المؤلفون: Biswas, Piyashi, Dodakian, Lucy, Wang, Po T., Johnson, Christopher A., See, Jill, Chan, Vicky, Chou, Cathy, Lazouras, Wendy, McKenzie, Alison L., Reinkensmeyer, David J., Nguyen, Danh V., Cramer, Steven C., Do, An H., Nenadic, Zoran

المصدر: BMC Neurology; 6/13/2024, Vol. 24 Issue 1, p1-11, 11p

مصطلحات موضوعية: ELECTRIC stimulation, BRAIN-computer interfaces, CLINICAL trials, STROKE rehabilitation, NEURAL stimulation, MEDICAL rehabilitation, BODY-weight-supported treadmill training

مصطلحات جغرافية: UNITED States

مستخلص: Background: In the United States, there are over seven million stroke survivors, with many facing gait impairments due to foot drop. This restricts their community ambulation and hinders functional independence, leading to several long-term health complications. Despite the best available physical therapy, gait function is incompletely recovered, and this occurs mainly during the acute phase post-stroke. Therapeutic options are limited currently. Novel therapies based on neurobiological principles have the potential to lead to long-term functional improvements. The Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) system is one such strategy. It is based on Hebbian principles and has shown promise in early feasibility studies. The current study describes the BCI-FES clinical trial, which examines the safety and efficacy of this system, compared to conventional physical therapy (PT), to improve gait velocity for those with chronic gait impairment post-stroke. The trial also aims to find other secondary factors that may impact or accompany these improvements and establish the potential of Hebbian-based rehabilitation therapies. Methods: This Phase II clinical trial is a two-arm, randomized, controlled, longitudinal study with 66 stroke participants in the chronic (> 6 months) stage of gait impairment. The participants undergo either BCI-FES paired with PT or dose-matched PT sessions (three times weekly for four weeks). The primary outcome is gait velocity (10-meter walk test), and secondary outcomes include gait endurance, range of motion, strength, sensation, quality of life, and neurophysiological biomarkers. These measures are acquired longitudinally. Discussion: BCI-FES holds promise for gait velocity improvements in stroke patients. This clinical trial will evaluate the safety and efficacy of BCI-FES therapy when compared to dose-matched conventional therapy. The success of this trial will inform the potential utility of a Phase III efficacy trial. Trial registration: The trial was registered as "BCI-FES Therapy for Stroke Rehabilitation" on February 19, 2020, at clinicaltrials.gov with the identifier NCT04279067. [ABSTRACT FROM AUTHOR]

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المؤلفون: Leavy, Breiffni, Sedhed, Jenny, Kalbe, Elke, Åkesson, Elisabet, Franzén, Erika, Johansson, Hanna

المصدر: BMC Neurology; 10/4/2023, Vol. 23 Issue 1, p1-10, 10p

مصطلحات موضوعية: PARKINSON'S disease, PATIENT reported outcome measures, TREADMILL exercise, BODY-weight-supported treadmill training, HOME rehabilitation, PHYSICAL activity, EXECUTIVE function, NEUROREHABILITATION

مستخلص: Background: Electronic health (eHealth) technology offers the potential to support and motivate physical activity for symptom management in Parkinson's disease (PD). It is also recommended that motor exercise in PD be complemented with cognitive training aimed at attentional or executive functions. This paper describes the protocol for a double-blind randomized controlled trial to evaluate the effects of motor-cognitive training in the home environment, supported by eHealth. Methods/design: The Support for home Training using Ehealth in Parkinsons diseaSe (STEPS) is a double-blind single center randomized controlled trial. Two parallel groups will include in total 120 participants with mild to moderate PD who will receive either (i) the intervention (a progressive 10-week individualized motor-cognitive eHealth training with cognitive behavioral elements to increase physical activity levels) or (ii) an active control group (an individualized 10-week paper-based home exercise program). The active control group will not receive motor-cognitive exercises or cognitive behavioral approaches to increase physical activity level. The primary outcome is walking capacity assessed by the six-minute walk test (6MWT). Secondary outcomes will include gait performance during single and dual task conditions, gait speed, functional mobility and lower limb strength, balance, physical activity behavior and a range of patient reported outcome measures relevant in PD. Discussion: The STEPS trial will answer the question whether 10 weeks of eHealth supported motor-cognitive exercise in the home environment can improve walking capacity in PD when compared to a standard paper exercise program. Findings from this study will also strengthen the evidence concerning the efficacy of PD-specific eHealth interventions with a view meeting future health care demands by addressing issues of inaccessibility to specialized neurological rehabilitation in PD. Trial registration: ClinicalTrials.gov August 2022, NCT 05510739. [ABSTRACT FROM AUTHOR]

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المؤلفون: Lars-Johan V. Valaas, Helene L. Soberg, Mari S. Rasmussen, Sophie E. Steenstrup, Nada Andelic, Ingerid Kleffelgård

المصدر: BMC Neurology, Vol 23, Iss 1, Pp 1-12 (2023)

مصطلحات موضوعية: mTBI, Exercise intolerance, Buffalo Concussion Treadmill Test, Sub-symptom threshold aerobic exercise, Persistent post-concussion symptoms, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Background Persistent post-concussion symptoms (PPCS) affect between 34 and 46% after a mild traumatic brain injury (mTBI). Many also experience exercise intolerance. Sub-symptom threshold aerobic exercise, SSTAE (exercise at an intensity level that does not increase symptoms) is proposed as a treatment to both reduce the symptom burden and increase the exercise tolerance after the injury. It is unclear if this also applies in a more chronic phase after mTBI. Main purpose The main purpose of this study is to evaluate whether SSTAE in addition to ordinary rehabilitation will lead to clinically meaningful improvement of symptom burden, normalize exercise tolerance, increase physical activity, improve health-related quality of life, and reduce patient-specific activity limitations compared to a control group that only receives ordinary rehabilitation. Design Randomized, controlled, single-blind parallel-group study with three measurement times; T0 at baseline, T1 after the intervention and T2 six months after T1. Methods Patients between the ages of 18 and 60 with exercise intolerance and persistent PPCS (> 3 months) will be recruited to the study and randomized to two groups. All patients will receive follow-up at the outpatient TBI clinic. The intervention group will in addition receive SSTAE for 12 weeks with exercise diaries and a retest every 3 weeks for optimal dosage and progression. The Rivermead post-concussion symptoms questionnaire will be the main outcome measure. The secondary outcome measure will be a test of exercise tolerance—the Buffalo Concussion Treadmill Test. Other outcome measures include the patient-specific functional scale that measures patient-specific activity limitations, as well as outcome measures for diagnosis-specific health-related quality of life, anxiety and depression, specific symptoms such as dizziness, headache and fatigue, and physical activity. Discussion This study will add knowledge about the effect of SSTAE and whether it should be implemented in rehabilitation for the adult population with persistent PPCS after mTBI. The nested feasibility trial showed that the SSTAE intervention was safe and that the study procedures and delivery of the intervention overall were feasible. However, minor amendments to the study protocol were made prior to the commencement of the RCT. Trial registration Clinical Trials.gov, NCT05086419. Registered on September 5th, 2021.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2377Test

الوصول الحر: https://doaj.org/article/c220802852ad41c397798b2c155bb673Test

المؤلفون: Devasahayam, Augustine J.¹ (AUTHOR), Chaves, Arthur R.¹ (AUTHOR), Lasisi, Wendy O.¹ (AUTHOR), Curtis, Marie E.¹ (AUTHOR), Wadden, Katie P.¹ (AUTHOR), Kelly, Liam P.¹ (AUTHOR), Pretty, Ryan¹ (AUTHOR), Chen, Alice¹ (AUTHOR), Wallack, Elizabeth M.¹ (AUTHOR), Newell, Caitlin J.¹ (AUTHOR), Williams, John B.² (AUTHOR), Kenny, Hannah¹ (AUTHOR), Downer, Matthew B.¹ (AUTHOR), McCarthy, Jason¹ (AUTHOR), Moore, Craig S.² (AUTHOR), Ploughman, Michelle¹ (AUTHOR) michelle.ploughman@med.mun.ca

المصدر: BMC Neurology. 1/22/2020, Vol. 20 Issue 1, p1-18. 18p. 7 Charts, 4 Graphs.

مصطلحات موضوعية: *AEROBIC capacity, *BODY-weight-supported treadmill training, *BRAIN-derived neurotrophic factor, *MULTIPLE sclerosis, *WALKING speed, *INSTITUTIONAL review boards

مصطلحات جغرافية: NEWFOUNDLAND & Labrador

مستخلص: Background: Aerobic training has the potential to restore function, stimulate brain repair, and reduce inflammation in people with Multiple Sclerosis (MS). However, disability, fatigue, and heat sensitivity are major barriers to exercise for people with MS. We aimed to determine the feasibility of conducting vigorous harness-supported treadmill training in a room cooled to 16 °C (10 weeks; 3times/week) and examine the longer-term effects on markers of function, brain repair, and inflammation among those using ambulatory aids.Methods: Ten participants (9 females) aged 29 to 74 years with an Expanded Disability Status Scale ranging from 6 to 7 underwent training (40 to 65% heart rate reserve) starting at 80% self-selected walking speed. Feasibility of conducting vigorous training was assessed using a checklist, which included attendance rates, number of missed appointments, reasons for not attending, adverse events, safety hazards during training, reasons for dropout, tolerance to training load, subjective reporting of symptom worsening during and after exercise, and physiological responses to exercise. Functional outcomes were assessed before, after, and 3 months after training. Walking ability was measured using Timed 25 Foot Walk test and on an instrumented walkway at both fast and self-selected speeds. Fatigue was measured using fatigue/energy/vitality sub-scale of 36-Item Short-Form (SF-36) Health Survey, Fatigue Severity Scale, modified Fatigue Impact Scale. Aerobic fitness (maximal oxygen consumption) was measured using maximal graded exercise test (GXT). Quality-of-life was measured using SF-36 Health Survey. Serum levels of neurotrophin (brain-derived neurotrophic factor) and cytokine (interleukin-6) were assessed before and after GXT.Results: Eight of the ten participants completed training (attendance rates ≥ 80%). No adverse events were observed. Fast walking speed (cm/s), gait quality (double-support (%)) while walking at self-selected speed, fatigue (modified Fatigue Impact Scale), fitness (maximal workload achieved during GXT), and quality-of-life (physical functioning sub-scale of SF-36) improved significantly after training, and improvements were sustained after 3-months. Improvements in fitness (maximal respiratory exchange ratio and maximal oxygen consumption during GXT) were associated with increased brain-derived neurotrophic factor and decreased interleukin-6.Conclusion: Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability.Trial Registration: The study was approved by the Newfoundland and Labrador Health Research Ethics Board (reference number: 2018.088) on 11/07/2018 prior to the enrollment of first participant (retrospectively registered at ClinicalTrials.gov: NCT04066972. Registered on 26 August 2019. [ABSTRACT FROM AUTHOR]

المؤلفون: Sandra G. Brauer, Suzanne S. Kuys, Jennifer D. Paratz, Louise Ada

المصدر: BMC Neurology, Vol 18, Iss 1, Pp 1-8 (2018)

مصطلحات موضوعية: Stroke, Randomised, Treadmill, Walking, Cardiorespiratory fitness, Physical activity, Neurology. Diseases of the nervous system, RC346-429

الوصف: Abstract Background The level of physical activity undertaken by stroke survivors living in the community is generally low. The main objectives of the IMPACT trial are to determine, in individuals undergoing rehabilitation after stroke, if 8 weeks of high-intensity treadmill training embedded in self-management education (i) results in more physical activity than usual physiotherapy gait training and (ii) is more effective at increasing walking ability, cardiorespiratory fitness, self-efficacy, perception of physical activity, participation, and health-related quality of life as well as decreasing cardiovascular risk, and depression, at 8 and 26 weeks. Methods A prospective, two-arm, parallel-group, randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis, will be conducted. 128 stroke survivors undergoing rehabilitation who are able to walk independently will be recruited and randomly allocated to either the experimental or control group, who will both undergo gait training for 30 min, three times a week for 8 weeks under the supervision of a physiotherapist. Outcomes will be measured at baseline (Week 0), on completion of the intervention (Week 8) and beyond the intervention (Week 26). This study has obtained ethical approval from the relevant Human Research Ethics Committees. Discussion Improving stroke survivors’ walking ability and cardiorespiratory fitness is likely to increase their levels of physical activity. Furthermore, if education in self-management results in sustained high levels of physical activity, this should result in improved participation and quality of life. Trial registration This trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12613000744752) on 4th July, 2013.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s12883-018-1015-6Test; https://doaj.org/toc/1471-2377Test

الوصول الحر: https://doaj.org/article/b7233f32625441fbaa93164053eb8ebcTest

المؤلفون: Brauer, Sandra G., Kuys, Suzanne S., Paratz, Jennifer D., Ada, Louise

المصدر: BMC Neurology; 1/30/2018, Vol. 18, p1-N.PAG, 8p, 1 Diagram

مصطلحات موضوعية: PHYSICAL activity, STROKE treatment, TREADMILL exercise, RANDOMIZED controlled trials, MEDICAL rehabilitation

مستخلص: Background: The level of physical activity undertaken by stroke survivors living in the community is generally low. The main objectives of the IMPACT trial are to determine, in individuals undergoing rehabilitation after stroke, if 8 weeks of high-intensity treadmill training embedded in self-management education (i) results in more physical activity than usual physiotherapy gait training and (ii) is more effective at increasing walking ability, cardiorespiratory fitness, self-efficacy, perception of physical activity, participation, and health-related quality of life as well as decreasing cardiovascular risk, and depression, at 8 and 26 weeks.Methods: A prospective, two-arm, parallel-group, randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis, will be conducted. 128 stroke survivors undergoing rehabilitation who are able to walk independently will be recruited and randomly allocated to either the experimental or control group, who will both undergo gait training for 30 min, three times a week for 8 weeks under the supervision of a physiotherapist. Outcomes will be measured at baseline (Week 0), on completion of the intervention (Week 8) and beyond the intervention (Week 26). This study has obtained ethical approval from the relevant Human Research Ethics Committees.Discussion: Improving stroke survivors' walking ability and cardiorespiratory fitness is likely to increase their levels of physical activity. Furthermore, if education in self-management results in sustained high levels of physical activity, this should result in improved participation and quality of life.Trial Registration: This trial was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000744752 ) on 4th July, 2013. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Neurology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Bernardes, Danielle, Rodrigues Oliveira, Alexandre Leite, Oliveira, Alexandre Leite Rodrigues

المصدر: BMC Neurology; 8/22/2017, Vol. 17, p1-14, 14p, 3 Charts, 7 Graphs

مصطلحات موضوعية: GAIT disorders, MULTIPLE sclerosis, DEMYELINATION, TREADMILL exercise, ALLODYNIA, ANIMAL experimentation, BIOLOGICAL models, GAIT in humans, HYPERALGESIA, MICE, NEURALGIA, PARALYSIS, DISEASE complications

مستخلص: Background: Multiple sclerosis (MS) is a demyelinating disease with a wide range of symptoms including walking impairment and neuropathic pain mainly represented by mechanical allodynia. Noteworthy, exercise preconditioning may affect both walking impairment and mechanical allodynia. Most of MS symptoms can be reproduced in the animal model named experimental autoimmune encephalomyelitis (EAE). Usually, neurological deficits of EAE are recorded using a clinical scale based on the development of disease severity that characterizes tail and limb paralysis. Following paralysis recovery, subtle motor alterations and even mechanical allodynia investigation are difficult to record, representing sequels of peak disease. The aim of the present study was to investigate the walking dysfunction by the catwalk system (CT) in exercised and non-exercised C57BL/6 mice submitted to EAE with MOG35-55 up to 42 days post-induction (dpi).Methods: Twenty-four C57BL/6 female mice were randomly assigned to unexercised (n = 12) or exercised (n = 12) groups. The MOG35-55 induced EAE model has been performed at the beginning of the fifth week of the physical exercise training protocol. In order to characterize the gait parameters, we used the CT system software version XT 10.1 (Noldus Inc., The Netherlands) from a basal time point (before induction) to 42 days post induction (dpi). Statistical analyses were performed with GraphPad Prisma 4.0 software.Results: Data show dynamic gait changes in EAE mice including differential front (FP) and hind paw (HP) contact latency. Such findings are hypothesized as related to an attempt to maintain balance and posture similar to what has been observed in patients with MS. Importantly, pre-exercised mice show differences in the mentioned gait compensation, particularly at the propulsion sub-phase of HP stand. Besides, we observed reduced intensity of the paw prints as well as reduced print area in EAE subjects, suggestive of a development of chronic mechanical allodynia in spite of being previously exercised.Conclusions: Our data suggest that Catwalk system is a useful tool to investigate subtle motor impairment and mechanical allodynia at chronic time points of the EAE model, improving the functional investigation of gait abnormalities and demyelination sequelae. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Neurology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Louise Ada, Sandra G. Brauer, Jennifer Paratz, Suzanne Kuys

المصدر: BMC Neurology, Vol 18, Iss 1, Pp 1-8 (2018)
BMC Neurology

مصطلحات موضوعية: medicine.medical_specialty, medicine.medical_treatment, Health Behavior, Walking, Randomised, lcsh:RC346-429, law.invention, 03 medical and health sciences, Study Protocol, 0302 clinical medicine, Randomized controlled trial, Quality of life, Gait training, Double-Blind Method, Patient Education as Topic, law, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Treadmill, Cardiorespiratory fitness, Stroke, Exercise, lcsh:Neurology. Diseases of the nervous system, Rehabilitation, business.industry, Physical activity, Self-Management, Australia, Stroke Rehabilitation, General Medicine, medicine.disease, Self Efficacy, 3. Good health, Exercise Therapy, Clinical trial, Research Design, Physical therapy, Quality of Life, Neurology (clinical), business, human activities, 030217 neurology & neurosurgery

الوصف: The level of physical activity undertaken by stroke survivors living in the community is generally low. The main objectives of the IMPACT trial are to determine, in individuals undergoing rehabilitation after stroke, if 8 weeks of high-intensity treadmill training embedded in self-management education (i) results in more physical activity than usual physiotherapy gait training and (ii) is more effective at increasing walking ability, cardiorespiratory fitness, self-efficacy, perception of physical activity, participation, and health-related quality of life as well as decreasing cardiovascular risk, and depression, at 8 and 26 weeks. A prospective, two-arm, parallel-group, randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis, will be conducted. 128 stroke survivors undergoing rehabilitation who are able to walk independently will be recruited and randomly allocated to either the experimental or control group, who will both undergo gait training for 30 min, three times a week for 8 weeks under the supervision of a physiotherapist. Outcomes will be measured at baseline (Week 0), on completion of the intervention (Week 8) and beyond the intervention (Week 26). This study has obtained ethical approval from the relevant Human Research Ethics Committees. Improving stroke survivors’ walking ability and cardiorespiratory fitness is likely to increase their levels of physical activity. Furthermore, if education in self-management results in sustained high levels of physical activity, this should result in improved participation and quality of life. This trial was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000744752 ) on 4th July, 2013.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3322be7c57467487e31330a529d765c6Test
http://link.springer.com/article/10.1186/s12883-018-1015-6Test

المؤلفون: Mirelman, Anat, Rochester, Lynn, Reelick, Miriam, Nieuwhof, Freek, Pelosin, Elisa, Abbruzzese, Giovanni, Dockx, Kim, Nieuwboer, Alice, Hausdorff, Jeffrey M.

المصدر: BMC Neurology; 2013, Vol. 13 Issue 1, p2-12, 11p, 2 Diagrams, 1 Chart

مصطلحات موضوعية: RISK factors of falling down, MOTOR neurons, COGNITIVE ability, TREADMILL exercise, VIRTUAL reality, HEALTH of older people, RANDOMIZED controlled trials

مستخلص: Background: Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Methods/Design: Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson's disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. Discussion: This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk, improves mobility and enhances cognitive function in a diverse group of older adults. In addition, the comparison to an active control group that undergoes treadmill training without virtual reality will provide evidence as to the added value of addressing motor cognitive interactions as an integrated unit. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Neurology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Tamara R. Wright, Jeremy R. Crenshaw, Darcy S. Reisman, Jamie Pigman, Ryan T. Pohlig

المصدر: BMC Neurology
BMC Neurology, Vol 19, Iss 1, Pp 1-11 (2019)

مصطلحات موضوعية: Adult, Male, Balance, medicine.medical_specialty, Neurology, medicine.medical_treatment, Psychological intervention, lcsh:RC346-429, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Medicine, Humans, Neurochemistry, 030212 general & internal medicine, Treadmill, Adverse effect, Chronic stroke, Perturbation training, lcsh:Neurology. Diseases of the nervous system, Aged, Retrospective Studies, Rehabilitation, business.industry, Stroke Rehabilitation, General Medicine, Middle Aged, Exercise Therapy, Stroke, Chronic Disease, Feasibility Studies, Accidental Falls, Female, Falls, Neurology (clinical), Neurosurgery, business, Stability, 030217 neurology & neurosurgery, Research Article

الوصف: Background Exercise has failed to reduce falls in those with chronic stroke. A limitation of traditional exercise is that the motor responses needed to prevent a fall are not elicited (i.e. they lack processing specificity). Balance reactions often require compensatory steps. Therefore, interventions that target such steps have the potential to reduce falls. Computerized treadmills can deliver precise, repeatable, and challenging perturbations as part of a training protocol. The objective of this study was to develop and determine the feasibility of such training applied to those with chronic stroke. We developed the training to address specificity, appropriate duration and repetition, and progressive overloading and individualization. We hypothesized that our intervention would be acceptable, practical, safe, and demonstrate initial signs of efficacy. Methods In this single-arm study, thirteen individuals with chronic stroke (29–77 years old, 2–15 years post stroke) performed up to six training sessions using a computer-controlled treadmill. Each session had separate progressions focused on initial steps with the non-paretic or paretic limbs in response to anterior or posterior falls. Perturbation magnitudes were altered based on performance and tolerance. Acceptability was determined by adherence, or the number of sessions completed. Practicality was documented by the equipment, space, time, and personnel. Adverse events were documented to reflect safety. In order to determine the potential-efficacy of this training, we compared the proportion of successful recoveries and the highest perturbation magnitude achieved on the first and last sessions. Results The training was acceptable, as evident by 12/13 participants completing all 6 sessions. The protocol was practical, requiring one administrator, the treadmill, and a harness. The protocol was safe, as evident by no serious or unanticipated adverse events. The protocol demonstrated promising signs of efficacy. From the first to last sessions, participants had a higher proportion of successful recoveries and progressed to larger disturbances. Conclusions Using a computerized treadmill, we developed an approach to fall-recovery training in individuals with chronic stroke that was specific, considered duration and repetition, and incorporated progressive overloading and individualization. We demonstrated that this training was acceptable, practical, safe, and potentially beneficial for high-functioning individuals with chronic stroke. Trial registration Retrospectively registered at clinicaltrials.gov (NCT03638089) August 20, 2018.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::93cc86fff73639c15dcf6dffed12a52cTest
https://pubmed.ncbi.nlm.nih.gov/31128598Test