Stroke
Conditions
Keywords
stroke, rehabilitation, gait, timing, transcranial magnetic stimulation
Brief summary
The purpose of the first part of this study is to understand plastic brain mechanisms associated with successful gait-oriented stroke rehabilitation. Patients are randomized to receive intensive in-patient multiprofessional rehabilitation at different time points. One group will receive rehabilitation immediately after an acute care at the neurological clinic (8 days) and one group 5 weeks after the insult. Patients practise walking every workday for 60 min (actual 30min) either on a treadmill or on a gait trainer for four weeks, and receive also other physiotherapy. In addition to selected parameters measuring brain plasticity, detailed assessments of functional abilities including motor ability and quality of life will be performed. A novel tool, MR-image navigated transcranial magnetic stimulation (TMS) is utilized in assessing cortical excitability in relation to stroke, time, rehabilitation, and recovery.
Interventions
OTHERgait-oriented rehabilitation
Patients practise walking every workday for 60 min (actual 30min) either on a treadmill or on a gait trainer for four weeks, and receive also other physiotherapy 60 min daily.Patients starts within 10 days since stroke onset.
Sponsors
Northern Savo Hospital District
Academy of Finland
Brain Research and Rehabilitation Center Neuron (grant # 1/2009)
University of Jyvaskyla
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
55 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* first supratentorial stroke or no significant disturbance from an earlier stroke (Modified Ranking Scale, MRS 0-2) * time since onset of stroke no more than 10 days * Functional Ambulatory Category (FAC) 0-3 * voluntary movement in the leg of the affected side * Barthel Index (BI) 25-75 points- no unstable cardiovascular disease * Body Mass Index (BMI) \<32 * no severe malposition of joints * no severe cognitive or communicative disorders * no other health-related or social barriers to participate intensive rehabilitation
Exclusion criteria
* ICH, or MRS \>2 * time since onset of stroke more than 10 days * FAC \>3 * no voluntary movement in the leg of the affected side * BI \<25 or \>75 * severe malposition of joints * severe cognitive or communicative disorders
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Functional Ambulatory Category | 4 measures during six months |
| Barthel Index | 4 measures during 6 months |
Secondary
| Measure | Time frame |
|---|---|
| WHOQOF-BREF | at end and at 6 months' follow-up |
| TMS responses (MT,MEPs,SP,SICI) | 4 measures during 6 months |
| 10 meters's walking speed | 4 measures during 6 months |
| 6 minutes' walking distance | 4 measures during 6 months |
| Postural sway by Good Balance | 3-4 measures during 6 months |
| Functional Status Questionnaire | 4 measures during 6 months |
| Geriatric Depression Scale -15 | 4 measures during 6 months |
| Beck Depression Intervention modified by Raitasalo | 4 measures during 6 months |
| Modified Motor Assessment Scale | 4 measures during 6 months |
| Berg Balance Scale | 4 measures during 6 months |
| spatio-temporal gait analysis by GaitRite | 3-4 measures during 6 months |
Countries
Finland
Contacts
Primary ContactSinikka H Peurala, PhD, PT
Outcome results
None listed