The effects of cognitive dual-task gait training and motor dual-task gait training on lower-limb coordination during walking in subacute stroke patients: A randomized controlled trial

Background: Dual-task gait training often improves walking ability in stroke patients, but its effect on lower-limb coordination and the effects of different training types remains unclear. Improving lower-limb coordination could decrease fall risk during walking. Research question: To observe the rehabilitation effect of cognitive dual-task gait training (CDTG) and motor dualtask gait training (MDTG) on lower-limb coordination during walking in subacute stroke patients. Methods: Thirty-five subacute stroke patients were randomly assigned to the CDTG group (n = 18) and the MDTG group (n = 17), receiving cognitive dual-task gait training and motor dual-task gait training, respectively, three times a week for 4 weeks. If training benefits lower-limb coordination, a larger mean continuous relative phase (MCRP) and smaller variability (MCRPV) should be observed during walking. Results: After training, the MCRP of the bilateral hip joints increased during the stance phase of the affected side in both groups (P = 0.034), while the MCRPV of the bilateral hip joints decreased significantly (P = 0.024). During the swing phase of the affected side, the MCRPV between the hip and knee joints of the unaffected side (P = 0.001), the knee and ankle joints of the unaffected side (P = 0.011), and the two knee joints (P = 0.048) all decreased. There was no difference between the two groups before and after training. Significance: Four weeks of cognitive dual-task gait training and motor dual-task gait training can effectively improve lower-limb coordination in subacute stroke patients, and there is no difference in the effects of the two training methods.