Ischemic Preconditioning for Stroke Rehabilitation

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Medical College of Wisconsin, Milwaukee, WI
Stroke Rehabilitation+4 More
Ischemic Preconditioning - Other
Eligibility
18+
All Sexes
Eligible conditions
Select

Study Summary

This study is evaluating whether ischemic preconditioning (IPC) can improve stroke rehabilitation.

See full description

Eligible Conditions

  • Stroke Rehabilitation
  • Physical and Rehabilitation Medicine
  • Ischemic Preconditioning

Treatment Effectiveness

Study Objectives

This trial is evaluating whether Ischemic Preconditioning will improve 1 primary outcome and 1 secondary outcome in patients with Stroke Rehabilitation. Measurement will happen over the course of Admission into study and within 3 days of Discharge from Froedtert Hospital.

Day 3
Change in Knee Extensor Strength
Change in Walking Speed

Trial Safety

Trial Design

2 Treatment Groups

Ischemic Preconditioning
1 of 2
Sham
1 of 2
Experimental Treatment
Non-Treatment Group

This trial requires 50 total participants across 2 different treatment groups

This trial involves 2 different treatments. Ischemic Preconditioning is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.

Ischemic Preconditioning
Other
Inflation of blood pressure cuff to 225 mmHg on paretic leg. 1 session: 5 minutes of inflation, 5 minutes deflation, repeated 5 times.
Sham
Other
Inflation of blood pressure cuff to 25 mmHg on paretic leg. 1 session: 5 minutes of inflation, 5 minutes deflation, repeated 5 times.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: admission into study and within 3 days of discharge from froedtert hospital
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly admission into study and within 3 days of discharge from froedtert hospital for reporting.

Who is running the study

Principal Investigator
M. D.
Prof. Matthew Durand, Assistant Professor
Medical College of Wisconsin

Closest Location

Medical College of Wisconsin - Milwaukee, WI

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 4 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
be between the ages of 40-80
able to give informed consent.
be < 6 months post diagnosis of unilateral cortical stroke
have residual leg paresis.

Patient Q&A Section

What causes physical and rehabilitation medicine?

"Although specific causes cannot be identified, many factors, both physical and psychological, can lead to the development of P/R illness. These factors include illness, stressful life-experiences, and chronic stress conditions. P/R illness is a complex disease process that requires careful investigation to identify its exact cause." - Anonymous Online Contributor

Unverified Answer

What are common treatments for physical and rehabilitation medicine?

"Physical and rehabilitation medicine (PRM) patients are commonly treated with medications, but also receive home-based physical therapy, occupational therapy and non-pharmacological treatments, such as relaxation therapies. The type of treatment a patient receives depends both on the physical problems that affect him or her as well as contextual factors like lifestyle, health system funding and staff availability." - Anonymous Online Contributor

Unverified Answer

How many people get physical and rehabilitation medicine a year in the United States?

"At least 100,000 people get inpatient rehabilitation or inpatient hospitalization each year in the United States. This makes up 5.9% of Americans. This number only represents people requiring inpatient services. It does not consider how many get outpatient rehabilitation or home physical therapy." - Anonymous Online Contributor

Unverified Answer

Can physical and rehabilitation medicine be cured?

"There is a theoretical possibility for cure that is based on the self-perceived or perceived curability, which depends on the individual's beliefs about their own cure potential. However, the degree of perceived cure potential has to be further investigated." - Anonymous Online Contributor

Unverified Answer

What is physical and rehabilitation medicine?

"Physical and Rehabilitation Medicine (PRM) is a subspecialty of physical medicine and rehabilitation, whose goals are to improve the physical function, wellbeing, and quality of life of people with and at risk for health conditions, and prevent and treat disabling conditions. PRM is practiced mainly by clinicians with expertise in physical medicine and rehabilitative medicine, physical therapists, nutritionists, personal care workers, and social workers." - Anonymous Online Contributor

Unverified Answer

What are the signs of physical and rehabilitation medicine?

"Symptoms of p&R, a disease by itself, may also be seen in patients with other medical conditions such as COPD and diabetes. The presence of signs of p&R in these other medical conditions or, the absence, may be important indicators that the condition for which the patient presenting for consultation requires specific management, and has an increased risk of death, and that is a sign of the need for urgent treatment. The overall clinical impression and risk factors must be taken into consideration in deciding the management and prognosis for patients presenting with symptoms suggestive of p&R." - Anonymous Online Contributor

Unverified Answer

Is ischemic preconditioning safe for people?

"While no adverse effects were documented in this cohort of patients undergoing interventional angiography, it could be argued that this clinical setting is unsuitable for the application of IPC." - Anonymous Online Contributor

Unverified Answer

What are the latest developments in ischemic preconditioning for therapeutic use?

"Ischemic preconditioning is a new therapeutic approach that has been used for the last fifteen years in major cardiac operations. Its use in cardiac surgery is justified by its efficacy in reducing cardiac postoperative morbidity and mortality, especially in high risk patients. The protective and anti-apoptotic effect of ischemic preconditioning is widely recognized. The potential utility of this principle in improving myocardial salvage in the current perioperative period is well established. Thus, despite the absence of published clinical trials of ischemic preconditioning in coronary artery bypass graft procedures, several small randomized clinical trials and a number of reviews of the literature have shown clear clinical benefits from ischemic preconditioning." - Anonymous Online Contributor

Unverified Answer

Does ischemic preconditioning improve quality of life for those with physical and rehabilitation medicine?

"Data from a recent study, a protocol of brief preconditioning with acetylcholine prior to major cardiac surgery was found to be associated with higher scores on a quality of life measure and was not associated with worse short- and long-term survival. This finding suggests that a protocol of brief ischemic preconditioning may improve the quality of life of older patients with cardiac and noncardiac critical illness." - Anonymous Online Contributor

Unverified Answer

How does ischemic preconditioning work?

"If one applies the same PAD protocol as PTC, reperfusion of the ischemic limb of the rabbit does not occur. Application of the ischemic preconditioning protocol does not prevent microemboli from traveling to remote organs. There are no observable changes in the morphology and cell proliferation of the muscular tissue of the ischemic limb after reperfusion. If one applies the ischemic preconditioning protocol, there is no increase in myocardial infarction or edema and no increase in the cell proliferation of the muscular tissue of the ischemic limb after reperfusion." - Anonymous Online Contributor

Unverified Answer

Have there been any new discoveries for treating physical and rehabilitation medicine?

"There are many things to consider when choosing the right management plan for an individual's medical condition. As with any therapy, there may be many variables and personal factors to take into account when deciding which treatment option to choose first. For example, the amount and location of muscle mass loss affects how quickly an individual will regain movement. As the amount of muscle loss decreases, the amount of time required to regain movement and regain mobility increases. For this reason, treatment options such as braces and wheelchairs should be considered. Finally, when it comes to choosing the right management plan for an individual's condition, there are also many factors to consider such as what [condition] will be most beneficial for their recovery and how well it will be managed at home." - Anonymous Online Contributor

Unverified Answer

What is the latest research for physical and rehabilitation medicine?

"There was an emphasis on research methods, such as animal models, animal models of disease, cell biology, in vitro studies, and in vivo studies. There was also an emphasis on clinical research, such as clinical trials in humans, patients, and the patient's perspective. There was less emphasis on clinical psychology; on the patient's role in the course of progress; on research methods, such as animal models, model systems, and cell culture; and on ethics. For more extensive guidelines, see research guidelines in research design." - Anonymous Online Contributor

Unverified Answer
Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.
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