Understanding Different Parameters in Locomotor Training (a Type of Walking Training) for Person After a Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Observational

Summary: 
      This is a research study to understand how people who have experienced a stroke walk in order
      to develop better and more effective types of therapy. Data collected from people who have
      experienced a stroke and healthy individuals will be used to compare a neurologically healthy
      person to someone, which has sustained an injury.
    

Detailed description: 
      The first day will be a chance for the participants to become familiar with the body weight
      support (BWS) system and walking at different speeds. This first day will last about 2 hours
      and will consistent of fifteen total minutes of locomotor training utilizing manual trainers.
      This means trainers will move the participants'' body into a more normal walking pattern. The
      participants will be given a chance to rest between bouts; however, the participants may also
      rest at any point.

      First, the participants will walk for five minutes at normal comfortable speed with 15% of
      the body weight supported through an overhead system. This will be followed by walking at
      speeds faster and slower than the participants' comfortable speed. After these initial bouts
      of stepping, will be the training bouts. Training will be conducted with 30% of the body
      weight supported and at speeds considered normal for adults. Trainers will assist the trunk
      and with each leg, and will assist with initiation of steps and leg positioning, maintenance
      of an upright trunk, pelvic rotation, and weight shift. Training will consist of three bouts
      of five minutes of stepping for a total duration of 15 minutes of stepping. Vital signs,
      heart rate and blood pressure, will be monitored after each 5-minute bout. If the
      participants wear an Ankle Foot Orthosis (AFO), the participants will be asked to walk
      without it, but the investigators will provide the participants with an Aircast, which
      supports the ankle and prevents it from rolling side to side, but allows the foot to move
      freely up and down ,

      Data will be collected on the second day. This will take approximately five hours. During
      this time the participants will be asked to walk on the ground and on a treadmill. For the
      overground portion, the participants will walk across a 14-foot level, pressure-sensitive
      walkway at the participants' own speed and then as fast as the participants' can safely. This
      walkway measures the speed of walking and the size of steps. The participants can use any
      assistive device that the participants' typically use. A physical therapist or trained
      assistant will walk beside as the participants walk across the walkway. The participants will
      be asked to walk several times across the walkway at the two speeds while recordings are made
      from the participants' muscles and are videotaped.

      The participants will also be asked to walk on a treadmill. The participants will be
      permitted to practice treadmill walking until the participants' feel comfortable. Once the
      participants feel comfortable the investigators will ask the participants to walk a couple
      different ways. The order will be random, and the speeds will be determined from the first
      visit. The participants will be asked to walk some with Body Weight Support and some without.
      The investigators will ask the participants to walk at the participants' comfortable speed
      and then as fast as the participants' can safely walk. The participants will also walk at
      these same speeds and percentage of body weight support while trainers help the participants
      step in a way as close to normal.

      The participants will be able to rest at any point and for as long as they wish, however,
      after each trial the participants will be required to rest at least 2 minutes.

      During all treadmill walking, the participants will wear a harness attached to a mobile
      device attached to the ceiling. This device is for safety to prevent a fall and it can catch
      the participants should they lose balance or stumble. It will also be used to provide body
      weight support for some of the walking trials. If the participants use braces and/or
      assistive devices, the participants will be asked to do some walking with and without them,
      according to the participants' comfort and safety. A therapist will walk with the
      participants to provide any physical assistance that may be needed.

      For the walking testing, the investigators may need to shave small areas of the participants'
      legs to attach small sensors to the skin to measure the electrical activity of the leg
      muscles. The investigators will also attach reflective markers or small angle measurement
      devices to the skin over the participants' hips and several locations on the legs. The
      investigators will film the participants' movements with video cameras.
    

Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Healthy Controls and persons who have sustained a stroke
      
Keywords: Stroke; walking; Treadmill; body weight support system