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.
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.
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 2 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 second 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.
People who have experienced a stroke often have an increased risk of falling and decreased confidence in their balance, in part because of an inability to accurately place their feet while walking. Unfortunately, existing therapies have not been able to improve this problem. This study will test whether a novel therapy can improve foot placement accuracy during walking. Specifically, the therapy will involve repeated practice walking on a treadmill, while forces are applied to the legs to affect foot placement.
It is common for stroke survivors to have difficulty attending to the affected side of their body or to the affected side of space after stroke (unilateral neglect). Individuals with neglect frequently experience weakness in their arm/hand also. The purpose of this study is to test the effects of 3 different rehabilitation training sessions that combine non-invasive brain stimulation (transcranial direct current stimulation, tDCS) with arm/hand rehabilitation training (repetitive task-specific practice, RTP). This study is designed to determine the effects of tDCS + RTP on the excitability in the brain, attention to the affected side, and arm movement ability.