Stroke
Conditions
Brief summary
The goal of this clinical trial is to to determine the effect of movement-based priming using the upper limbs on lower limb neuroplasticity and behaviors in chronic stroke. The main questions we aim to answer are: 1. What are the acute effect of UL-priming on lower limb neuroplasticity and motor behaviors in persons with stroke compared to other priming modalities? 2. What are the time effects of UL-priming on neuroplasticity and motor behavior in individuals with stroke? In this cross over study, participants will be involved in three priming sessions involving \- UL-priming using rhythmic, symmetric, bilateral priming involving the movement of at least one major joint in the upper limbs. AND \- Sham priming using auditory stimulation (1 Hz metronome). AND \- Lower-limb movement-based priming using rhythmic, symmetric, dorsiflexion and plantarflexion movements. Researchers will compare outcome measures between the different priming sessions.
Interventions
OTHERUpper limb-based movement priming (UL-priming)
Repetitive upper limb movements administered to the beat of a metronome.
OTHERLower limb-based movement priming (LL-priming)
Repetitive lower limb movements administered to the beat of a metronome.
OTHERSham priming
Auditory stimulation.
Sponsors
University of Illinois at Chicago
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Single, monohemispheric stroke * Chronic stroke (\> 6 months prior) * Residual hemiparetic gait deficits (e.g., abnormal gait pattern) * Minimum score of stage 2 on the Chedoke Arm Impairment Scale which includes stage 2, task 3 (facilitated elbow flexion) as one of the stage 2 tasks.
Exclusion criteria
* Use of anti-spasticity medications * Existence of other neurological disorders * Have brainstem or cerebellar lesions. * Score of ≥2 on the Modified Ashworth Scale. * MMSE score of \<21, to ensure they will follow instructions. * Non-English-speaking individuals * Bone, joint or soft tissue injury * Uncontrolled medical conditions (such as uncontrolled hypertension, untreated cardiac disease, or untreated pulmonary disease) * No Motor evoked potentials (MEPs) during TMS TMS
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Corticomotor excitability using transcranial magnetic stimulation (TMS) | Change from baseline to immediately after priming and to 24 hours after priming. | Single-pulse transcranial magnetic stimulation (TMS) will be used to assess the corticomotor excitability from the tibialis anterior and soleus muscles. |
| Spinal H-reflex excitability using peripheral nerve stimulation (PNS) | Change from baseline to immediately after priming and to 24 hours after priming. | Peripheral nerve stimulation (PNS) will be used to assess the H reflexes excitability from the soleus muscles. |
| Muscle Strength | Change from baseline to immediately after priming and to 24 hours after priming. | An estimate of maximum ankle muscle force will be obtained for three trials of dorsiflexion and plantarflexion contractions using a force transducer and EMG. |
Countries
United States
Outcome results
None listed