Rehabilitating Corticospinal Control of Walking "ABC of Walking"


Phase 2 Results N/A

Eligibility Criteria

Inclusion Criteria

- occurrence of a single unilateral stroke within the previous 6-18 months (verified by MRI or CT from medical record)
- living in the community and able to travel to training and assessment sites
- approval of participation by primary care physician
- age 18 - 80 years
- lower extremity paresis indicated by Fugl-Meyer Assessment Score < 30
- deficit in at least one "synergy" subcategory (II - IV) of the Fugl-Meyer Assessment
- self-selected 10m gait speed of 0.4 - 0.8 m/s (with or without an ankle/foot orthosis or cane)
- able to provide informed consent
- willingness to be randomized to either intervention group
- written approval by primary care physician

Exclusion Criteria

neurological disorder or injury (other than stroke) such as Parkinson' s disease or spinal cord injury
- severe arthritis, such as awaiting joint replacement, that would interfere with study participation
- cardiovascular disease (congestive heart failure, significant valvular disease, history of cardiac arrest, presence of an implantable defibrillator, uncontrolled angina)
- myocardial infarction or major heart surgery in the previous year
- cancer requiring treatment in the past three years, except for nonmelanoma skin cancers and other cancers having an excellent prognosis (e.g., early stage breast or prostate cancer)
- lung disease requiring use of corticosteroids or supplemental oxygen
- renal disease requiring dialysis
- current diagnosis of schizophrenia, other psychotic disorders, or bipolar disorder
- Mini-Mental State Examination (MMSE) score <23
- major depression (Patient Health Questionnaire score > 10)
- severe obesity (body mass index > 35)
- uncontrolled hypertension (systolic > 200 mmHg and/or diastolic > 110 mmHg)
- uncontrolled diabetes with recent diabetic coma or frequent hypoglycemia
- bone fracture or joint replacement in the previous six months
- diagnosis of a terminal illness
- current participation in physical therapy or cardiopulmonary rehabilitation
- significant visual impairment affecting capability to gauge movement accuracy
- previous enrollment in a clinical trial for recovery of walking function
- current enrollment in any clinical trial
- planning to relocate out of the greater Gainesville FL area during the study period
- unable to communicate sufficiently with study personnel
- clinical judgment regarding safety or noncompliance