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Arm and Leg Cycling Exercise After Stroke

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ClinicalTrials.gov Identifier: NCT02232867
Recruitment Status : Unknown
Verified September 2014 by Dr. E. Paul Zehr, University of Victoria.
Recruitment status was:  Recruiting
First Posted : September 5, 2014
Last Update Posted : September 5, 2014
Sponsor:
Collaborators:
Heart and Stroke Foundation of Canada
Canadian Stroke Network
Information provided by (Responsible Party):
Dr. E. Paul Zehr, University of Victoria

Brief Summary:
It has been found that arm and leg cycling is similar to walking in terms of the muscle activation patterns and joint ranges of motion. In addition, arm and leg cycling and walking activate similar neural pathways. Another advantage of arm and leg cycling is that it involves coordination of all four limbs in a rhythmic movement. This may be particularly beneficial given previous findings that arm movement contributes to the activation of leg muscles during walking in humans. This is achieved with interconnected neural pathways that link the arms to the legs. These neural interlimb connections remain intact in stroke victims, such that maximizing the contribution of the arms to the legs may increase coordination for walking. Thus, the objectives of this research are to determine if arm and leg cycling can be used to increase the strength of interlimb connections and if this helps to improve walking ability in a post-stroke population. It is hypothesized that arm and leg cycling will transfer to improvements in walking in a post stroke population.

Condition or disease Intervention/treatment Phase
Stroke Behavioral: Arm and Leg Cycling Exercise Program Not Applicable

Detailed Description:
For those who have suffered a stroke, damage to the brain can result in a decreased ability to walk, thus decreasing quality of life in a significant way. Traditionally, body weight supported treadmill training has been used for walking rehabilitation; however, this therapy requires specialized technicians, equipment, and facilities. Arm and leg cycle ergometers, a device commonly found in a gym, could provide an inexpensive and readily accessible means for walking rehabilitation.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Adjunct Locomotor Training to Improve Walking Ability After Stroke
Study Start Date : July 2011
Estimated Primary Completion Date : December 2014
Estimated Study Completion Date : March 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Arm and Leg Cycling Exercise Program
Multiple baseline test sessions will be used for the same participant to establish a meaningful baseline thus confirming consistency of all outcome measures prior to the intervention.
Behavioral: Arm and Leg Cycling Exercise Program
Participants will perform arm and leg cycling training three times a week, with 30 minutes of aggregate exercise time per session. To evaluate the physiological cost of exercise, heart rate and a rating of perceived exertion will be collected. The progressive element of this training will include increasing the resistance of the ergometer over the six weeks in order to maintain the same relative exercise stress.




Primary Outcome Measures :
  1. Change in Treadmill Walking Characteristics [ Time Frame: Baseline, immediately post-intervention (average of 4 days following last exercise session) ]
    Treadmill walking characteristics will be gauged via a customized analysis of muscle activity patterns and lower limb joint kinematics. Walking frequency, symmetry, and timing will also be analyzed


Secondary Outcome Measures :
  1. Interlimb Connections [ Time Frame: Baseline, immediately post-intervention (average of 4 days following the last exercise session) ]
    To assess the strength of inter-limb coupling, simultaneous electrical stimulation will be applied to (5x1.0ms trains at 300Hz) the cutaneous nerves in the hand (superficial radial) and foot (superficial peroneal). The reflex responses recorded in all four limbs will be evaluated at different phases of the walking cycle.

  2. Fugl-Meyer Assessment [ Time Frame: Baseline, immediately post-intervention (average of 4 days following the last exercise session) ]
    The Fugl-Meyer Assessment is a stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia.

  3. Brunnstrom recovery stages [ Time Frame: Baseline, immediately post-intervention (average of 4 days following the last exercise session) ]
    The Brunnstrom Approach emphasises the synergic pattern of movement which develops during recovery from hemiplegia.

  4. Timed up and go test [ Time Frame: Baseline, immediately post-intervention (average of 4 days following the last exercise session) ]
    The Timed Up and Go test is a simple test used to assess a person's mobility and requires both static and dynamic balance. It uses the time that a person takes to rise from a chair, walk three metres, turn around, walk back to the chair, and sit down. During the test, the person is expected to wear their regular footwear and use any mobility aids that they would normally require.

  5. 10 meter walk test [ Time Frame: Baseline, immediately post-intervention (average of 4 days following the last exercise session) ]
    The 10 meter walk test is a timed test to evaluate walking speed

  6. Six minute walk test [ Time Frame: Baseline, immediately post-intervention (average of 4 days following last exercise session) ]
    The six-minute walk test (6MWT) measures the distance an individual is able to walk over a total of six minutes on a hard, flat surface. The goal is for the individual to walk as far as possible in six minutes. The individual is allowed to self-pace and rest as needed as they traverse back and forth along a marked walkway.



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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • stroke
  • lives within the Victoria, Vancouver Island, and Vancouver mainland communities

Exclusion Criteria:

  • inability to stand for 5 minutes unassisted

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02232867


Contacts
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Contact: Taryn Klarner, M.Sc. (250) 472-5487 rnl@uvic.ca

Locations
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Canada, British Columbia
Rehabilitation Neuroscience Laboratory Recruiting
Victoria, British Columbia, Canada, V8W 3N4
Contact: Marj Wilder, B.Sc.       mwilder@uvic.ca   
Principal Investigator: E Paul Zehr, PhD         
Sponsors and Collaborators
University of Victoria
Heart and Stroke Foundation of Canada
Canadian Stroke Network
Investigators
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Principal Investigator: E. Paul Zehr, PhD University of Victoria
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Responsible Party: Dr. E. Paul Zehr, University of Victoria
ClinicalTrials.gov Identifier: NCT02232867    
Other Study ID Numbers: 07-480-04d
First Posted: September 5, 2014    Key Record Dates
Last Update Posted: September 5, 2014
Last Verified: September 2014
Keywords provided by Dr. E. Paul Zehr, University of Victoria:
rehabilitation
stroke
walking
interlimb connections
Additional relevant MeSH terms:
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Stroke
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases