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Visit National Institute on Disability and Rehabilitation Research, NIDRR, the funding agency for RRTC-Stroke.

R2. Improving Delivery of Intensive Gait Training in the Clinical setting to Augment Community Ambulation

Contact Information:

George Hornby, Ph.D, P.T.

g-hornby@northwestern.edu

Abstract

This is a randomized, controlled, single-blinded clinical trial on the effects of large doses of high intensity locomotor training performed on a treadmill and over-ground in individuals less than 6 months post-stroke, as compared to conventional physical therapy as performed in the clinical setting. Subjects are stratified according to the extent of walking impairments after stroke, and randomized to receive 8-10 weeks of either the experimental training or conventional physical therapy.  

 

Conventional therapy is provided in the clinical setting by a licensed therapist, with training protocols determined by the treating therapist, the patient, and their family/caregivers, without consultation from the research group.  Patients receiving conventional therapy for 8-10 weeks may be eligible to receive experimental training for 4 weeks.

 

The experimental training will be provided inside the Rehabilitation Institute of Chicago, and will consist of continuous upright stepping performed over-ground, on a treadmill, or on stairs.  Over-ground walking will consist of level walking at variable speeds, in multiple directions, with variable assistance or resistance to perform these tasks.   Other tasks performed during over-ground training can include dual tasking, walking over uneven surfaces, or balance beam walking. Treadmill walking will also be performed at variable speeds, in multiple directions and with variable assistance or resistance.  Stair climbing will be performed in a staircase, or on a “stair treadmill”.  Heart rate and perceived exertion will be monitored throughout the training.

 

Primary outcome measures include standard measures of over-ground walking speed and distance, peak treadmill speed, and walking activity in the community.  Secondary outcome measures include volitional strength, balance, energy consumption, and ability to safely and rapidly rise from a chair.

This research is supported by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research, Grant Number H133B080031.