Responses to Backward Walking Training Post-Stroke

Description

Approximately 15,000 Veterans are hospitalized for stroke each year with new cases costing an estimated $111 million for acute inpatient, $75 million for post-acute inpatient, and $88 million for follow-up care over 6 months post-stroke. The investigators have previously established the effectiveness of a backward walking training program to improve gait and balance in post-stroke Veterans. To best serve Veterans in this era of personalized medicine, there is a current need to determine the appropriate training dose as well as which post-stroke Veterans would most benefit. This study addresses both needs as it will 1) test responses to two different doses (18 vs. 27 sessions) of backward walking training and 2) assess brain activity, measured by magnetic resonance imaging, before and after training intervention to determine its ability to predict rehabilitation response as well as brain mechanisms of behavioral change.

Conditions

Stroke

Study Overview

Study Details

Study overview

Approximately 15,000 Veterans are hospitalized for stroke each year with new cases costing an estimated $111 million for acute inpatient, $75 million for post-acute inpatient, and $88 million for follow-up care over 6 months post-stroke. The investigators have previously established the effectiveness of a backward walking training program to improve gait and balance in post-stroke Veterans. To best serve Veterans in this era of personalized medicine, there is a current need to determine the appropriate training dose as well as which post-stroke Veterans would most benefit. This study addresses both needs as it will 1) test responses to two different doses (18 vs. 27 sessions) of backward walking training and 2) assess brain activity, measured by magnetic resonance imaging, before and after training intervention to determine its ability to predict rehabilitation response as well as brain mechanisms of behavioral change.

Brain and Behavioral Responses to Backward Walking Training Post-Stroke

Responses to Backward Walking Training Post-Stroke

Condition
Stroke
Intervention / Treatment

-

Contacts and Locations

Gainesville

North Florida/South Georgia Veterans Health System, Gainesville, FL, Gainesville, Florida, United States, 32608-1135

Jacksonville

Brooks Rehabilitation, Jacksonville, Florida, United States, 32216

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Berg Balance Scale \< 45
  • * Self-selected 10 meter gait speed \< 0.8 m/s
  • * Diagnosis of unilateral stroke
  • * \> 2 months \< 4 months post-stroke
  • * Able to ambulate at least 10 feet with maximum 1 person assist
  • * Medically stable
  • * Presence of neurological condition other than stroke
  • * Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within 3 months, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living)
  • * Anyone meeting New York Heart Association criteria for Class 3 or Class 4 heart disease will be excluded
  • * Severe arthritis or orthopedic problems that limit passive ranges of motion of lower extremity (knee flexion contracture of -10 degrees, knee flexion ROM \< 90 degrees, hip flexion contracture \> 25 degrees, and ankle plantar flexion contracture \> 15 degrees)
  • * Severe hypertension with systolic greater than 200 mmHg and diastolic greater than 110 mmHg at rest
  • * Pain upon ambulation
  • * Receiving physical therapy services for mobility and/or gait
  • * Living in a skilled nursing facility
  • * Any MRI contraindication, including but not limited to the presence of metal, MR sensitive implanted medical devices, or claustrophobia

Ages Eligible for Study

18 Years to 90 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

VA Office of Research and Development,

Dorian Kay Rose, PhD MS BS, PRINCIPAL_INVESTIGATOR, North Florida/South Georgia Veterans Health System, Gainesville, FL

Study Record Dates

2025-12-31