Combined Exercise and Therapy for Post-Stroke Reading Deficits
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Kessler Foundation
Disqualifiers: Neurological disease, Dyslexia, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The goal of the proposed project is to test the effectiveness of a novel hybrid approach to treatment of reading disorders after stroke, in which exercise training will be used in combination with a targeted reading treatment. This approach is expected to increase cerebral circulation and help to rebuild and strengthen the damaged phonological neural networks. Through this combinatory approach, the study aims to enhance the reading and language improvements seen with existing treatments.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Combined Exercise and Therapy for Post-Stroke Reading Deficits?
Research shows that exercise-based treatments can significantly improve reading fluency and cognitive skills related to literacy in children with reading difficulties. Additionally, oculomotor rehabilitation, which involves eye movement training, has been shown to improve reading abilities in individuals with acquired brain injuries, including stroke.
12345Is the combined exercise and therapy treatment for post-stroke reading deficits safe for humans?
The research mentions various therapies like fitness and circuit training, which are generally considered safe for humans when supervised properly. However, specific safety data for the combined exercise and therapy treatment for post-stroke reading deficits is not directly available in the provided studies.
16789How is Phono-Motor Therapy different from other treatments for post-stroke reading deficits?
Phono-Motor Therapy is unique because it combines exercises that target both phonological skills (sound-related skills) and motor skills (movement-related skills) to improve reading abilities, which is different from treatments that focus solely on reading practice or physical rehabilitation.
1241011Eligibility Criteria
This trial is for right-handed individuals who were fluent in English and literate before their first-ever stroke, which occurred over 3 months ago. They must have reading deficits as defined by specific accuracy percentages for words and nonwords, be cleared for exercise by a physician, and live within 50 miles of the Kessler Foundation. People with MRI contraindications, prior neurological diseases, or those currently undergoing speech therapy cannot participate.Inclusion Criteria
Fluent and literate in English prior to stroke
I have had my first stroke.
Reading deficits, defined as reading aloud accuracy <83% for single words or <65% for readable nonwords
+4 more
Exclusion Criteria
Contraindication to MRI
I have had a neurological disease before.
Contraindication to exercise
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive 40 sessions of targeted reading treatment combined with either aerobic exercise or stretching
8-10 weeks
40 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment
2 weeks
MRI and Behavioral Testing
Participants undergo MRI scans and complete behavioral testing before and after the intervention
Throughout the study
Participant Groups
The study tests a new treatment method combining physical exercises (stretching and aerobic training) with Phono-Motor Therapy to improve reading abilities after a stroke. The goal is to boost brain circulation and repair damaged language networks through this dual approach.
2Treatment groups
Experimental Treatment
Active Control
Group I: Aerobic Exercise Treatment (AET) combined with Phono-Motor Therapy (PMT)Experimental Treatment2 Interventions
Patients will receive 40, once-daily 2-hour intervention sessions administered 4-5 times per week by trained research assistants. Sessions will begin with a 5-min warm-up, followed by 20 min of aerobic exercise (cycling, 60% heart rate range), and a 5-min cool-down. Participants will rate their perceived effort every 5 minutes and complete a log at the end of each session to characterize their experience. When HR returns to near resting levels (i.e., 5-min after cool-down), participants will undertake the PMT for the remaining 90 min.
Group II: Stretching and PMTActive Control2 Interventions
Patients will receive 40, once-daily 2-hour intervention sessions administered 4-5 times per week by trained research assistants. Sessions will begin with a 5-min warm-up, followed by 20 min of stretching and a 5-min cool-down. Stretching activities will target the head/neck, shoulder, elbow/forearm, hand/wrist, trunk/hip, ankle/foot. Participants will complete a log at the end of each session to characterize their experience, and within 5 min of completing the last stretching activity, participants will undertake PMT for the remaining 90 min of a given session.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Kessler FoundationWest Orange, NJ
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Who Is Running the Clinical Trial?
Kessler FoundationLead Sponsor
References
Effects of intensive phonomotor treatment on reading in eight individuals with aphasia and phonological alexia. [2022]The aim of this study was to investigate effects of a multimodal treatment of phonology, phonomotor treatment, on the reading abilities of persons with aphasia (PWA) with phonological alexia.
Evaluation of an exercise-based treatment for children with reading difficulties. [2007]An evaluation is reported of an exercise-based approach to remediation of dyslexia-related disorders. Pupils in three years of a Warwickshire junior school were screened for risk of literacy difficulty using the Dyslexia Screening Test (DST). The 35 children scoring 0.4 or over on the DST were divided randomly into two groups matched for age and DST score. One quarter of the participants had an existing diagnosis of dyslexia, dyspraxia or ADHD. Both groups received the same treatment at school but the intervention group used the DDAT exercise programme daily at home. Performance on the DST and specialist cerebellar/vestibular and eye movement tests were assessed initially and after six months. Cerebellar/vestibular signs were substantially alleviated following the exercise treatment whereas there were no significant changes for the control group. Even after allowing for the passage of time, there were significant improvements for the intervention group in postural stability, dexterity, phonological skill, and (one-tailed) for naming fluency and semantic fluency. Reading fluency showed a highly significant improvement for the intervention group, and nonsense passage reading was also improved significantly. Significantly greater improvements for the intervention group than the control group occurred for dexterity, reading, verbal fluency and semantic fluency. Substantial and significant improvements (compared with those in the previous year) also occurred for the exercise group on national standardized tests of reading, writing and comprehension. It is concluded that, in addition to its direct effects on balance, dexterity and eye movement control, the benefits of the DDAT exercise treatment transferred significantly to cognitive skills underlying literacy, to the reading process, and to standardized national literacy attainment tests.
Oculomotor rehabilitation for reading in acquired brain injury. [2016]The purpose of this study was to assess reading-related oculomotor rehabilitation in individuals with acquired brain injury. Adults with either stroke (n=5) or traumatic brain injury (n=9) participated. Training paradigms included single-line and multiple-line simulated reading, as well as basic versional tracking (fixation, saccade, and pursuit), twice per week over an 8 week period. Training modes included normal internal oculomotor visual feedback either in isolation (4 weeks) or concurrent with external oculomotor auditory feedback (4 weeks). Training effects were assessed objectively using infrared eye movement recording technology for simulated and actual reading, with the assessments occurring before, midway, and after training. In addition, the individuals were assessed subjectively using a reading rating-scale questionnaire. All reported considerably improved reading ability, and this was confirmed by several of the objective oculomotor measures. There was a trend for improvement to be better with the combined visual and auditory oculomotor feedback. Reading-related oculomotor rehabilitation produced significant gains in both the subjective and objective domains. It is believed that rapid saccadic oculomotor adaptation, as well as the training of rhythmicity and automaticity, were involved in modifying eye movement behavior to produce a more systematic approach and resultant improved reading profile.
Can treatment for pure alexia improve letter-by-letter reading speed without sacrificing accuracy? [2019]An experimental treatment study designed to improve both the accuracy and the speed of reading was administered to a patient with pure alexia and impaired letter naming. The study focused on the use of letter-by-letter reading. A two-stage approach was employed. The first stage implemented a tactile-kinesthetic strategy to improve accuracy. The second stage concentrated on speed. At the end of the treatment, patient DL was reading both trained and untrained words more accurately and with considerably greater speed than prior to treatment. Accuracy and speed of reading at the sentence level improved as well.
Multimodal therapy of word retrieval disorder due to phonological encoding dysfunction. [2019]To determine whether phonological multimodal therapy can improve naming and communication in a patient showing a lexical phonological naming disorder. This study employed oral and written learning tasks, using an error reduction procedure.
Motor speech treatment protocol for developmental motor speech disorders. [2018]This study examines the effect of the Motor Speech Treatment Protocol (MSTP), a multi-sensory hybrid treatment approach on five children (mean: 3;3 years; S.D. 0;1) with severe to profound speech sound disorders with motor speech difficulties.
Treatment of reading impairment after stroke. [2013]Reading impairments after left or right hemisphere stroke are common yet receive little attention from clinicians and therapists. In this review, we focus on the classification of acquired alexia and the current theory and practice underlying the rehabilitation of this diverse set of disorders.
[Evidence-based methods in motor rehabilitation after stroke]. [2022]In this review, treatments for motor rehabilitation after stroke will be presented. In particular, randomised, controlled trials, meta-analyses and systematic reviews, mainly from the years 2009 - 2011, were taken into consideration. In summary, evidence is best for constraint-induced movement therapy and Botulinum toxin type A in patients with focal spasticity. Superiority has been demonstrated for the administration of drugs (serotonin re-uptake inhibitors and L-dopa), mirror therapy, the use of virtual reality, electromechanical devices to restore independent walking, and fitness and circuit training. Other therapies (bilateral arm training, treadmill therapy, robot-assisted arm therapy) did not show superiority. For sensory training and repetitive transcranial magnetic stimulation large clinical studies still need to be done.
Ultrasound biofeedback treatment for persisting childhood apraxia of speech. [2022]The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS).
How much exercise does the enhanced gait-oriented physiotherapy provide for chronic stroke patients? [2016]Physical exercise therapy in sensorimotor rehabilitation of stroke patients includes active and repetitive exercise and task-specific training. The time spent in active practice is fundamental. The purpose of this study was to analyse what was the actual amount of exercise and content of the performed exercise of the three-week gait-oriented physiotherapy program for chronic stroke patients in an in-patient setting.
Physical activity in the prevention and treatment of stroke. [2021]The role of physical activity in the prevention of stroke is of great interest due to the high mortality and significant impact of stroke-related morbidity on the individual and on healthcare resources. The use of physical activity as a therapeutic strategy to maximise functional recovery in the rehabilitation of stroke survivors has a growing evidence base. This narrative review examines the existing literature surrounding the use of exercise and physical therapy in the primary and secondary prevention of stroke. It explores the effect of gender, exercise intensities and the duration of observed benefit. It details the most recent evidence for physical activity in improving functional outcome in stroke patients. The review summaries the current guidelines and recommendations for exercise therapy and highlights areas in which further research and investigation would be useful to determine optimal exercise prescription for effective prevention and rehabilitation in stroke.