Stroke Clinical Trial
Official title:
Visual Cue Training to Improve Walking and Turning After Stroke: a Pilot Study
Given that visual information comprises one of the most important and salient sources of
information used during walking, that visual cues have been shown to be more effective than
auditory cues in triggering gait adjustments and that stroke survivors have been reported to
become more dependent on visual cues, the investigators hypothesize that visual cues would
be more effective in triggering gait recovery and adaptability following stroke than
interventions not including visual cues.
The investigators will integrate visual cues with walking and turning practice, and contrast
this intervention to routine overground walking practice. Stroke participants recruited from
NHS stroke rehabilitation clinics in the West Midlands, will be randomized to one of three
gait rehabilitation groups. Each group will receive the same frequency and duration of
treatment delivered by qualified physiotherapists. Overground visual cue training (OVCT) and
usual care (UC) groups will be treated in participating NHS sites. Treadmill training with
visual cues (TVCT) will take place at the University of Birmingham.
The gait of many stroke patients remains impoverished and characterized by impairments
including asymmetries in propulsive forces between the paretic and non-paretic limbs, step
lengths, widths and stance and swing phase durations. Currently there is insufficient
evidence that current rehabilitation strategies improve walking in people who are more than
6 months post-stroke.
The purpose of the trial is to determine the necessary information on which to base a future
definitive trial examining the effectiveness of visual cues for gait training following
stroke in contrast to conventional over-ground walking practice.
The study will determine the numbers of patients willing to be recruited into both control
and VCT groups; the willingness of physiotherapists at each collaborating site to enroll
patients to usual care OVCT and TVCT groups.
It will determine the numbers of patients who do not complete the allocated treatment, thus
dropping out of the study, and the reasons for dropping out.
The knowledge gathered about recruitment, outcomes and drop-out rates will determine sample
size for a subsequent definitive trial.
The study will also measure completeness of outcome data, i.e. percentage of patients with
no missing values in outcome assessments.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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