Optimization Principles in Hemiparetic Gait

Study Overview
=================
Brief Summary
-----------------
This project seeks to identify the how walking impairments in stroke survivors contribute to mobility deficits through the use of behavioral observations and computational models. The chosen approach integrates biomechanical analyses, physiological assessments and machine learning algorithms to explain how asymmetries during walking influence balance and the effort required to walk. Ultimately, the results of this work may lead to more personalized rehabilitation strategies to improve walking capacity and efficiency, and ultimately reduce fall risk in stroke survivors.

Official Title
-----------------
Toward a Mechanistic Understanding of Optimization Principles Underlying Hemiparetic Gait

Conditions
-----------------
Stroke

Intervention / Treatment
-----------------
* Behavioral: Manipulation of spatiotemporal coordination during walking


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria for Control Participants: No musculoskeletal injury or conditions that limit walking ability No history of neurological disorders or severe head trauma Absence of cognitive impairment as demonstrated by a Mini-Mental score greater than 24 Inclusion Criteria for Post-Stroke Participants Presence of unilateral brain lesion from a single stroke Weakness confined to one side Ability to walk on a treadmill for five minutes continuously without a cane or walker Absence of cognitive impairment as demonstrated by a Mini-Mental score greater than 24

Ages Eligible for Study
-----------------
Minimum Age: 21 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: For this study, the investigators will recruit two separate groups of participants who will complete the study procedures in parallel. One group will be comprised of individuals post-stroke and the second group will be comprised of adults who have not had a stroke.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Healthy Participants<br>The investigators will determine how asymmetric walking constraints influence spatiotemporal coordination, energetic cost, and dynamic balance in healthy individuals. The investigators will manipulate spatiotemporal coordination using a special treadmill. Energetic cost will be quantified using expired gas analysis and inverse dynamic approaches. Stability will be evaluated by characterizing participants' ability to recover from unexpected perturbations. | Behavioral: Manipulation of spatiotemporal coordination during walking<br>* A description of the intervention is included in the description of the study arms.<br>|
| Experimental: Post-stroke Participants<br>The investigators will determine how different patterns of coordination during walking influence energetic cost and dynamic balance in people post-stroke. The investigators will manipulate coordination using a special treadmill. Energetic cost will be quantified using expired gas analysis and inverse dynamic approaches. Stability will be evaluated by characterizing participants' ability to recover from unexpected perturbations. | Behavioral: Manipulation of spatiotemporal coordination during walking<br>* A description of the intervention is included in the description of the study arms.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oxygen consumption (VO2) | The investigators will use a metabolic cart to measure the rate of oxygen consumption (VO2) while participants walk at a fixed speed on a treadmill. | At the beginning of study day one | 
| Correlation between oxygen consumption (VO2) and step length asymmetry | The investigators will use a metabolic cart to measure the rate of oxygen consumption (VO2) while participants walk at a fixed speed on a treadmill. VO2 will be measured in five trials where participants walk with different levels of step length asymmetry. This outcome will capture the relationship between measures of VO2 and step length asymmetry. | During study day one | 
| Angular momentum during walking | Motion capture will be used to measure the kinematics of the body when participants respond to accelerations of the treadmill | At the beginning of study day two | 
| Correlation between angular momentum and step length asymmetry during walking | Participants will complete five trials at different levels of step length asymmetry. During these trials, motion capture will be used to measure the kinematics of the body when participants respond to accelerations of the treadmill. This outcome measure will use data from all trials to determine the relationship between angular momentum and step length asymmetry. | During study day two | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Walking, Gait, Stability, Energetic cost