Background: In daily living, walking usually combines with cognitive or motor dual tasks.
For individuals with Parkinson's disease (PD), gait performance becomes worse while doing
dual tasks, which may due to insufficient executive function. Declined executive function
may occur in early stage of PD. For those with stroke, impaired dual-task performance
also exists. Although 75% of patients with stroke may suffer from impaired executive
function, impaired dual-task performance correlates with declined executive function
directly or not still unknown. Undoubtedly, impaired executive function decreases their
daily activities. Recently, dual-task training by walking with secondary tasks resulted
in improvement of single or dual-task gait performance in individuals with PD. As for
stroke, dual-task training performed in walking with secondary tasks and resulted in
improvement of single or dual-task gait performance. However, previous studies less
mentioned about combine cognitive and motor tasks simultaneously with gait training.
While dual-task training with exergame and treadmill can include cognitive and motor
tasks simultaneously while walking. Thus, whether dual-task training with exergame and
treadmill can improve executive function and dual-task performance in individuals with PD
and stroke is worth to investigate. Purposes: To investigate the effects of dual-task
training with exergame and treadmill on executive function and dual-task performance in
individuals with PD and stroke and discuss the correlation between the change values of
executive function and dual-task performance after training. Besides, investigate
cortical activation after training. Methods: This research will be implemented in two
phases. First phase will include 50 subjects with PD and the second phase will include 50
subjects with stroke. After pre-test, subjects will be randomly assigned into either the
experimental group or the control group. Subjects in the experimental group will receive
24 sessions dual-task training with exergame and treadmill in 8 weeks; while the control
group will receive treadmill training only in same frequency. Each session lasts an hour.
Primary outcomes include general cognitive performance, executive function, dual-task
performance, dual-task effects and cortical activation. Secondary outcomes include single
walking performance, functional walking and quality of life. Statistical analysis:
Descriptive statistics will be generated for all variables. Intergroup differences among
baseline characteristics will be evaluated by independent t test or χ2 analysis. Primary
and secondary outcomes will be analyzed by two-way repeated measures ANOVA and post-hoc
test. The correlation between change values of executive function and dual-task
performance will be evaluated by Pearson correlation coefficient. Statistical
significance will set at P<0.05.