Long Term Split Belt Treadmill Training for Stroke Recovery

Active, not recruiting

Phase 1 Results N/A

Trial Description

The purpose of this study is to determine whether split belt or conventional treadmill training can be used to treat walking pattern deficits from stroke and to determine whether this improves gait asymmetry and metabolic efficiency.

Detailed Description

Coordination between the legs during walking is often disrupted after neurological injury, resulting in asymmetric gait patterns. Recent data shows that walking patterns can be altered through treadmill training, even after central nervous system damage. The investigators have studied short-term adaptation of inter-limb coordination during walking using a split-belt treadmill to control speed of the two legs independently. Our findings demonstrate that walking patterns are adaptable. The investigators have also shown that people with cerebral damage from stroke can benefit in the short-term to correct asymmetric walking patterns. Since all of our previous work has focused on single training sessions or up to 4 week training sessions, the investigators would like to study long-term effects of split belt treadmill training. Therefore, the purpose of this study is to prepare for a clinical trial of split-belt treadmill training to treat walking pattern deficits from cerebral damage. The investigators will gather data to determine whether different types of treadmill training on a custom split-belt treadmill are likely to change/improve walking symmetry as well as metabolic efficiency.
The investigators will study adults with cerebral damage due to stroke. Subjects with hemiparesis will undergo training 3 times a week for a total of 33 training session. These 33 sessions will be broken into 3 blocks of 11 sessions. After each block of 11 sessions an evaluation will be done to record any gait improvements. Training for the subjects with hemiparesis will either be conventional treadmill walking (both legs moving at the same speed) or split-belt treadmill walking (with one leg moving faster than the other). These studies will provide important new information about normal mechanisms of locomotor adaptation, as well as providing a new rehabilitation tool for people with asymmetric gait patterns. Note that this study is not an aerobic conditioning program since subjects will work well below their age-adjusted target heart rate; it is instead a retraining program aimed at teaching people a new inter-limb coordination pattern as well as to determine whether this training can influence the subject's body's ability to use its intake of oxygen more efficiently. This study is also critical for developing procedural reliability processes, calculating effect sizes, training clinical staff, and determining other salient clinical variables in preparation for a randomized clinical trial.

Conditions

Interventions

  • Split Belt treadmill Behavioral
    Other Names: Woodway Split Belt Treadmill; Company: Woodway USA, Inc
    Intervention Desc: A split belt treadmill is like a typical treadmill that is seen in the gym, except that this treadmill has two belts that move instead of just one. One leg goes on one belt and the other leg uses the other belt. The belt speeds can be set to move at the same speed, making this treadmill similar to any regular treadmill, but, belt speeds can also be set so that one belt moves a little faster than the other. The belts are never set at a running or jogging speed, only a self-paced walking speed regardless of whether the belts are both going the same or slightly different speeds.
    ARM 1: Kind: Experimental
    Label: Treadmill Exercise
    Description: Split-belt treadmill training

Trial Design

  • Masking: Open Label
  • Purpose: Treatment
  • Endpoint: Safety/Efficacy Study
  • Intervention: Single Group Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Change in Baseline Step length symmetry. That is, whether the steps with right and left legs are the same length. Baseline Visit 1 (week 1) and Baseline Visit 2 (week 2), 2 times during training (once at week 6 and once at week 10), after training (week 14), and 1- and 3 months after training No
Secondary Change in Baseline Oxygen intake Baseline Visit 1 (week 1) and Baseline Visit 2 (week 2), 2 times during training (once at week 6 and once at week 10), after training (week 14), and 1- and 3 months after training No
Secondary Walking speed Before training, periodically during training, post training and 1- and 3 months after training No
Primary Change in Baseline Step length symmetry. That is, whether the steps with right and left legs are the same length. Baseline Visit 1 (week 1) and Baseline Visit 2 (week 2), 2 times during training (once at week 6 and once at week 10), after training (week 14), and 1- and 3 months after training No

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