Efficacy of cognitive dual task training on balance in patients with stroke

INTERVENTION: Participants allocated to the experimental group will receive cognitive dual‐task training (CDTT) in combination with conventional balance exercises. The cognitive tasks include: addition/subtraction, forward and backward counting, category naming, word chain execution, poem recitation, backward sentence recitation, colour discrimination, backward spelling, and verbal analogical reasoning. All tasks will be performed concurrently with conventional balance exercises. The intervention will be delivered by a qualified physiotherapist with experience in neurorehabilitation and stroke rehabilitation. Sessions will be conducted face‐to‐face on an individual basis under direct supervision. The intervention will be provided 3 times per week for 4 weeks. Each session will last 30 minutes, consisting of 10 tasks performed for 3 minutes each alongside balance exercises. The intervention will be conducted in the outdoor neurology unit of the physiotherapy department of Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. Adherence will be monitored through supervised sessions and attendance records. Participants will receive reminders for scheduled sessions, and missed sessions will be followed up. The intervention will not be individualised. All participants allocated to the experimental group will receive the same standardized cognitive dual‐task training (CDTT) protocol, combined with conventional balance exercises. CONDITION: Stroke ‐ Haemorrhagic Stroke ‐ Ischaemic Stroke; ; Stroke PRIMARY OUTCOME: To evaluate the efficacy of cognitive dual‐task training on balance in patients with stroke.[Berg Balance Scale (BBS) Baseline and after 4 weeks of intervention] SECONDARY OUTCOME: Gait parameters will be assessed as a composite secondary outcome, comprising gait speed, cadence, step length, and stride length.[Gait parameters (step length, stride length, gait speed and cadence) ; ; Gait speed will be assessed using the 10‐Metre Walk Test (10MWT). Cadence will be calculated as the number of steps per minute during the test. Step length will be measured as the distance between the heel strike of one foot and the subsequent heel strike of the opposite foot, while stride length will be measured as the distance between two consecutive heel strikes of the same foot using a measuring tape. Baseline and after 4 weeks of intervention] INCLUSION CRITERIA: 1. Patients with stroke who are taking rehabilitation service at CRP 2. Age between 20 to 80 (Liu et al., 2017) 3. Both male and female (Rai and Ganvir, 2020) 4. A score of greater than 24 on the mini‐mental state examination (MMSE) (Liu et al., 2017) 5. Ability to take one or more steps with or without assistance (Zheng Jiejiao et al., 2012) 6. Stable medical condition to allow participation in testing protocol and intervention (Zheng Jiejiao et al., 2012)