Task-oriented Training for Stroke: Impact on Function Mobility
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cerebrovascular Accident
- Sponsor
- VA Office of Research and Development
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Economy of Gait
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
Residual neurological deficits from stroke lead to gait inefficiencies, resulting in an extremely high energy cost of movement and contributing to overall disability and lower quality of life. Therefore, interventions targeting movement economy should be developed for those in the chronic phase of stroke recovery. This study is designed to compare the effect of two distinctly different exercise paradigms (a higher-intensity treadmill training program and a lower-intensity group exercise program) on economy of movement during over-ground walking and activities of daily living, as well as the extent to which gains in muscular strength, muscular endurance, and balance predict changes in movement economy.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Stroke \> 6 months prior with residual hemiparetic gait in women or men aged 40-85 years.
- •Completion of all regular post-stroke physical therapy
- •Adequate language and neurocognitive function to participate in testing and training and to give adequate informed consent.
- •Able to rise from a chair unaided.
- •Able to walk 10 meters without human assistance.
Exclusion Criteria
- •Regular structured aerobic exercise (\> 2x week).
- •Alcohol consumption \> 3 oz. liquor, or 3 x 4 oz glasses of wine, or 3 x 12 oz. beers per day, by self-report.
- •Clinical history of
- •unstable angina,
- •recent (\< 3 months) myocardial infarction or congestive heart failure (NYHA category II),
- •hemodynamically significant valvular dysfunction,
- •Peripheral Arterial Obstructive Disease with claudication,
- •major orthopedic, chronic pain, or non-stroke neuromuscular disorders restricting exercise,
- •pulmonary or renal failure,
- •poorly controlled hypertension (\>190/110), measured on at least two separate occasions
Outcomes
Primary Outcomes
Economy of Gait
Time Frame: 3 months
Over-ground gait economy measured using a portable metabolic monitoring system, K4b2 during a 6 minute walk, with subjects walking at their comfortable self-selected walking speed while open circuit spirometry collects break-by-break data. The K4b2 consists of a small battery pack and portable gas analyser (weighing less than 1 kg) that participants wear on their chest. Attached to the portable system is a flexible rubber facemask with flowmeter used for breath-by-breath analysis. The mean rate of oxygen consumption (VO2) will be calculated based on the final 3 minutes of a 6-minute walk under steady state oxygen consumption conditions. A 6 minute walk is a distance most representative of community-based ambulatory capacity and is a sensitive outcome measure in exercise studies in chronic stroke subjects. The higher the VO2 used during the 6 minute walk, represents a less efficient economy of gait.
Secondary Outcomes
- Muscular Endurance(3 months)
- Balance(3 months)
- Muscular Strength(3 months)