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Not yet recruitingNCT07494357DTOCT-StrokeUpdated May 28, 2026

Effects of Dual Task-Oriented Circuit Training on Walking Recovery in Sub-acute Stroke

An interventional study of Dual task oriented circuit training and Task Oriented Circuit Training in Stroke, Cerebrovascular, sponsored by Universitas Padjadjaran. Not yet recruiting at 1 site in Indonesia. Open to participants aged 40 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-05-28.

Sponsored by Universitas Padjadjaran · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
36
Allocation
Randomized
Ages
40 Years to 65 Years
Sex
All
01

Study summary

This pilot study aims to assess the feasibility, safety, and initial efficacy of an integrated Dual Task-Oriented Circuit Training (DTOCT) program for individuals in the subacute phase of stroke recovery. Although numerous patients recover the capacity to walk in a regulated hospital environment, they frequently encounter difficulties with "community ambulation," the capability to traverse real-world settings while multitasking (e.g., walking while conversing or circumventing barriers). This study will examine if the integration of high-intensity circuit training with cognitive difficulties can promote neuroplasticity and enhance the patient's capacity to safely traverse intricate daily settings.

Read the detailed description

Cognitive-Motor Interference (CMI) makes it challenging for stroke survivors to reintegrate into their communities. Walking is an automatic subcortical process in a healthy brain. After a stroke, however, the brain often has to "consciously" control walking, which takes away mental resources from other tasks. This "functional gap" is why almost 80% of survivors can walk house-hold, but only 30% can safely get around in the community. This study examines the "Golden Window" of recovery (2 weeks to 5 months post-stroke), a timeframe characterized by optimal physiological conditions for neuroplasticity. The DTOCT protocol functions as a synergistic intervention: the circuit training induces cardiovascular intensity to stimulate systemic Brain-Derived Neurotrophic Factor (BDNF) release, while concurrent cognitive tasks (e.g., memory recall or the Stroop test) focus on localized neurotrophic support within the prefrontal cortex and hippocampus. This three-arm pilot study (DTOCT vs. pure task-oriented training vs. pure dual-tasking) will give us important information about how easy it is to recruit participants, how well they stick to the plan, and how big the initial effects are. These results will constitute an essential basis for an upcoming comprehensive Randomized Controlled Trial (RCT) designed to enhance the standard of neurorehabilitation in Indonesia.

02

Conditions studied

  • Stroke, Cerebrovascular

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03

In context

Stroke

8,255 studies on the registry are indexed under Stroke; 2,056 are open to participants now.

This study's planned enrollment of 36 is below the median of 49 across 6,024 interventional studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Universitas Padjadjaran is the lead sponsor of 93 studies on the registry; 23 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Diagnosed with a first-ever subacute stroke (defined as 2 weeks to 5 months post-onset) with anterior circulation involvement.
  2. Diagnosis confirmed via neuroimaging (CT or MRI).
  3. Men and women aged 40 to 65 years.
  4. Motor recovery in the lower limbs corresponding to Brunnstrom stages 4 to
  5. Functional Ambulation Category (FAC) score of at least grade 3.
  6. Ability to walk independently, with or without walking aids.
  7. Indonesian version (MoCA-INA) score of ≥20, demonstrating the capacity to collaborate and follow multi-step instructions.
  8. Medically stable with controlled comorbidities.

Exclusion criteria

Exclusion Criteria

  1. Expressive or receptive aphasia that impedes task comprehension
  2. Unstable cardiovascular or medical conditions (e.g., severe hypertension, congestive heart failure) for which moderate exercise is .
  3. Moderate to severe depression, indicated by a Patient Health Questionnaire-9 (PHQ-9) score of ≥ 15.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
36 participants (estimated)

Study arms

  • Experimental
    Dual Task Oriented Circuit Training (DTOCT)

    Experimental: DTOCT Behavioral: Dual Task-Oriented Circuit Training. Participants engage in 5 circuit stations (e.g., obstacle walking, stair navigation) while performing secondary cognitive tasks (e.g., backward counting, object naming). 3 sessions/week for 4 weeks.

    Behavioral: Dual task oriented circuit training

  • Active comparator
    Task Orinted Circuit Training (TOCT)

    Behavioral: Task-Oriented Circuit Training. Focuses on high-intensity motor repetition using circuit stations (e.g., sit-to-stand, stepping) without added cognitive load.

    Behavioral: Task Oriented Circuit Training

  • Active comparator
    Dual Task Training (DTT)

    Behavioral: Pure Dual-Task Training. Participants practice walking under cognitive load (e.g., Stroop task) in a standard non-circuit format.

    Behavioral: Dual task training

Interventions

  • BehavioralDual task oriented circuit training

    1\. Experimental Arm: Dual Task-Oriented Circuit Training (DTOCT) Intervention Name: Behavioral: Dual Task-Oriented Circuit Training (DTOCT) Description: Participants will undergo an integrated 60-minute rehabilitation session, 3 times per week for 4 weeks (total 12 sessions). Each session includes 25-50 minutes of active circuit training across five specialized stations: Dual-Task Walking: Straight walking (3-8m) while performing forward/backward number sequencing. Obstacle Walking: Stepping over cone or hurdle obstacles (5-14cm) while naming object categories from long-term memory. Stair Navigation: Ascending/descending stairs (10-17cm step height) while identifying colors and shapes. Walking with Navigation: Navigating an oval path (3-8m) while performing an incongruent Stroop color-word task. ADL Stimulation: Walking while carrying a cup of liquid or a shopping bag to train executive function and working memory. Training intensity and cognitive difficulty are progressed weekly

    Also known as: DTOCT

  • BehavioralTask Oriented Circuit Training

    2\. Active Comparator Arm: Task-Oriented Circuit Training (TOCT) Intervention Name: Behavioral: Task-Oriented Circuit Training (TOCT) Description: Participants will focus exclusively on functional motor relearning and cardiovascular endurance through 6 circuit-based stations: Standing and Reaching: Multidirectional reaching to targets while standing. Sit-to-Stand: Transitions using chairs of various heights to strengthen extensors. Anterior/Posterior Stepping: Stepping onto blocks of various heights. Lateral Stepping: Side-stepping for lateral stability. Forward Step-Up: Strengthening for stair climbing mechanics. Heel Raise: Improving gait push-off mechanics. Each station is performed for 2.5 to 5 minutes with 1-minute rest periods. Training is conducted 3 times per week for 4 weeks (total 12 sessions), with each session lasting 60 minutes including warm-up and cool-down. No explicit secondary cognitive tasks are added.

    Also known as: TOCT

  • BehavioralDual task training

    3\. Active Comparator Arm: Pure Dual-Task Training (DT) Intervention Name: Behavioral: Pure Dual-Task Training (DT) Description: Participants will perform standard, non-circuit walking at a self-selected comfortable speed while executing simultaneous cognitive demands. The protocol includes: Backward Counting: Continuous subtraction from a random 3-digit number. Stroop Task: Identifying font colors or semantic meanings of incongruent words. Memory Tasks: Sequential recall of shopping lists (3-5 items) and reverse word recall (2-4 words). Verbal Fluency: Generating word chains or category naming. Each session consists of two 15-minute sets of core dual-task training (30 minutes total activity) within a 60-minute therapist-supervised visit. Training is conducted 3 times per week for 4 weeks (total 12 sessions). Cognitive difficulty is adjusted weekly to maintain an optimal challenge.

    Also known as: DTT

06

What researchers measure

Primary outcomes

  1. Adherence Rate

    Description: Percentage of attended sessions (out of 12) during the 4-week intervention period.

    Time frame: 4 weeks

  2. Retention Rate

    Proportion of participants who complete the full 4-week protocol and follow-up assessments

    Time frame: 4 weeks

  3. Incidence of Adverse Events

    Frequency of falls or medical adverse events documented during the training sessions.

    Time frame: 4 weeks

  4. Mean Exercise Heart Rate

    Evaluation of cardiovascular demand and tolerability during the circuit training stations. Measured using a digital heart rate monitor. Unit of Measure: Beats per minute (bpm)

    Time frame: During each of the 12 training sessions (4 weeks)

  5. Mean Systolic and Diastolic Blood Pressure

    Monitoring of hemodynamic stability to ensure the high-intensity circuit training is safe for subacute stroke patients Unit of Measure: Millimeters of mercury (mmHg)

    Time frame: Pre-and post-each training session (4 weeks)

  6. Mean Borg Rating of Perceived Exertion (RPE) Score

    Assessment of subjective physical effort and tolerability. The scale ranges from 6 to 20 (or 0-10 depending on the version used), where higher scores indicate greater perceived exertion. Unit of Measure: Units on a scale

    Time frame: At the end of each circuit station during all 12 sessions (4 weeks)

Secondary outcomes

  1. Change from Baseline in 6-Minute Walk Test (6MWT)

    Change in total distance walked in meters during the 6-Minute Walk Test from baseline to 4 weeks.

    Time frame: Baseline and 4 weeks

  2. Change from Baseline in 10-Meter Walk Test (10MWT)

    Change in gait speed measured in meters per second (m/s) in 10 meter walk test

    Time frame: Baseline and 4 weeks

  3. Change from Baseline of Completion Time in Standardized Walking Obstacle Course (SWOC)

    Mean time taken to complete the 12.2-meter curved course across three conditions (normal, tray, dark-glasses) and measured using a stopwatch. The total time in seconds taken to complete the 12.2-meter curved obstacle course under three conditions (normal, tray, and dark-glasses). A shorter time indicates better walking adaptability. Unit of Measure: Seconds

    Time frame: Baseline and 4 weeks

  4. Change from Baseline in Standardized Walking Obstacle Course (SWOC) Step Count

    Mean number of contacts between the foot and ground during course completion across three conditions Unit of measure : Number of steps

    Time frame: Baseline and 4 weeks

  5. Change of number of errors in Standardized Walking Obstacle Course (SWOC)

    Errors are operationally defined as the aggregate sum of "stumbles" (where the participant's leg or walking aid strikes an obstacle) and "step-offs" (where a whole foot is placed outside the 0.92-meter wide curved pathway) Number of errors (atau "Count of errors")

    Time frame: Baseline and 4 weeks (Post-intervention)

  6. Change from Baseline in Serum BDNF Concentration

    Concentration of Brain-Derived Neurotrophic Factor quantified via sandwich ELISA to measure neuroplasticity. Unit of measure : Picograms per milliliter (pg/mL)

    Time frame: Baseline and 4 weeks

07

Study locations

1 site
  • RS Dustira Bandung
    Bandung, West Java 40131, Indonesia
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07494357
Lead sponsor
Universitas Padjadjaran
Responsible party
Farida Arisanti (MD, PMR, Universitas Padjadjaran) — Principal investigator
First posted
Mar 27, 2026
Start date
Jun 1, 2026 (estimated)
Primary completion
Aug 30, 2026 (estimated)
Completion
Aug 30, 2026 (estimated)
Last update
May 28, 2026

Study contacts

Farida Arisanti, MD, PMR
Contact
farida.arisanti@unpad.ac.id
+62-85351111946
Vitriana Biben, Prof., MD, PMR
Contact
vitriana@unpad.ac.id
+628156262733
Farida Arisanti, MD, PMR
principal investigator · Faculty of Medicine Universitas Padjadjaran

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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