Dual-task Training Combined With tDCS on Cognitive-motor Performance and Brain Activity in Stroke Patients

In China, the prevalence of stroke increased by 106.0% (93.7-118.8) between 1990 and 2019, highlighting the persistent and substantial burden of this condition. Post-stroke recovery, particularly the ability to achieve community ambulation, plays a critical role in improving health-related quality of life. Effective community ambulation in daily life requires the ability to dual-task-namely, to perform concurrent tasks requiring attentional resources while maintaining walking function and balance. Emerging evidence suggests that stroke survivors face greater challenges in walking function and dual-task balance compared to their age-matched, able-bodied counterparts. For instance, when tasked with recalling a shopping list while walking, stroke patients exhibit a more pronounced decline in both walking speed and cognitive performance relative to control groups. Given the necessity for stroke survivors to reintegrate into the community, it is imperative to thoroughly investigate this phenomenon of cognitive-motor interference.

Inclusion criteria

• a diagnosis of stroke, stroke onset of more than 6 months,
• aged 50 or more,
• capable of following verbal and visual instructions,
• having a Montreal Cognitive Assessment score ≥ 22,
• able to walk for 10 meters with/without a mobility aid,
• community-dwelling, unilateral stroke

Exclusion criteria

• neurological disorders, gait-precluding pain or comorbidity,
• receiving any formal rehabilitation training,
• contraindications to exercise (e.g., unstable angina),
• contraindications to fNIRS, MRI, and tDCS (e.g., brain skin injury, pacemaker, metal implants in the brain),
• history of seizure or epilepsy,
• color blindness.
• unable to walk with/without a mobility aid while responsing stimulus by the remote control