Fall Recovery Training for Individuals With Chronic Stroke

Study Overview
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Brief Summary
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The purpose of this study is to quantify how fall-recovery training improves the fall-recovery response of individuals with chronic stroke. Up to 20 participants with chronic stroke will be recruited from the community. Over six laboratory visits, participants will undergo sessions of fall-recovery training. Each session is comprised of simulated trips and slips as participants stand on a computer-controlled treadmill. Trip-recovery training consists of treadmill-delivered disturbances that induce a forward fall. Slip-recovery training consists of a treadmill-delivered disturbances that induce a backward fall. Separate progressions focus on initial steps with the left and right limbs. The training intensity, as determined by the disturbance magnitude, is progressive and dependent on participant performance. Step length and maximum trunk angle will be calculated. The hypothesis is that, with practice, participants will recover from larger perturbations, and they will increase step length and reduce trunk rotation during fall recoveries.

Official Title
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Fall Recovery Training for Individuals With Chronic Stroke

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Fall-recovery training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants must be 18 years or older Participants must have had a single stroke of non-cerebellar origin Exclusion Criteria: More than one stroke Unable to walk one block without stopping or using a walking aid, such as a cane Acute illness at the time of functional assessment or training Body mass greater than 136 kg (300 lbs) Lower extremity joint replacement or shoulder joint replacement within a year prior to participation Dementia Parkinson's disease A history of back surgery A history of neck surgery More than one occurrence of back or neck pain in the month prior to participation Current back or neck pain at the time of participant enrollment Bulging vertebral discs Spine, hip, or lower extremity fracture within a year prior to participation Open lesions on the lower extremity Insulin-dependent diabetes Use of a pacemaker Use of an ostomy pouch Pregnancy Osteoporosis Doctor recommendation to avoid moderate physical activity or exercise Any neural, muscular, or skeletal condition or injury that precludes safe participation in the training or introduces a confounding factor on the study, at the discretion of the clinician or study staff

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Group<br>This group will receive up to six sessions of fall-recovery training over the course of 2-3 weeks. | Behavioral: Fall-recovery training<br>* Participants practice recovering from simulated, treadmill-induced slips and trips.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disturbance magnitude | The highest disturbance magnitude from which a successful fall-recovery resulted on the first and last training sessions | 2-3 weeks (first to last training session) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Step length | The length of the initial recovery step in response to the highest disturbance magnitude common to the first and last training sessions | 2-3 weeks (first to last training session) | 
| Trunk rotation | The maximum trunk rotation angle in response to the highest disturbance magnitude common to the first and last training sessions | 2-3 weeks (first to last training session) |