Control Strategies of the Locomotor System During Obstacle-Crossing in Stroke Patients

The recruitment status of this study is unknown because the information has not been verified recently.
Verified August 2005 by National Taiwan University Hospital.
Recruitment status was  Recruiting
Sponsor:
Information provided by:
National Taiwan University Hospital
ClinicalTrials.gov Identifier:
NCT00174044
First received: September 13, 2005
Last updated: December 20, 2005
Last verified: August 2005
  Purpose

Tripping over obstacles is one of the common movements in daily life and is the most frequently mentioned cause of falls in the elderly. Indeed, crossing obstacles is a more complex motor skill than walking, and ensuring sufficient clearance of an obstacle during locomotion requires accurate movement and appropriate modifications of the swing limb. However, little is known about the obstacle crossing deficits that following stroke, especially in good outcome and function independently strokes. It is still a mystery about motor control and motor plastic of central nerve system.

The purpose of the study was to observe and quantify certain characteristics of the performance of subjects following stroke with good outcome to understand the damage of central nerve system how to affect motor control. The present study investigated selected spatial-temporal characteristics, kinematic variables and kinetic variables of the gait pattern to define further the problems in obstacle crossing following strokes. To quantify the deficits, we compared results from a group of subjects with stroke with a group of healthy subjects matched for age, gender, and height.


Condition
Stroke

Study Type: Observational
Study Design: Observational Model: Defined Population
Time Perspective: Cross-Sectional
Official Title: Control Strategies of the Locomotor System During Obstacle-Crossing in Stroke Patients

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Further study details as provided by National Taiwan University Hospital:

Estimated Enrollment: 120
Study Start Date: August 2005
Estimated Study Completion Date: July 2006
Detailed Description:

A stroke (or cerebrovascular accident) is a neurological deficit that lasts beyond 24 hours. It is a disruption in the blood supply to a region of the brain that causes neurological impairment. According to 2003 statistical data of National Health Administration of executive organ in Taiwan, a stroke is considered the second most common cause of death after cancer. According to the research of the stroke incidence in Taiwan, the incidence is 0.3% in the population over 35 years-old, and the incidence increases sharply to 3% in the population over 65 years-old which is nearly 294 to 1806 people. From above, we know that a stroke is one of the most common neural diseases in the old population.

Strokes are classified as ischemic and hemorrhagic. Approximately 70-80% of all strokes are ischemic strokes, including cerebrovascular thrombosis and embolism. The other 10-15% are either intracerebral hemorrhage or subarachnoid hemorrhage strokes. Distinctive neurological signs reflect the region of the brain involved. The type and severity of neurological deficits cover a wide range and gradation of symptoms. Cerebrovascular accidents frequently cause upper motor neuron syndrome (Change of muscle tension, unilateral hemiplegia, movement un-coordination, un-reciprocal movement, poor movement control, etc.), sensory deficits, aphasia, cognitive and behavior problems, etc. These deficits often left with dependence of movement function in daily life. Previous studies showed that 10% of all strokes resume working, 40% is slight disability, 40% is server disability and 10% have to live in the medical organization forever. Moderate to server disability are evaluated easily using different kinds of outcome measures to determinate the status of neurological injury and resulting disabilities, which provide guideline of aggressive treatment of rehabilitation. However, good outcome and function independently in daily life may be showed in some strokes with mild disability by outcome measures. It is not clear that the nearly normal strokes are really the same with normal group without stroke, even the normal status was showed in the strokes by outcome measures. It is unknown that the motor control strategies of strokes with function independently in daily life are similar to normal group indeed. A recent study found that 73% of subjects with stroke fell at least once in the 6 months after being discharged from the hospital; of these, 10% reported falling over an obstacle. Falling may be caused by the impairment after stroke or the different motor control strategy in the strokes with mild disability.

In addition, tripping over obstacles is one of the common movements in daily life and is the most frequently mentioned cause of falls in the elderly (Lu,2005). Crossing obstacles successfully and safely depend on the stability of the stance leg and maintaining a good clearance with the obstacles. Indeed, crossing obstacles is a more complex motor skill than walking, and ensuring sufficient clearance of an obstacle during locomotion requires accurate movement and appropriate modifications of the swing limb. Therefore, obstacle crossing is one exercise program in diminishing disability in the rehabilitation. Studies about obstacle crossing in young or old adults have been much attention. However, little is known about the obstacle crossing deficits that following stroke, especially in good outcome and function independently strokes. It is still a mystery about motor control and motor plastic of central nerve system. Otherwise, knowledge of the motor control strategy after stroke during obstacle-crossing is helpful for the design of fall-prevention devices and for the planning of programs for the prevention of associated injuries.

The purpose of the study was to observe and quantify certain characteristics of the performance of subjects following stroke with good outcome to understand the damage of central nerve system how to affect motor control. The present study investigated selected spatial-temporal characteristics, kinematic variables and kinetic variables of the gait pattern to define further the problems in obstacle crossing following strokes. To quantify the deficits, we compared results from a group of subjects with stroke with a group of healthy subjects matched for age, gender, and height.

  Eligibility

Ages Eligible for Study:   35 Years to 75 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. stroke after 1 month.
  2. Modified Rankin Scale: 0-2 grade.
  3. NIH Stroke Scale: <5 degree.
  4. Berg Balance Test: >45 degree.
  5. Tinetti Gait Analysis: >8 degree.
  6. Barthel Index: >95 degree.

Exclusion Criteria:

  1. other neuro-musculoskeletal system disease.
  2. other visual problems to affect locomotion.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00174044

Contacts
Contact: Jeng Jiann-Shing, M.D. 886-2-23123456 ext 5338 jsjeng@ha.mc.ntu.edu.tw

Locations
Taiwan
Jeng Jiann-Shing Recruiting
Taipei, Taiwan
Contact: Jiann-Shing Jeng, M.D.    886-2-23123456 ext 5338    jsjeng@ha.mc.ntu.edu.tw   
Sponsors and Collaborators
National Taiwan University Hospital
Investigators
Principal Investigator: Jeng Jiann-Shing, M.D. Department of Neurology ,National Taiwan University Hospital
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00174044     History of Changes
Other Study ID Numbers: 9461700706
Study First Received: September 13, 2005
Last Updated: December 20, 2005
Health Authority: Taiwan: Department of Health

Additional relevant MeSH terms:
Stroke
Cerebral Infarction
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Brain Infarction
Brain Ischemia

ClinicalTrials.gov processed this record on August 20, 2014