Clinical trial NCT01573585: Fast Muscle Activation and Stepping Training (FAST) Post-stroke
Official title: Effectiveness of Fast Muscle Activation and Stepping Training (FAST) on Balance and Mobility Post-stroke
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Stroke
Hemiparesis
Keywords: Physical Therapy
Exercise therapy
Lead sponsor: University of British Columbia
Sponsor class: OTHER
Collaborators: name: Heart and Stroke Foundation of Canada
First posted: 2012-04-09
Enrollment: 60
Sex: ALL
Minimum age (years): 19
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine whether FAST (Fast muscle Activation and Stepping Training) exercises will improve walking balance in individuals after stroke to a greater extent than usual care.

Hypothesis: The primary hypothesis is that improvements in walking balance will be larger following 12 sessions of FAST exercise retraining compared to usual care in persons in the sub-acute phase after stroke.

Detailed description: It is estimated that 75-80% of individuals who have had a stroke will survive the acute event and be left with residual disability. Regaining independence in standing and walking is of utmost importance for patients recovering from stroke. Walking balance requires muscles in the legs and trunk to contract quickly if people lose their balance. Physical therapy plays a key role in the rehabilitation of walking balance in individuals after stroke. Given that maintaining one's balance requires fast muscle activity, rehabilitation post-stroke should focus on speed of movement. Thus we are proposing to compare a program that emphasizes speed of movement, Fast muscle Activation and Stepping Training versus an active control (usual care).

Eligibility criteria: Study population: Subjects with a diagnosis of stroke

Inclusion Criteria:

* first stroke (\<6 months ago)
* presence of hemiparesis in the lower extremity
* minimum Berg Balance Score (BBS) of 30/56
* cognitive ability to give informed consent

Exclusion Criteria:

* bilateral stroke, or a previous stroke in the other hemisphere
* severe co-morbidity that is likely to dominate the pattern of care
* co-existing peripheral neuropathies or disorders of the vestibular apparatus
* musculoskeletal problems
* global aphasia or receptive aphasia

Primary outcomes:
measure: Community Balance and Mobility Scale
timeFrame: Pre treatment and Post treatment (6 weeks)
Secondary outcomes:
measure: Gait assessment
timeFrame: Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
measure: Physiological balance assessment by internal and external perturbations
timeFrame: Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
measure: Activities-specific Balance Confidence Scale
timeFrame: Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
measure: Community Balance and Mobility Scale
timeFrame: Post treatment and Retention (+1 month after treatment)
Other outcomes:
Locations:
city: North Vancouver
country: Canada
facility: Lions Gate Hospital
state: British Columbia
city: Vancouver
country: Canada
facility: Holy Family Hospital
state: British Columbia
Study officials:
affiliation: University of British Columbia
name: S. Jayne Garland, PT, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Miller KJ, Hunt MA, Pollock CL, Bryant D, Garland SJ. Protocol for a randomized controlled clinical trial investigating the effectiveness of Fast muscle Activation and Stepping Training (FAST) for improving balance and mobility in sub-acute stroke. BMC Neurol. 2014 Oct 10;14:187. doi: 10.1186/s12883-014-0187-y.
citation: Peters S, Ivanova TD, Lakhani B, Boyd LA, Garland SJ. Neuroplasticity of Cortical Planning for Initiating Stepping Poststroke: A Case Series. J Neurol Phys Ther. 2020 Apr;44(2):164-172. doi: 10.1097/NPT.0000000000000311.