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.
The purpose of this research study is to understand the association between heart and brain health in a population of 40-75 year olds. In this study, we will work to better understand blood vessel stiffness and brain function in African American and non-Hispanic white individuals. You will be asked to give blood during the study visit. Additional information will be obtained to help the researcher better understand the blood vessel and brain function data collected. There is only one study visit that last roughly 2 hours and compensation will be available.
After stroke, it is common for individuals to experience hand impairment. This deficit can severely restrict functional ability and independence. Recovery of hand function following stroke is highly variable. In this study, we will use brain imaging to predict individual response to treatment after only one therapy session. Survivors of stroke will receive upper extremity therapy with a novel intervention using a smart watch. The device applies imperceptible vibration to the wrist and has been shown to immediately improve chronic stroke survivors' touch sensation and hand dexterity in preliminary studies.
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.
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.
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.
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.
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.
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).
This study has 4 parts: In one part of this study, people with stroke will either play a custom designed computer game for stroke rehabilitation called Duck Duck Punch or an off the shelf computer game with their weaker arm 3 times per week for 6 weeks. Evaluations will determine whether or not one computer game improved arm movement more than the other. In the 2nd part of the study, people with stroke, caregivers of people with stroke and stroke rehabilitation therapists will meet in several focus groups to design a useful and informative Duck Duck Punch performance report. In the 3rd part of the study we will test the accuracy of the Duck Duck Punch tracking system. Finally, in the 4th part of the study, we will test a new online class to teach about how to carry on stroke rehabilitation after the therapy ends.