Stroke is the leading cause of long-term disability in the United States and less than 50% of survivors regain independent ambulation. While lower extremity performance is a prime target of rehabilitation, little is known about patterns of neural function and structure which may influence, or be influenced by recovery of coordinated, lower extremity function. In this pilot study, we are developing a paradigm to measure lower extremity movement on brain function. Heathy controls will undergo 2 MRI scans wherein we will measure the brain activity associated with lower extremity movement.
The purpose of this study is to determine if giving the medicine "heparin" intravenously (through the veins) continuously for up to 14 days to subjects after a brain aneurysm has burst will help improve the chances of subjects having a good recovery after the bleed compared to subjects who get routine brain aneurysm care (standard of care). Patients who get routine care would also get heparin, but they would typically get an overall lower dose and the heparin would be injected under the skin (heparin shot) instead of in the veins.
The Palliative Performance Scale has been shown to predict survival among hospice and palliative medicine patients in the outpatient and inpatient clinical settings, where lower PPS scores are directly related to shorter survival. We seek to evaluate if this relationship persists among a racially diverse, older adult population when assessed at the time of admission from the emergency department.
Many individuals who volunteer to participate in research studies are never informed about the results of those studies, and what the researchers learned from having conducted them. We believe that if researchers share results of studies with those who participated in them as volunteers, these past participants may be more likely to feel positively that they have contributed to improving the health in their communities, be more likely to enroll in other studies in the future, share their experience with others, encourage others to participate in research, and experience other positive outcomes. We want to know people's feelings about the importance of receiving study findings and how they would prefer to receive such information (what channels/formats, what kinds of messages, etc). In this study, we are looking to get the feedback of adolescents (ages 15 through 24) and older adults (50 and over) who completed their participated in an MUSC study between January 1, 2010 and present. We are also looking for MUSC researchers whose research studies have included adolescents and older adults between January 1, 2010 and the present, to get their feedback on their current strategies of sharing findings and what they believe might be best practices for doing so. Participation in our study will involve surveys and focus groups interviews.
This study, for stroke survivors with partial paralysis of one arm, will test whether or not an arm exoskeleton (the MyoPro Motion-G) immediately impacts arm movement more than a regular brace or more than wearing no brace. A stroke survivor who is 1 year or more post-stroke will qualify for this study if he/she has at least a little movement in the more affected arm. Subjects who qualify will come to MUSC 4 times over 3 weeks for about 2-3 hours per visit. During that time subjects will be fit for, and learn how to operate the exoskeleton and the comparison brace. Subjects' arm movement will be tested with a series of standard clinical measures of dexterity, functional task performance, range of motion, and strength.
The purpose of this clinical study is to see whether injections of AbobotulinumtoxinA in the upper limb (arm) and lower limb (leg) in combination with a personal exercise plan can improve voluntary movements in subjects with hemiparesis.
Post-stroke hand impairment is highly prevalent and severely restricts functional ability and independence. Yet, there is no assistive device to help hand function at home, every day, during activities of daily living. This study addresses this gap by providing an innovative technology. The "TheraBracelet" is a wristband applying imperceptible white-noise vibration to skin. TheraBracelet is efficacious, as it has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies. TheraBracelet is affordable by using only a low-cost vibrator. TheraBracelet is also translational, because a vibrator strategically placed at the wrist does not interfere with dexterous finger motions, and it is low-risk by involving only imperceptible vibration on skin. These practicalities assure easy adoption in home environment for large impact on sensorimotor impairment. This study is to determine the feasibility and safety of using this assistive device all day every day for a month during daily activity, and to determine if TheraBracelet's instant effects are sustained during prolonged use. This objective will be accomplished in a double-blinded, randomized, controlled, crossover design study. Feasibility (compliance of using the device everyday) and safety will be assessed for the treatment condition compared to the control condition (wearing the device without vibration) through weekly evaluations. In addition, TheraBracelet's instant benefits in improving hand function will be assessed weekly. Persistence of TheraBracelet's instant benefits across all weekly evaluations will support durability (i.e. desensitization to vibration does not occur during extended daily use over a one-month period). This project is expected to lead to an assistive wristband that increases hand function during activities of daily living, thus increasing independence and quality of life and reducing caregiver burden for a large number of stroke survivors with hand impairment.
Many individuals post-stroke have a hard time walking independently and freely in their homes and communities. Therefore, it is not surprising that the number one goal stated post-stroke is to regain walking function and is a central focus in rehabilitation. Current recommendations for improving post-stroke walking speed involves walking at a constant or continuous speed, however an new approach is the use of interval training that includes alternating between higher intensity and low intensity periods. Interval training is shown to result in larger gains in speed in neurologically healthy subjects. Preliminary data show higher intensity interval training to be possible in individuals following stroke, however direct comparisons of interval training to continuous training on walking function are not known. For this study there are two required sessions with the possibility of being asked to participate in additional sessions. A minimum of 48 hours in required between sessions. Each session lasts approximately two and half hours.
Our long term goal is to enhance the locomotion of impaired individuals after a neurological injury.
We are trying to recruit as healthy control participants, and neurologically impaired individuals (incomplete SCI and after-stroke patients) to participate in this study.
For neurologically impaired individuals a physical therapist will complete IRB approved questionnaires to measure your mobility, muscle strength, balance, walking speed, and distance.
All participants will meet with study staff who would then test your reflexes by placing some superficial skin based electrodes behind the knee and apply mild stimulation while standing/sitting.
If enrolled, you may be required to participate for 30 sessions (3 sessions/week), each lasting about one hour over a period of 3 months. Compensation is available for your participation.
We have designed a comprehensive, evidence-based approach to physical therapy rehabilitation after stroke that focuses on the intensity of cardiovascular, strength, and gait training, standardizing the dosage and progression of each type of training. Implementation of this standardization of intensity protocol will be guided via an internet-based (REDCap) interactive program available to each treating therapist. This program will cue the therapist to complete two sessions of cardiovascular, strength, and gait training each week at the appropriate intensity while not being prescriptive about specific activities to meet the stated goals. Eighty individuals with stroke (20 each from Charleston, SC; Anderson, SC; Rock Hill, SC; and York, PA ) who meet inclusion and exclusion criteria and will undergo a standardized evaluation at admission and discharge assessing gait speed, endurance, strength, balance, and overall functional independence and will be compared to 80 individuals with stroke receiving usual care. In addition, each enrollee will participate in a telephone screen at 90 days post-stroke to assess participation, quality of life, falls efficacy, falls history, and stroke-related secondary health conditions/readmissions.