Perturbation Training for Stroke Survivors
Trial Summary
What is the purpose of this trial?
The long-term objective of this research is to develop an efficacious training paradigm to enhance stroke survivors' defense mechanisms against falls and possibly reduce healthcare cost. The Centers for Disease Control and Prevention estimates the direct medical cost for fall related injuries to be $34 billion annually. Forty percent to 70% of community-dwelling stroke survivors experience detrimental falls each year and tend to have 1.5 to 4 times higher risk of hip fracture than their healthy counterparts; with only less than 40% of those individuals regaining independent mobility. Falls, thus not only affect activities of daily living but also reduce mobility, increase risk of second stroke and mortality. Despite potential financial and functional implications of falls in this population, health-care personnel are limited in their ability to develop and validate interventions to reduce fall-risk for them. Further emphasis is placed on locomotor training with focus on enhancing paretic limb function. The project design consists of a randomized controlled trial to examine the ability of chronic stroke survivors to acquire, generalize and retain adaptations to slip-perturbation training for not only mitigating fall risk but also improving walking function. It also explores translation of this paradigm to the sub-acute population. The paradigm is novel in that it targets contributions of the paretic vs. non-paretic limbs on fall-risk through a bilateral training paradigm that involves training the non-paretic side first and then paretic to facilitate acquisition of fall-prevention skills on the paretic side, which may otherwise take longer to acquire training effects. The longer-term benefits of such perturbation training, targeting both limbs for reducing falls will be assessed not only in the laboratory but also in real life via wearable sensors, along with improved community walking function. The hypothesis of this study if supported by the results will provide an evidence-supported training protocol to reduce the fall-risk not only in people living with hemiparetic stroke but also among survivors of other acquired unilateral cortical lesions.
Research Team
Tanvi Bhatt, PhD PT
Principal Investigator
University of Illinois at Chicago
Eligibility Criteria
This trial is for stroke survivors who can walk at least 10 meters with or without help, have had a stroke over 6 months ago confirmed by their doctor and brain scans. They should not have other major health issues, recent surgeries, hospital stays, or be on sedatives.Inclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Baseline Monitoring
Baseline activity monitoring using wearable sensors for chronic stroke subjects
Treatment
Slip perturbation training for stroke survivors, targeting both paretic and non-paretic limbs
Follow-up
Participants are monitored for stability and fall incidence post-training
Treatment Details
Interventions
- Overground slip perturbation training
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of Illinois at Chicago
Lead Sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborator