Stroke Clinical Trial
Official title:
The Effects of Plantar Flexion Training on Plantar Flexion Activation, Torque, and Step Length Asymmetry in People With Chronic Stroke
Verified date | September 2021 |
Source | The University of Texas Health Science Center, Houston |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study consists of three phases that aim to develop an exercise intervention to promote maximal activation of ankle plantar flexors in the paretic lower extrimty (LE) in order to restore a more normalized gait pattern in chronic stroke survivors. The aim of the first phase is to determine if there are differences between standing on different levels of inclination on plantar flexion activation during forward movement of the contralateral LE in adults with chronic with stroke. The aim of second phase is to determine if there are differences between different percentages of weight bearing on the paretic LE on plantar flexion activation during forward movement of the contralateral LE in adults with chronic stroke. The aim of the third phase is to determine if there are differences between a 4-week plantar flexion training intervention and conventional physical therapy.
Status | Completed |
Enrollment | 15 |
Est. completion date | July 1, 2021 |
Est. primary completion date | July 1, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Must be able to perform five times sit to stand test without the use of upper extremities - Must have 10 degrees of passive ankle dorsiflexion measured in standing - Must be able to walk with supervision level assistance with no assistive device Exclusion criteria: - Currently receiving physical therapy - History of orthopedic ankle instability - Lacking knee extension to neutral - Unable to understand English - Unable to follow multi-step commands - History of orthopedic pathology that prevents completion of experimental condition - Pain with weight bearing on paretic LE - Received Botox to the plantar flexors within the last three months or phenol injections within the last six months - Walk with a longer nonparetic step length than paretic step length |
Country | Name | City | State |
---|---|---|---|
United States | The University of Texas Health Science Center at Houston | Houston | Texas |
Lead Sponsor | Collaborator |
---|---|
The University of Texas Health Science Center, Houston | Texas Woman's University |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Step length asymmetry ratio as assessed by the GAITRite® | The step length asymmetry ratio will be calculated by dividing the paretic step length by non-paretic step lengths. The magnitude of the ratio indicates the nature of the asymmetry, with symmetrical gait defined as step length ratio of 0.9-1.1, and asymmetrical gait where the non-paretic step lengths are longer than the paretic step lengths with any step length ratio greater than 1.1. | baseline, 6 weeks (relative to the phase 3 intervention) | |
Primary | Muscle activity of the medial gastrocnemius as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of medial gastrocnemius muscle in the paretic lower extremity (LE). | on the 1 day of the phase 1 intervention | |
Primary | Muscle activity of the soleus as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of soleus muscle in the paretic lower extremity (LE). | on the 1 day of the phase 1 intervention | |
Primary | Plantar flexion torque as assessed by isokinetic dynamometry | Peak plantar flexion torque will be acquired using an isokinetic dynamometer(Biodex Medical Systems, Shirely, New York, USA). Calibration of the Biodex® will be performed prior to the assessment of each individual. For each participant, the plantar flexors will be warmed-up on a LE ergometer for 10 minutes prior to testing. The participant will be fully secured to prevent compensatory behaviors from trunk or hips that may influence results. A pre-speed warm up on the Biodex of three submaximal repetitions and one maximal repetition will be conducted prior to testing so the participant understands what these repetitions feel like. The angular velocity will be set a 60°/second, five repetitions will be performed, and the peak torque of the plantar flexors will be collected. | baseline, 6 weeks (relative to the phase 3 intervention) | |
Primary | Muscle activity of the medial gastrocnemius as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of medial gastrocnemius muscle in the paretic lower extremity (LE). | on the 1 day of the phase 2 intervention | |
Primary | Muscle activity of the soleus as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of soleus muscle in the paretic lower extremity (LE). | on the 1 day of the phase 2 intervention | |
Secondary | Gait speed as assessed by the GAITRite® | Self-selected gait speed will be acquired using the GAITRite®. | baseline, 6 weeks (relative to the phase 3 intervention) | |
Secondary | Muscle activity of the medial gastrocnemius as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of medial gastrocnemius muscle in the paretic lower extremity (LE). | baseline, 6 weeks (relative to the phase 3 intervention) | |
Secondary | Muscle activity of the soleus as assessed by surface EMG | Muscle activity of the medial gastrocnemius will be assessed using surface EMG (Delsys Trigno EMG system, Boston, MA, USA). The EMG instrument will be placed on the muscle belly of soleus muscle in the paretic lower extremity (LE). | baseline, 6 weeks (relative to the phase 3 intervention) | |
Secondary | Quality of life as assessed by the Stroke Impact Scale | The physical domain of the Stroke Impact Scale will used to determine quality of life. The Stroke Impact Scale is a self-report measure designed to capture eight domains of health status. The physical domain has nine items that are rated using a 5 point Likert scale in terms of how difficult certain physical tasks are. The domains are scored separately using a transformed scale formula: [(raw score - lowest possible raw score) / highest possible raw score] x 100. A composite score will be assessed. | baseline, 6 weeks (relative to the phase 3 intervention) |
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