Exercise for Improved Walking After Stroke
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Delaware
Disqualifiers: Cerebellar stroke, Neurologic conditions, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?Subjects with chronic stroke (\> 6 months post-stroke) will learn a new walking pattern through distorted visual feedback. Retention of the pattern will be tested without visual feedback immediately after learning and 24 hours later. Subjects will be randomly assigned to the control group or the exercise group. The control group will simply complete the learning task. The exercise group will complete 5 minutes of exercise immediately following the first retention test to test for the effects of exercise on retention 24 hours later.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Exercise, Physical Activity, Workout, Fitness Training for improving walking after stroke?
Research shows that exercise, including aerobic and resistance training, can improve physical activity and walking ability in people who have had a stroke. These activities help increase strength and fitness, which are important for better walking and overall recovery.
12345Is exercise safe for people after a stroke?
Research shows that exercise programs, including aerobic and resistance training, are generally safe for people after a stroke, with studies focusing on safety analyses to ensure no serious adverse events occur.
24678How does exercise treatment differ from other treatments for improving walking after stroke?
Exercise treatment, including aerobic and resistance training, is unique because it focuses on improving physical activity and overall fitness, which can enhance walking ability and cardiovascular health after a stroke. Unlike some other treatments, exercise can be adapted to individual needs and can be performed in various settings, such as at home or in community programs, making it a flexible and accessible option for stroke rehabilitation.
4691011Eligibility Criteria
This trial is for individuals aged 18-85 who have had a single, unilateral stroke more than 6 months ago and can walk unassisted. They must have a specific level of stroke severity, confirmed by MRI or CT scan, and normal heart rate and blood pressure. People with recent serious heart issues, walking-limiting pain, additional neurological conditions, or severe communication problems cannot join.Inclusion Criteria
Your heart beats between 40 and 100 times per minute when you are at rest.
I am between 18 and 85 years old.
Your blood pressure should be within a certain range when measured at rest. It should not be too low or too high.
+3 more
Exclusion Criteria
I couldn't walk outside my home before having a stroke.
I have not had a heart bypass or heart attack in the last 3 months.
I have pain in my muscles or bones that makes it hard to walk.
+6 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Learning and Retention Testing
Participants learn a new walking pattern through distorted visual feedback. Retention is tested immediately after learning and 24 hours later.
1 day
2 visits (in-person)
Exercise Intervention
Exercise group completes 5 minutes of high intensity exercise immediately following the first retention test.
5 minutes
Follow-up
Participants are monitored for retention of the walking pattern 24 hours after initial learning.
24 hours
1 visit (in-person)
Participant Groups
The study examines how exercise affects the ability to retain a new walking pattern learned through visual feedback in chronic stroke survivors. Participants are divided into two groups: one does the learning task only (control), while the other performs exercises after learning to see if it helps memory retention after 24 hours.
2Treatment groups
Experimental Treatment
Active Control
Group I: ExerciseExperimental Treatment1 Intervention
Subjects will complete learning of a new walking pattern through distorted visual feedback and retention will be tested immediately without visual feedback. This will be followed immediately by 5 minutes of high intensity exercise. Retention without visual feedback will them be tested again 24 hours later.
Group II: ControlActive Control1 Intervention
Subjects will complete learning of a new walking pattern through distorted visual feedback and retention will be tested immediately after and 24 hours later (without visual feedback).
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of DelawareNewark, DE
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Who Is Running the Clinical Trial?
University of DelawareLead Sponsor
References
Comparison of effect of aerobic cycle training and progressive resistance training on walking ability after stroke: a randomized sham exercise-controlled study. [2016]To determine whether changes in strength or cardiorespiratory fitness after exercise training improve walking ability in individuals who have had a stroke.
Physical fitness training for stroke patients. [2023]Levels of physical activity and physical fitness are low after stroke. Interventions to increase physical fitness could reduce mortality and reduce disability through increased function.
Effects of a multidisciplinary intervention to promote physical activity in patients with stroke undergoing rehabilitation: study protocol for the ActivePAS pilot randomised controlled trial. [2022]Physical activity after stroke is related to functional recovery and outcomes. To optimise physical activity adapted to a patient's walking ability and characteristics, multidisciplinary support and interventions are required. The Activate Physical Activity for Stroke pilot randomised controlled trial aims to assess the safety and feasibility of a multidisciplinary intervention that promotes physical activity in patients who had a stroke undergoing rehabilitation.
Efficacy of interventions aimed at improving physical activity in individuals with stroke: a systematic review. [2021]Purpose: To identify interventions employed to increase post-stroke physical activity, evaluate their efficacy, and identify the gaps in literature.Materials and methods: Randomized controlled trials published until March 2018 were searched in MEDLINE, PEDro, EMBASE, LILACS, and SCIELO databases. The quality of each study and overall quality of evidence were assessed using the PEDro and the GRADE scales.Results: Eighteen studies were included (good PEDro and very low GRADE-scores). In seven, the experimental groups showed significant increases in physical activity (aerobics, resistance, and home-based training; counseling, aerobics, resistance, and home-based training; electrical stimulation during walking; functional-task training; robot-assisted arm therapy; accelerometer-based feedback, and physical activity encouragement). In seven, there were no significant between-group differences (physical activity plan; stretching, use of toe-spreaders, standard treatment; counseling; circuit video-game; functional-task; counseling and cognitive training). The combined experimental and control groups showed significant declines in physical activity in one study (aerobic training or stretching) and increases in three others (aerobic, resistance or sham resistance training; stroke-with advice or only stroke-counseling; aerobic training, educational sessions, standard treatment, and coaching, or mobilization and standard treatment). A meta-analysis could not be performed, due to heterogeneity.Conclusions: Some interventions improved physical activity after stroke. However, the interpretability is limited.Implications for rehabilitationIndividuals with stroke show low physical activity, which may compromise function and health.The use of interventions aimed at improving and maintaining physical activity of individuals with stroke are recommended.Some interventions, such as aerobic, resistance, and combined home-based training, electrical stimulation during walking, functional task training, and arm robot-assisted therapy, could improve the physical activity after stroke.
Assessing adherence to physical activity programs post-stroke at home: A systematic review of randomized controlled trials. [2021]Physical activity at home provides significant benefits post-stroke. Adherence assessments contribute to objective evaluation of treatment effectiveness across settings.
What Is the Dose-Response Relationship Between Exercise and Cardiorespiratory Fitness After Stroke? A Systematic Review. [2019]Exercise after stroke improves cardiorespiratory fitness and walking capacity; however, the effect of altering exercise dose (via frequency, intensity, time, and type) on fitness or walking capacity is unclear.
Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): Safety analyses of a randomized clinical trial. [2022]To report the six-month safety analyses among patients enrolled in the "Physical Fitness Training in Subacute Stroke-PHYS-STROKE" trial and identify underlying risk factors associated with serious adverse events.
Exercise Programs Delivered According to Guidelines Improve Mobility in People With Stroke: A Systematic Review and Meta-analysis. [2020]To determine if prescribing a combined aerobic and resistance training exercise program in accordance with American Stroke Association physical activity guidelines improves mobility and physical activity levels of people after stroke.
[Adapted exercise important after stroke. Acute and long-term effects of different training programs]. [2017]Following stroke, persons experience deficits in motor control, reduced muscle strength, disuse atrophy, reduced cardiovascular fitness and elevated energy expenditure during locomotion. Recent exercise studies with few subjects, report beneficial outcomes after strength and low intensity aerobic exercise training. Progressive strength and aerobic exercise programmes from 3 to 6 months produced gains in functional recovery and health-related functional status such as motor function, peak isokinetic torque, balance, endurance, peak aerobic capacity and overall fitness without exacerbating spasticity. Increased access to community-based physical activity programmes is recommended to prevent deconditioning and to improve health related quality of life in persons after stroke. Well-functioning rehabilitation from acute care, through special rehabilitation units to community-based physical activity programmes is important.
Treadmill training and body weight support for walking after stroke. [2023]Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane review first published in 2005.
Treadmill training and body weight support for walking after stroke. [2023]Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014.