This study explores the use of a new form of neuromodulation known as transcutaneous auricular vagus nerve stimulation (taVNS) which stimulates the ear. This stimulation will be delivered concurrently with upper limb motor rehabilitation training (3 days/week for 4 weeks) in chronic stroke patients. Patients will undergo a series of baseline assessments (including a brain scan), a 4-week course of motor rehabilitation, and post-assessments (including a second brain scan).
The objective is to determine if continuous use of TheraBracelet in the home has a clinically meaningful effect in chronic stroke survivors. The study design is a double-blinded randomized controlled trial. We will enroll 40 chronic stroke survivors with moderate hand impairment. Subjects will be randomly assigned to the treatment or control group (n=20 per group). All subjects will wear the TheraBracelet device on the paretic wrist for 8 hours/day every day during their normal daily activity for 1 month. The device will deliver vibration (treatment) or no vibration (control). Double-blinding is possible because the treatment vibration is imperceptible (i.e., subthreshold). Measures of neural plasticity, the amount of the paretic arm use in daily living, clinical hand function, biomechanical grip control, and self-reported abilities for activities of daily living will be assessed at baseline, once a week during the month of wearing the device, and for 3-month follow-up, allowing determination of the efficacy and persistence.
This research is being done to find out if brain stimulation combined with a rehabilitation therapy improves arm weakness as a result of having a stroke. The stimulation technique is called transcranial direct current stimulation (tDCS). The treatment uses direct electrical currents to stimulate specific parts of the brain. The rehabilitation therapy is called "modified Constraint Induced Movement Therapy" (mCIMT). During this rehabilitation therapy study participants will wear a mitt on the hand of the arm that was not affected by their stroke. It is designed to restrain the use of the unaffected arm, while performing therapy with impaired one.
It is not known if brain stimulation combined with rehabilitation therapy will improve arm weakness. Study participants will receive rehabilitation therapy while on this study. Study participants may or may not receive the brain stimulation therapy.
This study seeks to identify the impact of structured communication between Registered nurses (RNs) and Unlicensed Assistive Personnel (UAP) to decrease the fall rate and number of injurious falls on a Medical-Surgical unit. A seven item tool addressing fall risks (pocket card) will be utilized to communicate fall risks on admission, at hand off of care, and every 4 hrs.
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.