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Internally Versus Externally Guided Body Weight-Supported Treadmill Training (BWSTT) for Locomotor Recovery Post-stroke

This study has been completed.
Information provided by (Responsible Party):
VA Office of Research and Development Identifier:
First received: July 28, 2005
Last updated: October 27, 2014
Last verified: October 2014

July 28, 2005
October 27, 2014
September 2005
December 2009   (final data collection date for primary outcome measure)
Physiological and biomechanical effects of Body Weight Supported Treadmill Training [ Time Frame: 20 Weeks plus a 6 month follow-up. ] [ Designated as safety issue: No ]
Overground gait speed and gait dependency following each treatment and at six months post-intervention, Health-related quality of life (Reintegration to Normal Living Scale).
Complete list of historical versions of study NCT00125619 on Archive Site
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Gait kinematics and kinetics, 6:00 timed walk, Stroke Impact Scale, Beck Depression Scale
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Internally Versus Externally Guided Body Weight-Supported Treadmill Training (BWSTT) for Locomotor Recovery Post-stroke
Internally v. Externally Guided BWSTT for Locomotor Recovery Post-stroke
The overriding goal of this proposal is to identify the critical physiological and biomechanical effects of BWSTT for promoting improved locomotor function in persons with post-stroke hemiparesis.

The investigators hypothesize that key differences are present in both biomechanical (i.e., loading, kinetic energy at toe off, trunk energetic cost, muscle tendon lengthening velocity) and physiological (i.e., temporal patterning of intermuscular electromyogram [EMG], central reflex modulation) constituents of locomotion between internally and externally-driven modes of BWSTT. Externally-driven BWSTT (Lokomat) produces a more controlled, consistent and mechanically appropriate locomotor pattern promoting positive adaptation in the spinal locomotor circuitry and improved integration of descending motor drive which in combination promote improved gait dynamics. These therapeutically-induced differences will be manifest in the ability to generalize the effects of BWSTT to overground locomotion and will include: improved gait symmetry, increased knee flexion during swing phase, normalization of limb kinetic energy at the stance-to-swing transition, and the ability to scale gait speed effectively between self-selected and fast speeds. The investigators further hypothesize that externally-driven BWSTT will produce more persistent treatment-related effects.

In this pilot study, the investigators will conduct a series of twelve single-case, ABA or BAB, designs in which hemiparetic subjects will experience both internally and externally-driven BWSTT. Training parameters (i.e., body weight support, treadmill speed and support stiffness) will be held constant between modes of BWSTT and physiological and biomechanical responses will be compared between modes for individual subjects. Adaptations in overground gait parameters (i.e., limb kinetic energy at toe off, knee flexion, trunk mechanical energetic cost, gait symmetry, gait speed) will be compared using reference normal gait data obtained from non-disabled, age and gender-matched control subjects walking at matched speeds. The response of non-disabled control subjects to both forms of BWSTT will also be studied.

Not Provided
Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Crossover Assignment
Masking: Single Blind (Subject)
Primary Purpose: Treatment
Cerebrovascular Accident
Behavioral: Rehabilitation: Two Forms of Locomotor Training for Gait
Individuals receive locomotor training on two devices - a treadmill with body weight support while therapists assist the movement of the paretic leg and a robotic device called the Lokomat that moves your legs over a treadmill with body weight support.
Arm 1
Post-Stroke hemiparesis
Intervention: Behavioral: Rehabilitation: Two Forms of Locomotor Training for Gait

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
December 2009
December 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Clinical diagnosis of cerebrovascular accident
  • Single event
  • Unilateral hemiplegia
  • Locomotor disability
  • Ability to walk independently 25' on level ground (may use an assistive device [cane or walker]; may NOT use a brace)
  • Cognitive ability to follow 3-step commands

Exclusion Criteria:

  • Unstable or uncontrolled blood pressure
  • Uncontrolled seizures
  • Severe cognitive impairment
18 Years and older   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
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VA Office of Research and Development
VA Office of Research and Development
Not Provided
Principal Investigator: Carolynn Patten, PhD North Florida/South Georgia Veterans Health System
VA Office of Research and Development
October 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP