Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=iejp20 European Journal of Physiotherapy ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/iejp20 Effects of over-ground walking and cognitive rehabilitation on cognition, brain-derived neurotrophic factor, participation and quality of life among stroke survivors: a study protocol Muhammad Aliyu Abba , Olubukola A. Olaleye & Talhatu K. Hamzat To cite this article: Muhammad Aliyu Abba , Olubukola A. Olaleye & Talhatu K. Hamzat (2020): Effects of over-ground walking and cognitive rehabilitation on cognition, brain-derived neurotrophic factor, participation and quality of life among stroke survivors: a study protocol, European Journal of Physiotherapy, DOI: 10.1080/21679169.2020.1808056 To link to this article: https://doi.org/10.1080/21679169.2020.1808056 Published online: 20 Aug 2020. Submit your article to this journal Article views: 3 View related articles View Crossmark data UNIV ERSIT Y O F IB ADAN L IB RARY https://www.tandfonline.com/action/journalInformation?journalCode=iejp20 https://www.tandfonline.com/loi/iejp20 https://www.tandfonline.com/action/showCitFormats?doi=10.1080/21679169.2020.1808056 https://doi.org/10.1080/21679169.2020.1808056 https://www.tandfonline.com/action/authorSubmission?journalCode=iejp20&show=instructions https://www.tandfonline.com/action/authorSubmission?journalCode=iejp20&show=instructions https://www.tandfonline.com/doi/mlt/10.1080/21679169.2020.1808056 https://www.tandfonline.com/doi/mlt/10.1080/21679169.2020.1808056 http://crossmark.crossref.org/dialog/?doi=10.1080/21679169.2020.1808056&domain=pdf&date_stamp=2020-08-20 http://crossmark.crossref.org/dialog/?doi=10.1080/21679169.2020.1808056&domain=pdf&date_stamp=2020-08-20 ORIGINAL ARTICLE Effects of over-ground walking and cognitive rehabilitation on cognition, brain-derived neurotrophic factor, participation and quality of life among stroke survivors: a study protocol Muhammad Aliyu Abbaa,b, Olubukola A. Olaleyeb and Talhatu K. Hamzatb aDepartment of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University Kano, Kano, Nigeria; bDepartment of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria ABSTRACT Background: Cognitive rehabilitation (CR) is an important component of stroke rehabilitation. Most of the strategies used for this purpose are not readily affordable. This is the protocol of a trial to investi- gate the effects of over-ground walking (OGW) exercise and CR on cognitive function among stroke survivors. Methods: This is a three-centre, single blind, randomised controlled trial (RCT). Fifty-seven stroke survi- vors with mild to moderate cognitive impairments will be recruited from three healthcare facilities and randomly assigned into three groups. Group A will receive moderate intensity OGW exercise. Group B will receive CR using an adapted cognitive intervention comprising an attention and a memory tasks. Group C will receive combine OGW and CR exercise. All interventions will be thrice weekly for 8 weeks. Outcomes to be assessed at baseline, 4th and 8th week of interventions are cognition, brain-derived neurotrophic factor (BDNF), quality of life and participation using Mini-Mental State Examination, Melsin brand ELISA kit, stroke-specific quality of life and London Handicap Scale, respectively. Friedman and Kruskal–Wallis tests will be used for within-group and between-group comparison of data. Discussion: This trial is the first to examine the effect of OGW exercise on cognition and BDNF among stroke survivors. ARTICLE HISTORY Received 7 March 2020 Revised 25 June 2020 Accepted 4 August 2020 Published online 19 August 2020 KEYWORDS Over-ground walking; cognition; attention; brain- derived neurotrophic factor; rehabilitation; stroke Introduction Stroke is one of the leading causes of adult disability world- wide and the second most common cause of cognitive impairment in neurology clinics [1,2]. Cognitive dysfunction of either multiple or single domain is highly associated with previous history of stroke [3,4]. Cognitive impairment after stroke or post-stroke cognitive impairment (PSCI) is the loss of abilities of cognition or impairment of functions of cogni- tive domains such as memory, thinking, problems solving and executive function following a stroke [3]. It occurs in about 30–70% of stroke population depending on regions of the world, race, age, gender, occupation and educational level [5,6] and is a major cause of disability and dependency [3]. Presentation of PSCI varies from focal neurological deficit to overall cognitive dysfunction [7]. It could however, improve through acute, sub-acute and chronic stages of stroke [8]. Early diagnosis and treatment of PSCI have been recom- mended in literature [9]. Hence, strategies to prevent or retard cognitive decline are important in stroke rehabilitation [10]. Given the limited success with pharmaceutical manage- ment of cognitive impairments, it has become necessary to employ alternative treatment approaches for cognitive rehabilitation (CR) [11]. Treatment approaches that can be used in the rehabilitation of cognitive dysfunction are restorative, compensatory training and behavioural approaches [1]. Cawood et al. [9], opined that the manage- ment of cognitive impairments is the responsibility of occu- pational therapists. Other researchers have reported the role of physiotherapy in the management of PSCI [12–16]. Physiotherapists have used aerobic exercises in the manage- ment of PSCI with reported improvement in cognition among participants [12–15]. It has been suggested that the positive effects of aerobic exercise on cognition is brought about by increase blood flow to the brain and increase arousal level [17–19]. Aerobic exercise has also been reported to induce angiogenesis and neural cell proliferation [20,21]. Improvement in cognitive function following aerobic exercise is also linked to increase production and uptake of peripheral brain-derived neurotrophic factor (BDNF) [22]. BDNF is a type of neurotrophins [23], which mediates neuronal survival, development, function and synaptic plasticity in adults [24,25]. It induces long-term changes in synaptic compos- ition, ion channels expression and neurotransmitter CONTACT Olubukola A. Olaleye olubukolaolaleye@yahoo.com, oaolaleye@com.ui.edu.ng Department of Physiotherapy, College of Medicine (U.C.H.), University of Ibadan, P.M.B. 5017 G.P.O., Dugbe, Ibadan, Nigeria � 2020 Informa UK Limited, trading as Taylor & Francis Group EUROPEAN JOURNAL OF PHYSIOTHERAPY https://doi.org/10.1080/21679169.2020.1808056 UNIV ERSIT Y O F IB ADAN L IB RARY http://crossmark.crossref.org/dialog/?doi=10.1080/21679169.2020.1808056&domain=pdf&date_stamp=2020-08-19 https://doi.org/10.1080/21679169.2020.1808056 http://www.tandfonline.com Abstract Introduction Methods Research design Ethical considerations Participants Inclusion criteria Exclusion criteria Sample size and sampling technique Procedure Randomisation and blinding Interventions Group A (over-ground walking exercise) Group B (cognitive rehabilitation) Group C (combined over-ground walking exercise and cognitive rehabilitation) Outcome measures Data analyses procedure Discussion Acknowledgements Disclosure statement References