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.
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).
- Usual care Behavioral
Intervention Desc: The Usual Care program will consist of 2 sessions a week for 45 minutes for a 6 week duration. ARM 1: Kind: Experimental Label: Usual care Description: The usual care will consist of strength training, endurance, range of motion, patient education, weight shifting in standing and gait re-training.
- FAST protocol Behavioral
Intervention Desc: The Fast muscle activation and Stepping Training (FAST protocol) will be exercises emphasizing speed, small squats and protective steps, that will be progressed. This program will be 2 sessions a week for 45 minutes for 6 weeks in duration. ARM 1: Kind: Experimental Label: FAST protocol Description: The Fast muscle activation and stepping training will be the Experimental arm of this trial. This program will be exercises emphasizing speed of movement.
- Allocation: Randomized
- Masking: Single Blind (Outcomes Assessor)
- Purpose: Treatment
- Endpoint: Efficacy Study
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Community Balance and Mobility Scale||Pre treatment and Post treatment (6 weeks)||No|
|Secondary||Gait assessment||Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)||No|
|Secondary||Physiological balance assessment by internal and external perturbations||Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)||No|
|Secondary||Activities-specific Balance Confidence Scale||Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)||No|