Gait Speeds and Demands in Chronic Stroke Patients: A Multi-dimensional Investigation

Study Overview
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Brief Summary
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This study investigated the effect of treadmill walking training with and without random speed changes in persons in the chronic stage of stroke. It was hypothesized that random speed change group will show less attention and balance demands for speed change in level walking.

Detailed Description
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This study includes chronic stroke patients who will be randomly assigned to blocked or random walking speed change group to receive 30 min per session, 3 sessions per week for 2 weeks' walking training on a treadmill. The outcome measures include gait characteristics under 3 tasks x 3 speed conditions x 2 attention conditions on an obstacle-free walk way. The three tasks are normal walking, narrow based walking and obstacle crossing. The three speed conditions are constant (preferred) speed, speeding up (preferred to maximum speed), and slowing down (maximum to preferred speed). The two attention conditions are none and serial subtraction of 3 during walking. Clinical sensorimotor function assessment, including hand grip strength, plantar sensitivity, stroke rehabilitation assessment of movement and Fugl-Meyer lower extremity motor scale will be conducted for subject characterization.

Official Title
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Gait Speeds and Demands in Chronic Stroke Patients: A Multi-dimensional Investigation

Conditions
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Stroke

Intervention / Treatment
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* Other: Treadmill walking training with random speed changes
* Other: Treadmill walking training with blocked speed changes


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients diagnosed with first stroke for at least 6 months Able to walk for at least 20 minutes independently without exhaustion Residual gait deficits Resting blood pressure is lower than 150/90 mmHg Exclusion Criteria: Unable to follow experimental instructions during the process Any pain, inflammation, or other neuromuscular or musculoskeletal conditions in the lower limbs that affect walking ability Unstable health problems

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 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
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: training with random speed changes<br>Walking training on treadmill with random speed changes, that is, random sequence of several different walking speeds | Other: Treadmill walking training with random speed changes<br>* Participants were asked to walk in different gait speed randomly on the treadmill (80%, 90%, 100%, 110% and 120% of preferred speed). The training speed would be changed in every 15 seconds in 2-minutes-section. 2 minutes/ section, 10 sections/ day, 3 days/ week, 2 weeks. 1 minute rest time would be held between sections.<br>|
| Active Comparator: training with blocked speed changes<br>Walking training on treadmill with blocked speed changes, that is a steady progression of faster walking speed. | Other: Treadmill walking training with blocked speed changes<br>* Participants were asked to walk in same gait speed on the treadmill per day (80%, 90%, 100%, 110% and 120% of preferred speed, respectively). 2 minutes/ section, 10 sections/ day, 3 days/ week, 2 weeks. 1 minute rest time would be held between sections.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| stride characteristics | Wearable movement sensors are used to measure stride characteristics, such step length, gait velocity, under different walking conditions (normal, narrow based, dual task) | 2 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, gait, dual tasks, motor learning