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Peer-reviewedCC BY 4.0PLOS One

The effect of dual task-oriented circuit training on neuroplasticity and walking adaptability in subacute stroke patients: A pilot and feasibility study

  • Farida Arisanti1,2
  • Bejo Ropii3
  • Saniy Ghaida4
  • Tsuchiya Tristiana Dewi4
  • Bernadeta Cahyo Setianingrum Poernomo5
  • Yunia Sribudiani6
  • Lisda Amalia7
  • Julia Patrick Engkasan8
  • Vitriana Biben2
8 affiliations
  1. 1Faculty of Medicine, Doctoral Study Program in Medical Science, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia
  2. 2Department of Physical and Rehabilitation Medicine, Faculty of Medicine Universitas Padjadjaran, Kabupaten Sumedang, Indonesia
  3. 3Preanger Institute for Biomedical Engineering, Science, and Technology, Bandung, Indonesia
  4. 4Kabupaten Sumedang, Physical Medicine and Rehabilitation Study Program, Faculty of Medicine, Universitas Padjadjdaran, Kabupaten Sumedang, Indonesia
  5. 5Dustira Hospital, Bandung, Indonesia
  6. 6Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia
  7. 7Department of Neurology, Faculty of Medicine, Universitas Padjadjaran, Kabupaten Sumedang, Indonesia
  8. 8Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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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)

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Cite

BibTeXRIS
BibTeX
@article{arisanti2026effect,
  title = {{The effect of dual task-oriented circuit training on neuroplasticity and walking adaptability in subacute stroke patients: A pilot and feasibility study}},
  author = {Farida Arisanti and Bejo Ropii and Saniy Ghaida and Tsuchiya Tristiana Dewi and Bernadeta Cahyo Setianingrum Poernomo and Yunia Sribudiani and Lisda Amalia and Julia Patrick Engkasan and Vitriana Biben},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0361255},
  url = {https://doi.org/10.1371/journal.pone.0361255},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The effect of dual task-oriented circuit training on neuroplasticity and walking adaptability in subacute stroke patients: A pilot and feasibility study
AU  - Farida Arisanti
AU  - Bejo Ropii
AU  - Saniy Ghaida
AU  - Tsuchiya Tristiana Dewi
AU  - Bernadeta Cahyo Setianingrum Poernomo
AU  - Yunia Sribudiani
AU  - Lisda Amalia
AU  - Julia Patrick Engkasan
AU  - Vitriana Biben
PY  - 2026
DA  - 2026/10/27
JO  - PLOS One
DO  - 10.1371/journal.pone.0361255
UR  - https://doi.org/10.1371/journal.pone.0361255
AB  - 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)
SN  - 1932-6203
ER  -