Stroke
Conditions
Keywords
High Intensity Gait Training
Brief summary
The study aims to describe the functional level of the patients who received high intensity gait training during inpatient stroke rehabilitation at discharge, three, six and twelve months after stroke. These data will determine if the observed gains from the high-intensity gait training are retained after discharge from inpatient rehabilitation.
Detailed description
The study is a cohort-study that will have a prospective observational design. This design allows us to follow patients who presently have had a stroke and received high intensity stepping training over time. At this time little is known about the patient's functional trajectory the first 12 months after receiving high intensity stepping treatment as no study has examined long-term effects of high-intensity stepping training delivered in inpatient rehabilitation for stroke in Norway nor internationally.
Interventions
The intervention provided in this project is routinely delivered as a standard of care at the participating sites for patients after stroke that have a goal of walking improvement. The intervention consists of 45-60 minute, physical therapy sessions that occur five days per week (not weekends), focusing on prioritizing stepping practice at higher aerobic intensities during scheduled treatments (target training zone of 70-85% heart rate max (HRmax). Stepping is performed on treadmills and over ground, with safety harness systems and body weight support only as needed to ensure successful stepping. Tasks are progressed by increasing task difficulty as determined by the therapist. Accordingly, practice of non-walking tasks performed during physiotherapy, including bed mobility, transfers, and standing balance/ pre-gait activities, is limited.
Sponsors
Indiana University School of Medicine
Norwegian Fund for Postgraduate Training in Physiotherapy
City of Oslo
Sunnaas Rehabilitation Hospital
Oslo University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (\>18 years old) who are receiving inpatient rehabilitation for stroke * \< six months post-stroke * have the goal to improve walking function * provide written consent will participate in the study.
Exclusion criteria
* inability to consent * use of bracing or instrumentation (e.g. ventilator) that limits walking * independence in walking outdoors and on stairs (Functional Ambulation Category (FAC) at admission = 5) * uncontrolled cardiopulmonary, metabolic, infectious or psychiatric disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 10 meter walk test | 12 months | Walking speed |
| 6-minute walk test | 12 months | Walking distance |
| Berg balance scale | 12 months | Balance measured on a scale 0-56 points, higher scores mean a better outcome |
| Steps | Daily through stay, average of 3 weeks | Number of Steps |
| Intensity | Each PT session trough stay, and average of 3 weeks | Heart Rate during training |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 10 meter walk test | Weekly through stay, average of 3 weeks | Walking speed, time in m/sec |
| 6 minute walk test | Weekly through stay, average of 3 weeks | Walking distance in meters |
| Sit-to-stand x5 | 3 weeks | Functional strength, time to complete in sec |
| MiniBESTest | Weekly through stay, average of 3 weeks | Balance measured on a scale 0-28, higher scores indicate a better outcome |
| Patient Satisfaction with treatment | 12 months | 6 questions on satisfaction with treatment, Likert scale, |
| Berg balance scale | Weekly through stay, average of 3 weeks | Balance measured on a scale 0-56 points, higher scores indicate a better outcome |
| Manual muscle testing | 3 weeks | Strength of lower extremities, ordinal scale 0-5, higher score indicate better outcome |
| Action-Research-Arm-Test (ARAT) | Weekly during inpatient stay, in average 3 weeks | Evaluation tool for motot function in the upper extremity after neurological injuries. Ordinal scale 0-57, higher score indicate better outcome |
| EQ-5D-5L | 3 weeks | Health related quality of life |
| PROMIS | 3 weeks | Health related quality of life |
Countries
Norway
Outcome results
None listed