Internally Versus Externally Guided Body Weight-Supported Treadmill Training (BWSTT) for Locomotor Recovery Post-stroke

Not Applicable

Completed

Brief Summary: The overriding goal of this proposal is to identify the critical physiological and biomechanical effects of BWSTT for promoting improved locomotor function in persons with post-stroke hemiparesis.

Detailed Description: In this pilot study, we tested two forms of locomotor training for gait rehabilitation in persons post-stroke: traditional locomotor training (partial body-weight support and manual assistance of therapists) vs. robotic-assisted locomotor training (partial body-weight support and robotic guidance with the Lokomat). We enrolled 16 persons with chronic (\>6 months) hemiparesis post-stroke who were randomized to traditional/manual or robotic locomotor training. All individuals received 12 sessions (thrice weekly for four weeks) of training. Each session involved 30 minutes of stepping.

The complete study results are published.

Recruitment & Eligibility

Inclusion Criteria

Clinical diagnosis of cerebrovascular accident
Single event
Unilateral hemiplegia
Locomotor disability
Ability to walk independently 25' on level ground (may use an assistive device [cane or walker]; may NOT use a brace)
Cognitive ability to follow 3-step commands

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Arm 1: Therapist assisted	Locomotor training	Therapist assisted locomotor training (partial body-weight supported)
Arm 2: Robot-assisted	Locomotor training	Robot-assisted locomotor training (partial body-weight supported)

Primary Outcome Measures

Name	Time	Method
Self-selected Overground Walking Speed	4 weeks (s/p 12 sessions of locomotor training)	Overground walking speed determined as rate of walking over a 10 meter distance.

Secondary Outcome Measures

Name	Time	Method
Six Minute Walk	4 weeks	distance, in meters, walked overground over a six minute interval.
Fast Walking Speed	4 weeks (s/p 12 training sessions)	Fastest comfortable walking speed measured while walking overground
Step Length Ratio (Abs)	4 weeks	measure of step length symmetry, calculated as = ABS \[1 - (Pstep length / NPstep length)\]
Berg Balance Scale	4 weeks	Clinical measure of balance
Lower Extremity Fugl-Meyer Motor Assessment	4 weeks	Standardized clinical measure of motor impairment. The lower extremity (leg) sub-scale ranges from 0 - 35 points, where less impairment corresponds with scores approaching 35 and worse impairment corresponds with scores approaching 0.
Short Physical Performance Battery	4 weeks	Standardized clinical measure of physical function involving tests of: walking speed, strength (repeated chair rise), and balance. The scale ranges from 0 - 12 points with better physical function as the score approaches 12 points and worse physical function as the score approaches 0 points.