Clinical trial NCT04069481: Dance for the Improvement of Balance and Gait After Stroke
Official title: Dance for the Improvement of Balance and Gait After Stroke: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Chronic Stroke
Keywords: Dance
Stroke
Randomized Controlled Trial
Rehabilitation
Gait
Balance
Lead sponsor: University Health Network, Toronto
Sponsor class: OTHER
Collaborators: name: Heart and Stroke Foundation of Canada
First posted: 2019-08-28
Enrollment: 136
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Two groups of participants. One group receives the dance intervention. The control group will receive mindful meditation, strengthening \& stretching exercises.
Primary purpose: TREATMENT

Brief summary: Stroke can drastically impact the ability to walk and keep your balance. In addition people with chronic stroke feel social isolated, become less satisfied with their walking and lose confidence in their ability to move without falling.

Ned new treatments are needed for walking and balance. Dancing is a fun, social activity that has similar benefits to traditional exercise. Another benefit of dancing is the use of music, which improves mood, increases motivation and can even improve motor performance. Finally, moving in synchrony with other people during dancing can make people feel connected. We believe that dance classes can benefit people with stroke, but few studies have been done.

The objective of our project is to conduct a randomized controlled trial to test whether dance can improve balance and walking for people with chronic stroke. The investigators are also interested in whether dancing improves people's confidence in their ability to do activities without losing their balance (i.e. balance confidence), decreases their feelings of isolation and increases their quality of life.

Detailed description: This study is a randomized controlled trial to investigate the effects of an adapted dance program for people with chronic stroke. Participants with stroke living in the community will be randomly assigned to either the dance group or the control group. Participants will attend classes 2 times a week for 12 weeks. The primary outcomes are change in balance balance (measured with the Mini BESTest) and change in gait speed. Participants will be assessed before and after the 12 week program.

Eligibility criteria: Inclusion Criteria:

1. \> 6 months post stroke
2. Ability to transfer sit to stand and stand to sit with minimal use of arm rests
3. Ability to stand without physical support from an aid or another person for 30 seconds
4. Ability to walk 10m without physical assistance from a walking device, but with standby assistance from another person if needed
5. Ability to follow 2-3 step instructions with minimal prompting from another person
6. Have received clearance from their physician to participate in exercise.

Exclusion Criteria:

1. Severe hearing loss
2. Pre-existing conditions that significantly impact gait and balance (e.g. osteoarthritis)
3. Other neurological conditions that impact gait and balance (e.g. PD).
4. Have participated in a dance class within the past 12 months

Primary outcomes:
measure: Change in balance
timeFrame: at study completion on average 14 weeks
measure: Change in gait speed
timeFrame: at study completion on average 14 weeks
Secondary outcomes:
measure: Change in social isolation
timeFrame: at study completion on average 14 weeks
measure: Change in Quality of life scale
timeFrame: at study completion on average 14 weeks
measure: Change in balance confidence
timeFrame: at study completion on average 14 weeks
measure: Change in upper extremity active range of motion (AROM)
timeFrame: at study completion on average 14 weeks
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: Toronto Rehabilitation Institute
state: Ontario
Study officials:
affiliation: Toronto Rehabilitation/ University of Toronto
name: Kara Patterson, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Toronto Rehabilitation
name: Dina Brooks, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Tsang CS, Liao LR, Chung RC, Pang MY. Psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in community-dwelling individuals with chronic stroke. Phys Ther. 2013 Aug;93(8):1102-15. doi: 10.2522/ptj.20120454. Epub 2013 Apr 4.
citation: Wong JS, Jasani H, Poon V, Inness EL, McIlroy WE, Mansfield A. Inter- and intra-rater reliability of the GAITRite system among individuals with sub-acute stroke. Gait Posture. 2014;40(1):259-61. doi: 10.1016/j.gaitpost.2014.02.007. Epub 2014 Feb 26.
citation: Patterson KK, Gage WH, Brooks D, Black SE, McIlroy WE. Changes in gait symmetry and velocity after stroke: a cross-sectional study from weeks to years after stroke. Neurorehabil Neural Repair. 2010 Nov-Dec;24(9):783-90. doi: 10.1177/1545968310372091. Epub 2010 Sep 14.
citation: Garland SJ, Willems DA, Ivanova TD, Miller KJ. Recovery of standing balance and functional mobility after stroke. Arch Phys Med Rehabil. 2003 Dec;84(12):1753-9. doi: 10.1016/j.apmr.2003.03.002.
citation: Hawthorne G Measuring social isolation in older adults: development and initial validation of the friendship scale. Social Indicators Research 2006; 77: 521-548
citation: Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999 Jul;30(7):1362-9. doi: 10.1161/01.str.30.7.1362.
citation: Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995 Jan;50A(1):M28-34. doi: 10.1093/gerona/50a.1.m28.
citation: Botner EM, Miller WC, Eng JJ. Measurement properties of the Activities-specific Balance Confidence Scale among individuals with stroke. Disabil Rehabil. 2005 Feb 18;27(4):156-63. doi: 10.1080/09638280400008982.
citation: Uswatte G, Taub E, Morris D, Vignolo M, McCulloch K. Reliability and validity of the upper-extremity Motor Activity Log-14 for measuring real-world arm use. Stroke. 2005 Nov;36(11):2493-6. doi: 10.1161/01.STR.0000185928.90848.2e. Epub 2005 Oct 13.
citation: Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.
citation: Patterson KK, Wong JS, Nguyen TU, Brooks D. A dance program to improve gait and balance in individuals with chronic stroke: a feasibility study. Top Stroke Rehabil. 2018 Sep;25(6):410-416. doi: 10.1080/10749357.2018.1469714. Epub 2018 May 10.