Hemiparesis, Stroke
Conditions
Keywords
Physical Therapy, Exercise therapy
Brief summary
The purpose of this study is to determine whether FAST (Fast muscle Activation and Stepping Training) exercises will improve walking balance in individuals after stroke to a greater extent than usual care. Hypothesis: The primary hypothesis is that improvements in walking balance will be larger following 12 sessions of FAST exercise retraining compared to usual care in persons in the sub-acute phase after stroke.
Detailed description
It is estimated that 75-80% of individuals who have had a stroke will survive the acute event and be left with residual disability. Regaining independence in standing and walking is of utmost importance for patients recovering from stroke. Walking balance requires muscles in the legs and trunk to contract quickly if people lose their balance. Physical therapy plays a key role in the rehabilitation of walking balance in individuals after stroke. Given that maintaining one's balance requires fast muscle activity, rehabilitation post-stroke should focus on speed of movement. Thus we are proposing to compare a program that emphasizes speed of movement, Fast muscle Activation and Stepping Training versus an active control (usual care).
Interventions
BEHAVIORALUsual Care
The Usual Care program will consist of 2 sessions a week for 45 minutes for a 6 week duration.
BEHAVIORALFAST protocol
The Fast muscle activation and Stepping Training (FAST protocol) will be exercises emphasizing speed, small squats and protective steps, that will be progressed. This program will be 2 sessions a week for 45 minutes for 6 weeks in duration.
Sponsors
University of British Columbia
Heart and Stroke Foundation of Canada
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Study population: Subjects with a diagnosis of stroke Inclusion Criteria: * first stroke (\<6 months ago) * presence of hemiparesis in the lower extremity * minimum Berg Balance Score (BBS) of 30/56 * cognitive ability to give informed consent
Exclusion criteria
* bilateral stroke, or a previous stroke in the other hemisphere * severe co-morbidity that is likely to dominate the pattern of care * co-existing peripheral neuropathies or disorders of the vestibular apparatus * musculoskeletal problems * global aphasia or receptive aphasia
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Community Balance and Mobility Scale | Pre treatment and Post treatment (6 weeks) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gait assessment | Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment) | Self selected speed and changes in electromyography |
| Physiological balance assessment by internal and external perturbations | Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment) | Electromyography and Center of pressure changes |
| Activities-specific Balance Confidence Scale | Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment) | — |
| Community Balance and Mobility Scale | Post treatment and Retention (+1 month after treatment) | — |
Countries
Canada
Contacts
PRINCIPAL_INVESTIGATORS. Jayne Garland, PT, PhD
University of British Columbia
Outcome results
None listed