Stroke survivors with arm paresis because of stroke use their "good" arm for daily activities, but in doing so may be self-limiting their own recovery of the "bad" arm. Traditional models of stroke rehabilitation fail to fully engage the survivor and care partner(s) in actively planning post-discharge habits that improve their capacity to live well over their entire lives. This study will test a cutting-edge in-person therapy + online training program designed to progressively transfer the responsibility of driving post-stroke recovery from the therapist to the survivor.
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.
The purpose of this research study is to determine if it is helpful to provide a peer-supported, health promotion intervention, known as PHOENIX, for people with spinal cord injury using telehealth. An additional purpose of this research is to test if PHOENIX has an effect on community participation, quality of life, and prevention of secondary conditions, such as pressure injuries and urinary tract infections, in people with spinal cord injury. Participants in PHOENIX will complete a 16-week spinal cord injury self-management program using iPads, provided by the study, to access online educational content and participate in video visits (weekly for the first 8 weeks, then every other week for the last 8 weeks) with a peer mentor who also has a spinal cord injury. There are 12 video visits in total and each visit will take about 1 hour. Participants will also be asked to complete a series of questionnaires several times while enrolled in the study. Participants will also be asked to take part in a group discussion or an interview to provide feedback on the PHOENIX program at the end of the study.
Depression contributes directly to disability following a stroke and is the single strongest predictor of quality of life. Treatment of depressive symptoms is associated with better functional recovery and return to activities of daily living. Resistance training can effectively improve post-stroke mobility and has the potential to serve as an alternative (non-drug) anti-depressant treatment option. The purpose of this study is to assess the effects of resistance training on post-stroke depressive symptoms.
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.
This research studies the effects of brain stimulation (transcranial magnetic stimulation, or "TMS") on balance in progressive supranuclear palsy (PSP). The purpose of this research is to look for improvements in balance when subjects are on a tilting platform after stimulating the brain with a magnetic wand held over the scalp over an area at the back of the brain called the cerebellum. Participants will receive both active and inactive stimulation during the course of the study. There is no surgery involved. There are also optional portions of the study that include functional magnetic resonance imaging (fMRIs) and speaking samples.
The goal of this study is to improve FES-cycling which is a common therapy. We will test a new method of adjusting the FES intensity to maintain a constant pedaling speed. We are looking for participants 18-75 years old who experienced a stroke more than 3 months ago. The study will last a single session.
After stroke, it is common for individuals to have difficulty attending to the affected side of their body or to the affected side of space (neglect). Rehabilitation therapists use many different clinical assessments to measure this inattention. However, it is unclear whether items from some of the most commonly used assessments are able to effectively and comprehensively measure inattention. Rehabilitation therapists use clinical assessments to inform treatment and document patient progress. Therefore, it is important that we examine these existing assessments.
Individuals with neglect frequently experience weakness in their arm/hand. This study also examines the effects of non-invasive brain stimulation (transcranial direct current stimulation) and arm/hand rehabilitation training (repetitive task-specific practice) on excitability in the brain, attention, and arm movement ability.
The study will use a new method for non-invasively examining the brain called Transcranial Magnetic Stimulation (TMS). TMS involves placing a coil of wire above the scalp and intermittently passing a very powerful current through it. This current produces energy in the form of a magnetic field that passes through the scalp. The magnetic field, in turn, induces a much weaker electrical current in the brain, causing the neurons directly under the coil to activate for a brief period of time. The U.S. Federal Drug Administration has approved TMS as a method for treating depression since 2008. By using TMS, we can evaluate how well your brain is controlling one of your hand or leg muscles. One way to measure this is by recording activity via electrodes on the hand opposite the side of the brain being stimulated. For example we will be stimulating on the left side of the brain and recording from electrodes on your right hand. In this study we are determining the effects of different types of repetitive Transcranial Magnetic Stimulation (rTMS) protocols on hand movement. rTMS means that the magnetic pulses are applied consecutively, and at a specified pace- the frequency. The specific type of rTMS you will receive is called "theta-burst stimulation" (TBS). TBS is characterized by a specific frequency of stimulation.
Speech and language therapy for the management of aphasia (a language impairment that often occurs as a result of a stroke) is generally shown to be effective. However, the reasons that certain treatments may work for some individuals, and not others, and why some individuals do not respond to treatment is largely unknown. In this study, we plan to identify and model the relationship between many different factors (such as personal/biographical factors and an individual's baseline cognitive and language abilities) to help predict aphasia treatment outcome. Participants will be recruited for speech and language testing, brain imaging (MRI), and aphasia treatment (as warranted).