Square Stepping Exercise Versus Cognitive Dual Task Training on Executive Functions in Subacute Stroke Subjects
Shivani Gupta, Sudheera Kunduru, Akshita Gaur, Pushpendra K. Yaduvanshi · Indian Journal of Physiotherapy and Occupational Therapy - An International Journal · 2026
Introduction: Stroke is the second-leading cause of death and disability globally, with over 13 million new cases annually. Executive function impairment is a major problem in stroke subjects, affecting day-to-day living. Early detection and intervention can support effective rehabilitation in post-stroke individuals.
Objective: This study compares the effect of square-stepping exercise versus cognitive dual-task training on executive functions in subacute stroke subjects.
Method: 44 subacute stroke subjects fulfilling the inclusion criteria were randomly allocated into two groups: Group A received square-stepping exercise for 50 minutes, 3 days/week for 8 weeks, and Group B received cognitive dual-task training for 40 minutes, 3 days/week for 8 weeks.
Result: Pre-test MoCA and Digit Span Backward Test (DSBT) scores were 18.68±1.58 and 2.50±0.57 in Group A, and 18.23±2.02 and 2.41±0.59 in Group B. Post-test scores were 19.55±1.47 and 3.05±0.72 in Group A, and 20.69±1.98 and 3.64±0.76 in Group B. Within-group pre-post comparisons were statistically significant for both groups (p < 0.05). Between-group comparison of post-intervention scores showed significantly greater improvement in Group B.
Conclusion: Though both groups improved significantly, cognitive dual-task training was more effective than square-stepping exercise in improving executive functions in subacute stroke subjects.