Clinical trial NCT03916562: Optimization Principles in Hemiparetic Gait
Official title: Toward a Mechanistic Understanding of Optimization Principles Underlying Hemiparetic Gait
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Stroke
Keywords: Walking
Gait
Stability
Energetic cost
Lead sponsor: University of Southern California
Sponsor class: OTHER
Collaborators: name: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
First posted: 2019-04-16
Enrollment: 108
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention 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.
Primary purpose: BASIC_SCIENCE

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.


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

Primary outcomes:
measure: Oxygen consumption (VO2)
timeFrame: At the beginning of study day one
measure: Correlation between oxygen consumption (VO2) and step length asymmetry
timeFrame: During study day one
measure: Angular momentum during walking
timeFrame: At the beginning of study day two
measure: Correlation between angular momentum and step length asymmetry during walking
timeFrame: During study day two
Secondary outcomes:
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: University of Southern California
state: California
Study officials:
References:
citation: Sanchez N, Finley JM. Individual Differences in Locomotor Function Predict the Capacity to Reduce Asymmetry and Modify the Energetic Cost of Walking Poststroke. Neurorehabil Neural Repair. 2018 Aug;32(8):701-713. doi: 10.1177/1545968318787913. Epub 2018 Jul 12.
citation: Liu C, Macedo L, Finley JM. Conservation of Reactive Stabilization Strategies in the Presence of Step Length Asymmetries During Walking. Front Hum Neurosci. 2018 Jun 27;12:251. doi: 10.3389/fnhum.2018.00251. eCollection 2018.
citation: Sanchez N, Park S, Finley JM. Evidence of Energetic Optimization during Adaptation Differs for Metabolic, Mechanical, and Perceptual Estimates of Energetic Cost. Sci Rep. 2017 Aug 9;7(1):7682. doi: 10.1038/s41598-017-08147-y.
citation: Finley JM, Bastian AJ. Associations Between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait. Neurorehabil Neural Repair. 2017 Feb;31(2):168-177. doi: 10.1177/1545968316675428. Epub 2016 Oct 22.
citation: Finley JM, Long A, Bastian AJ, Torres-Oviedo G. Spatial and Temporal Control Contribute to Step Length Asymmetry During Split-Belt Adaptation and Hemiparetic Gait. Neurorehabil Neural Repair. 2015 Sep;29(8):786-95. doi: 10.1177/1545968314567149. Epub 2015 Jan 14.
citation: Park S, Liu C, Sanchez N, Tilson JK, Mulroy SJ, Finley JM. Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke. Neurorehabil Neural Repair. 2021 Aug;35(8):738-749. doi: 10.1177/15459683211019346. Epub 2021 Jun 1.