Stroke Clinical Trial
Official title:
Effects of a Provision of a Cane on Locomotion and Social Participation of Individuals With Stroke: a Randomized Controlled Trial
Previous studies failed to determine the real effects of the provision of a walking cane after a stroke, mainly due to biases related to their methodological designs. In addition, there is no information on the carry-over effects of a cane to social participation. This study will test the hypothesis that the provision of a cane is effective in improving walking speed, step length, cadence, walking capacity, walking confidence, and participation of individuals with chronic stroke. For this prospective, single-blinded, randomized clinical trial, people after stroke will be randomly allocated into either experimental or control groups. The experimental group will receive a single-point cane, with ergonomic handgrip, which will be individually adjusted to the participant's height. A physiotherapist will provide instructions on how to walk with the cane and the participants will practice for about 15 minutes or until they feel comfortable with the device. Then, they will take the cane home and will be instructed to use it all the time during locomotion. Weekly, they will receive a phone call, to ensure that they are using the cane and to clarify any doubts. A home visit may be conducted, if necessary. The control group will be instructed to perform stretching of the lower limb muscles daily and keep their daily activities, without the use of a cane. To ensure the level of attention similar to that of the participants in the experimental group, the individuals in the control group will also receive weekly phone calls. At baseline (Week 0), post intervention (Week 4), and one month after the cessation (Week 8) of the interventions, researchers blinded to group allocations will collect all outcome measures.
Rationale: Motor impairments after a stroke are disabling and interfere with the performance
of daily activities, such as locomotion. Walking devices, such as a single cane, are usually
prescribed to increase safety and improve gait ability. Previous studies failed to determine
the real effects of the provision of a walking cane after a stroke, mainly due to biases
related to their methodological designs. In addition, there is no information on the
carry-over effects of a cane to social participation.
Aim: This study will test the hypothesis that the provision of a cane is effective in
improving walking speed, step length, cadence, walking capacity, walking confidence, and
participation of individuals with chronic stroke.
Design: For this prospective, single-blinded, randomized clinical trial, people after stroke
will be randomly allocated into either experimental or control groups. The experimental group
will receive a single-point cane, with ergonomic handgrip, which will be individually
adjusted to the participant's height. A physiotherapist will provide instructions on how to
walk with the cane and the participants will practice for about 15 minutes or until they feel
comfortable with the device. Then, they will take the cane home and will be instructed to use
it all the time during locomotion. Weekly, they will receive a phone call, to ensure that
they are using the cane and to clarify any doubts. A home visit may be conducted, if
necessary.
The control group will be instructed to perform stretching of the lower limb muscles daily
and keep their daily activities, without the use of a cane. To ensure the level of attention
similar to that of the participants in the experimental group, the individuals in the control
group will also receive weekly phone calls. At baseline (Week 0), post intervention (Week 4),
and one month after the cessation (Week 8) of the interventions, researchers blinded to group
allocations will collect all outcome measures.
Study outcomes: walking speed, step length, cadence, walking capacity, walking confidence,
and participation.
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