Reactive Balance Training for Stroke
Trial Summary
What is the purpose of this trial?
People with stroke should exercise to maintain function and reduce the risk of another stroke. Different types of exercise target different components of fitness, such as aerobic, strength, and balance. Post-stroke exercise guidelines exist for each type of exercise separately (eg, brisk walking as aerobic exercise, resistance training for strength, and Tai Chi for balance). Meeting these recommendations means spending a lot of time exercising, and people with stroke say that lack of time and fatigue are barriers to exercise. It is possible to target several components of fitness with one type of exercise. 'Reactive balance training' (RBT) is a type of exercise that improves control of reactions that are needed to prevent a fall after losing balance, and is the only type of exercise with potential to prevent falls in daily life post-stroke. Because RBT involves repeated whole-body movements it may have similar aerobic benefit as other exercises using whole-body movements (eg, brisk walking). Also, leg muscles need to generate a lot of force to make rapid steps in RBT; repeatedly generating this force may help to improve strength. The purpose of this study is to determine if RBT improves two important components of fitness among people with chronic stroke: aerobic capacity and strength. The investigators expect that the improvements in aerobic capacity and strength after RBT will not be any worse than after an exercise program that specifically targets aerobic fitness and strength. A secondary purpose of this study is to determine the effects of RBT compared to aerobic and strength training on balance control and balance confidence. The investigators expect that RBT will lead to greater improvements in balance control and balance confidence than an aerobic and strength training program.
Research Team
Avril Mansfield, PhD
Principal Investigator
University Health Network, Toronto
Eligibility Criteria
This trial is for community-dwelling adults who had a stroke more than 6 months ago, can stand without support for over 30 seconds, and handle multiple balance disturbances with a safety harness. It's not for those meeting current exercise guidelines, with lower limb amputations, severe cognitive issues, ongoing physiotherapy including aerobic or strength training, contraindications to exercise testing like unstable angina or significant arrhythmias, recent injuries that could worsen with exercise, previous perturbation training within the year, too tall/heavy for the harness system (>2.1m/150kg), other neurological conditions affecting balance like Parkinson's disease.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo Reactive Balance Training (RBT) or Aerobic and Strength Training (AST) to improve aerobic capacity and strength
Follow-up
Participants are monitored for safety and effectiveness after treatment
Treatment Details
Interventions
- Aerobic and Strength Training (AST)
- Reactive Balance Training
Find a Clinic Near You
Who Is Running the Clinical Trial?
Toronto Rehabilitation Institute
Lead Sponsor
University of Toronto
Collaborator
Heart and Stroke Foundation of Canada
Collaborator