Hand disability after stroke has a profound negative impact on functional ability and independence. Hand therapy may be augmented with sensory stimulation for better outcomes. We have developed a novel sensory stimulation - unfelt vibration applied via a wristwatch. In this study, we will determine if combining this stimulation with hand task practice is superior to hand task practice alone.
Fatigue is a common and disabling symptom post-stroke.
Causes of post-stroke fatigue are not well known.
This study will investigate how changes in the way the brain communicates may be associated with post-stroke fatigue.
To do this the investigators will use transcranial magnetic stimulation, TMS, to measure how the brain communicates.
TMS uses a magnet that turns on parts of the brain, and researchers can measure the response by placing sensors on specific muscles in the legs.
The researchers will also measure how you walk by placing sensors on your body and having you walk on a treadmill.
The purpose of this study is to determine if 3-dimensional finger force training is an effective tool in restoring hand function post stroke. Persons who survived a stroke 3 to 9 months ago and have a hand impairment will be eligible to participate in this study. Participants will be asked to come to the laboratory to practice controlling the finger force generation 3 times a week for 6 weeks. Participants will see their performance on a computer screen. Participants will also come to the laboratory for additional 4-7 visits for assessments of their upper extremity function. The total duration of the study will be 2.5 months.
This research is being done to figure out whether treatment for sleep apnea, in people who have had a stroke or TIA, improves recovery from stroke, and helps prevent future stroke, heart problems, and death.
The intervention being tested is called continuous positive airway pressure (CPAP). The U.S. Food and Drug Administration (FDA) has approved CPAP for the treatment of obstructive sleep apnea.
A total of 15,010 patients are expected to enroll in this study and be screened for sleep apnea across about 110 sites in the United States. About 3,000 are expected to participate in the second part of the study, in which sleep apnea treatment is tested. Participation in this study is approximately 6 months.
Post-stroke hand impairment diminishes stroke survivors' ability to perform activities of daily living. Motor recovery has been shown to improve through peripheral sensory stimulation. This study aims to determine if vibration from a smartwatch improves post-stroke hand function.
In-person delivery of structured, progressive home exercise programs during the subacute phase of stroke recovery has documented efficacy; however, in-person programs are resource-intensive and not economically sustainable. Advancements in telehealth are opening new avenues for efficient and scalable delivery of services. We will examine "tele" delivery of an important component of post-stroke care, exercise during community reintegration.
The purpose of this research study is to understand how the brain communicates with the muscles in the leg in people who have sustained a stroke by using a type of brain stimulation called transcranial magnetic stimulation, or TMS. TMS has been used successfully in numerous investigations but we are not confident of which measures are best to use in those with stroke. The purpose of this study is to establish how best to collect these measures when walking ability is of primary concern. In this study participants will undergo testing while sitting comfortably, which is standard practice, and then again while standing, our experimental condition.
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.