Task-Oriented Training Versus High-Intensity Gait Training in People With Chronic Stroke

The purpose of this study is to compare the effects of high-repetition task-oriented training and high-intensity gait training on walking capacity and functional mobility in individuals with chronic stroke. Forty-five participants will be randomly assigned to one of three groups: (1) neurodevelopmental treatment (NDT) alone, (2) NDT combined with high-repetition task-oriented training, or (3) NDT combined with high-intensity gait training. All participants will receive treatment 3 days per week for 8 weeks (24 sessions in total). Walking capacity (6-Minute Walk Test) and functional mobility (Timed Up and Go Test, modified Dynamic Gait Index, 10-Meter Walk Test) will be assessed before and after the intervention by an assessor blinded to group allocation. The study hypothesizes that adding structured, intensity-based training approaches to conventional NDT will lead to greater improvements in walking capacity than NDT alone.

Inclusion Criteria: * Diagnosis of first-ever unilateral stroke (ischemic or hemorrhagic) confirmed by clinical and/or radiological findings * Time since stroke onset of at least 6 months (chronic phase) * Age between 18 and 75 years * Ability to walk at least 10 meters independently, with or without an assistive device * Functional Ambulation Category (FAC) score of 3 or higher * Sufficient cognitive ability to understand and follow instructions (Mini-Mental State Examination score ≥ 24) * Willingness to participate and provision of written informed consent Exclusion Criteria: * Recurrent stroke or bilateral hemispheric involvement * Unstable cardiovascular disease or other medical conditions contraindicating high-intensity exercise * Severe lower extremity spasticity interfering with gait training (Modified Ashworth Scale score \> 3) * Orthopedic, rheumatological, or other neurological conditions affecting gait * Severe visual or vestibular impairment * Severe aphasia or cognitive impairment preventing participation in training or assessments * Participation in another structured rehabilitation or exercise program during the study period * Botulinum toxin injection to the lower extremity within the last 6 months