{ "abstract": "Background: Stroke remains a leading cause of long-term disability worldwide, with a substantial proportion of survivors experiencing persistent limitations in functional mobility. Although many individuals regain the ability to walk in structured clinical environments, only a minority achieve independent community ambulation due to cognitive–motor interference (CMI). The subacute phase is characterized by heightened neuroplastic potential and responsiveness to rehabilitation. Dual Task-Oriented Circuit Training (DTOCT) integrates task-oriented circuit training with concurrent cognitive challenges and may provide a functionally relevant approach to addressing cognitive–motor interference. However, its feasibility, safety, and preliminary effects in subacute stroke remain unclear. Methods: This three-arm, participant-blinded, randomized pilot and feasibility trial will recruit 36 individuals with subacute stroke and allocate them equally to DTOCT, Task-Oriented Circuit Training (TOCT), or Dual Task Training (DTT). Participants will receive three supervised sessions per week for 4 weeks (12 sessions). Primary outcomes will assess feasibility and safety, including adherence, retention, adverse events, heart rate, blood pressure, and perceived exertion. Secondary exploratory outcomes will include walking endurance assessed using the 6-Minute Walk Test, gait speed using the 10-Meter Walk Test, walking adaptability using the Standardized Walking Obstacle Course, and serum brain-derived neurotrophic factor as an exploratory peripheral biomarker associated with neuroplasticity. Discussion: This pilot study is designed to determine the feasibility and safety of DTOCT and to generate preliminary effect estimates for clinical and neurobiological outcomes. The findings will inform primary outcome selection, intervention refinement, and sample-size estimation for a subsequent adequately powered randomized controlled trial rather than establish definitive efficacy or superiority. Trial registration: ClinicalTrials.gov. Identifier: NCT07494357 (registered prospectively). Protocol ID: IKFR-202603.01)", "abstract_shown": true, "affiliations": [ "Faculty of Medicine, Doctoral Study Program in Medical Science, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia", "Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Kabupaten Sumedang, Indonesia", "Preanger Institute for Biomedical Engineering, Science, and Technology, Bandung, Indonesia", "Kabupaten Sumedang, Physical Medicine and Rehabilitation Study Program, Faculty of Medicine, Universitas Padjadjdaran, Kabupaten Sumedang, Indonesia", "Dustira Hospital, Bandung, Indonesia", "Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia", "Department of Neurology, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia", "Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia" ], "article_type": "Study Protocol", "arxiv": null, "author_total": 9, "authors": [ { "affs": [ 0, 1 ], "name": "Farida Arisanti", "orcid": "0000-0001-6427-6178" }, { "affs": [ 2 ], "name": "Bejo Ropii" }, { "affs": [ 3 ], "name": "Saniy Ghaida" }, { "affs": [ 3 ], "name": "Tsuchiya Tristiana Dewi" }, { "affs": [ 4 ], "name": "Bernadeta Cahyo Setianingrum Poernomo" }, { "affs": [ 5 ], "name": "Yunia Sribudiani" }, { "affs": [ 6 ], "name": "Lisda Amalia" }, { "affs": [ 7 ], "name": "Julia Patrick Engkasan", "orcid": "0000-0003-0599-4908" }, { "affs": [ 1 ], "name": "Vitriana Biben", "orcid": "0000-0002-0729-8853" } ], "bibtex": "https://research.draconitic.com/paper/8k89p64h35c6b.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0361255", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712583/", "id": "8k89p64h35c6b", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0361255", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Adverse Events" ], [ "heading", "Biological Locomotion" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Blood Pressure" ], [ "heading", "Cellular Neuroscience" ], [ "heading", "Cerebrovascular Diseases" ], [ "heading", "Clinical Research Design" ], [ "heading", "Exercise" ], [ "heading", "Medical Conditions" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Neurology" ], [ "heading", "Neuronal Plasticity" ], [ "heading", "Neurorehabilitation" ], [ "heading", "Neuroscience" ], [ "heading", "Physical Activity" ], [ "heading", "Physical Fitness" ], [ "heading", "Physiology" ], [ "heading", "Pilot Studies" ], [ "heading", "Public and Occupational Health" ], [ "heading", "Rehabilitation Medicine" ], [ "heading", "Research Design" ], [ "heading", "Research and Analysis Methods" ], [ "heading", "Sports Science" ], [ "heading", "Sports and Exercise Medicine" ], [ "heading", "Stroke" ], [ "heading", "Study Protocol" ], [ "heading", "Vascular Medicine" ], [ "heading", "Walking" ], [ "openalex", "2742|Stroke Rehabilitation and Recovery" ], [ "plos", "/Biology and life sciences/Neuroscience/Cellular neuroscience/Neuronal plasticity" ], [ "plos", "/Biology and life sciences/Physiology/Biological locomotion/Walking" ], [ "plos", "/Biology and life sciences/Sports science/Sports and exercise medicine/Exercise" ], [ "plos", "/Medicine and health sciences/Medical conditions/Cerebrovascular diseases/Stroke" ], [ "plos", "/Medicine and health sciences/Neurology/Cerebrovascular diseases/Stroke" ], [ "plos", "/Medicine and health sciences/Neurology/Neurorehabilitation" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Physical activity/Physical fitness/Exercise" ], [ "plos", "/Medicine and health sciences/Rehabilitation medicine/Neurorehabilitation" ], [ "plos", "/Medicine and health sciences/Sports and exercise medicine/Exercise" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Blood pressure" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Stroke" ], [ "plos", "/Research and analysis methods/Research design/Clinical research design/Adverse events" ], [ "plos", "/Research and analysis methods/Research design/Pilot studies" ] ], "openalex": "W7223802447", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0361255&type=printable", "pmcid": "PMC13712583", "pmid": "42945228", "published": "2026-10-27", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/8k89p64h35c6b.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0361255", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0361255" }, { "first_seen": "2026-10-31T12:23:08Z", "native_id": "PMC13712583", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0361255" } ], "subjects": [ { "field": "biology", "origin": "plos:neuroscience", "subfield": "neuroscience" }, { "field": "medicine", "origin": "heading:Public and Occupational Health", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:neurology", "subfield": "neurology" }, { "field": "medicine", "origin": "plos:physiology", "subfield": "physiology" } ], "title": "The effect of dual task-oriented circuit training on neuroplasticity and walking adaptability in subacute stroke patients: A pilot and feasibility study", "title_text": "The effect of dual task-oriented circuit training on neuroplasticity and walking adaptability in subacute stroke patients: A pilot and feasibility study", "type": "peer-reviewed", "updated_at": "2026-10-31T12:23:08Z", "url": "https://research.draconitic.com/paper/8k89p64h35c6b", "venue": "PLOS One", "versions": [] }