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.
Multi-arm Optimization of Stroke Thrombolysis (MOST): The goal of this study is to determine the effectiveness of combining a drug known as tissue plasminogen activator, or tPA, with blood thinners argatroban or eptifibatide. The research will look at whether combining tPA with either argatroban or eptifibatide will produce better results in stroke patients in the first 90 days after suffering a stroke versus tPA with a placebo. The safety of argatroban and eptifibatide in combination with IV rt-PA and endovascular thrombectomy will also be assessed.
The plan is for 110 hospitals to take part in the study through NIH StrokeNet, the University of Cincinnati based National Coordinating Center for all stroke trials funded by the National Institute of Neurological Disorders and Stroke. A maximum of 1200 subjects will be enrolled.
The first 150 subjects will be randomized in a 1:1:1 ratio to either argatroban, eptifibatide, or placebo. From the 150th to the 500th subject enrollment, response adaptive randomization (RAR) will favor the active arm showing the greatest benefit based on accrued data. After 500 subjects, one or both intervention arms may be carried forward for fixed randomization versus placebo.
Stroke affects millions of Americans and is a leading cause of disability. In addition to chronic disability, many survivors experience depressive symptoms such as reductions in mood and motivation. Post-stroke depression (PSD) is associated with poorer recovery from stroke, increased health care costs and higher mortality. Additionally, PSD may interfere with the recovery of the nervous system after stroke. Effective treatment options for PSD are limited and often come with side effects, highlighting the need for alternative treatment approaches. Aerobic exercise (AEx) has positive effects on the nervous system, is a powerful anti-depressant, and has limited side effects, yet remains underutilized in stroke survivors with PSD. This study will examine the short-term effects of AEx on the nervous system in stroke survivors with and without PSD. The results will serve as a foundation for the study of AEx as a treatment for PSD.
This study is to determine which stroke patients will develop moderate-to-severe limb tightness (spasticity) or limb weakness 90 days after a stroke.
Inpatients at Medical University of South Carolina, 21 years old or older, with first-ever stroke with limb tightness or weakness on one side can participate.
This study has 3 visits in 90 days.
The data from this study will then be combined with existing data to develop a simple bedside assessment for post-stroke limb spasticity 90 days post-stroke.
The goal of this pilot study is to determine whether a repetitive high-dose form of non-invasive brain stimulation is a promising and safe treatment for stroke-related cognitive difficulties. Repetitive transcranial magnetic stimulation (rTMS) is an FDA approved treatment for depression, and is used commonly to treat people for their depression. In studies of rTMS for depression and other disorders, individuals have experienced improved cognitive function. Thus, we are testing here whether cognitive function in individuals with chronic stroke could be improved by rTMS.
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.
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.
This study is gathering patient information and a saliva sample from people who have had a type of stroke called an intracerebral hemorrhage (ICH). Risk factors will be identified and analyzed for their contribution to the ICH as well as their effect on long term patient outcomes. Patients will be contacted over phone at 3 and 12 months after enrollment and asked a series of short questions about how they are feeling, how hard or easy it is to perform daily tasks, and any change in medication.
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.