary outcomes
Functional near infrared spectrometry (fNIRS)
The measurement of changes in concentration of oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HHb) in the prefrontal cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device.
Stride time during all conditions
Stride time will be analyzed with the APDM mobility system.
Velocity during all conditions
Velocity will be analyzed with the APDM mobility system.
Dual-task performance-reaction time
Cognitive performance of the dual task will be assessed as errors in the response to the Auditory stroop task.
Secondary outcomes
Cognitive performance
Global cognitive performance will be assessed with the Montreal Cognitive Assessment (MoCA). Scores range from 0-30, with higher score indicating better performance.
Stroke severity
Assessed using the National Institutes of Health Stroke Scale (NIHSS). Scores range from 0-42, with higher scores indicating greater stroke severity.
Stroke specific health status
Assessed using the Stroke Impact Scale (SIS). Scores range from 0-100, with higher scores indicating better functioning
Physical Impairment
Assessed using the Chedoke McMaster Stroke Assessment. Scores range from 1-7 for each impairment dimension, with higher scores indicating better motor recovery.
Sponsors and contacts
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Karolinska Institutet
Lead sponsor
Karolinska University Hospital
Collaborator