None listed
Conditions
Brief summary
Stroke is the most common cause of walking disability for New Zealanders. We know that improvements in walking are important for community participation and improved quality of life for people with stroke and this makes walking a very important focus of rehabilitation. When strength training is used to rehabilitate walking in people with stroke there are no improvements in walking ability. Whilst motor skill training studies show a modest improvement in walking, gains are still very limited. There is evidence that strength training followed immediately by practice of a specific motor skill may give better results. We expect our combination of strength training immediately followed by motor skill training (Strength for Task Training) will lead to improved walking. We will use a pilot study to determine if Strength for Task Training (STT) has potential as an effective rehabilitation strategy to improve walking ability in people following stroke and to establish the feasibility of the research methods planned to conduct a larger Randomised Clinical Trial.
Interventions
Strength for Task Training
Administered 3-9 months post- first stroke
Group exercise 5 participants : 1 physiotherapist and 1 therapy assistant
High intensity progressive resistance strength training of a prime mover immediately followed by motor skill training of a relevant motor skill task.
Frequency: 3 times per week, 1 hour per session
Duration: 12 weeks
Intensity: 50-80% 1 Repetition Maximum and at 'somewhat hard'
Sponsors
AUT University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All people aged over 18 years with a single disabling supratentorial ischaemic stroke or intracerebral haemorrhage (Rankin 2-3); between 3-9 months post stroke at the start of the intervention; with a gait speed of between 0.05m/s -<1.2m/s at entry to the study; who are able to walk with or without aid and with or without standby assistance will be eligible for recruitment.
Exclusion criteria
Individuals will be excluded if: (a) their behaviour would interfere with participation in a group setting, as noted during initial assessment (e.g., agitation, aggression); (b) they have a significant cognitive deficit ((Mini-Mental State Examination (MMSE) Score <23); (c)they are unable to follow a 1 step English verbal command; (d) they are unable to give informed consent; (e) they are medically unstable in the opinion of a medical clinician; (f) they are participating in another study that, in the opinion of the investigator, may affect gait speed or add significantly to participant’s burden; (g) they have excessive pain in any joint that could limit participation; or (h) they have another condition that could impact results (e.g., substance abuse, significant mental illnesses such as major depression) (i) they have any contra-indications to TMS, including pacemaker, artificial heart valves, other metal implants, pregnancy, skull abnormalities, history of seizures or epilepsy, taking medications that may lower seizure threshold, or claustrophobia.
Outcome results
None listed