Walking after a lower extremity amputation is often difficult. It is important that researchers and clinicians understand the mechanisms that inhibit normal walking function. In this study, we are recruiting individuals with lower extremity limb loss for a walking and balance investigation. We will also be studying matched healthy controls to do similar study procedures. All study procedures will occur on the campus of MUSC by a licensed Physical Therapist and experienced researcher. Any questions should be directed to the coordinator listed.
Stroke is the leading cause of disability, as many of those affected demonstrate difficulty with movement and
walking. Rehabilitation post-stroke can be challenging and often ineffective because no two stroke survivors
present with the same mobility impairments, yet the same physical therapy interventions are utilized. Thus, a need exists to personalize rehabilitation techniques to improve function and mobility post-stroke. The proposed innovative research will test a framework created to identify the most effective intervention based on a participant's specific motor control problems. We plan to study how self-selected walking speed is impacted by a four-week walking program that incorporates either walking on an inclined or declined treadmill compared to walking on a flat treadmill. We will determine the best intervention for each problem and identify predictors of response. Selecting the correct intervention for personalized motor control problems, as opposed to applying a one-size-fits-all strategy for rehabilitation, is likely to improve walking function in Veterans after stroke.
Walking is important to persons who have had a stroke and better rehabilitation methods are needed to restore or improve their walking. This project will investigate ways to improve upon and diagnose the specific underlying impairments. Future work will allow clinicians, such as physicians and physical therapists, to make measurements in their clinic to better diagnose a person's specific walking deficit, design a specific treatment plan, and monitor its ability to restore or improve the person's walking.
Individuals with chronic stroke (greater than 6 months post-stroke) will be evaluated to assess the effects of repetitive transcranial magnetic stimulation (rTMS) on walking function. Contributors to walking such as lesion size and location, brain activation, strength, force production during walking, and biomechanical variables will also be assessed. Each individual will be examined with excitatory, inhibitory and sham stimulation to assess the effects on the above variables. In addition, each type of stimulation will be combined with a walking rehabilitation program to determine the affect of adding rehabilitation. Each participant will be requested to undergo 8 sessions.
Rehabilitation interventions including resistance training, functional and task-specific therapy, and gait or locomotor training have been shown to be successful in improving motor function in individuals with neurologic disease or injury. Recent investigations conducted in our laboratory indicate that intense resistance training coupled with task-specific functional training lead to significant gains in functional motor recovery. Similarly, gait rehabilitation involving intense treadmill training and/or task-specific locomotor training has been shown to be effective in improving locomotor ability. However, the underlying neural adaptations associated with these therapeutic approaches are not well understood. Our primary goal is to understand the motor control underpinnings of neurologic rehabilitation in order to apply this knowledge to future generations of therapeutic interventions.