Stroke is a leading cause of disability in the U.S. and many Veteran stroke survivors live with severe disability. Despite recent advances in rehabilitation treatments many stroke survivors have persistent physical and mental difficulties such as reduced arm and leg function, difficulty thinking, and depression.
Developing treatments that address these problems is necessary to improve long-term recovery for stroke survivors. Aerobic exercise (AEx) can improve physical and mental function, and reduce depression. Additionally, AEx may enhance physical rehabilitation by making the brain more receptive to, and consequently improving the response to a rehabilitation treatment. Therefore, combining AEx with physical rehabilitation has the potential to improve multiple parts of stroke recovery. This study will examine the effect of combining AEx with physical rehabilitation on physical and mental function in stroke survivors. By gaining a better understanding of the effects of this combined intervention we aim to advance the rehabilitative care of Veteran stroke survivors.
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.
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 12 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.
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.
Walking after a lower extremity amputation is often difficult. It is important that researchers and clinicians understand the mechanisms that inhibit normal walking function. In this study, we are recruiting individuals with lower extremity limb loss for a walking and balance investigation. We will also be studying matched healthy controls to do similar study procedures. All study procedures will occur on the campus of MUSC by a licensed Physical Therapist and experienced researcher. Any questions should be directed to the coordinator listed.
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.
The overall goal of this feasibility study is to evaluate an individualize behavioral health program that leverages home telehealth technology to 1) directly teach low and fixed income older adults residing in the community to reduce their pain and fatigue by improving mobility; and, 2). to teach caregivers of persons with dementia to reduce stress, fatigue, and promote their and their loved-ones quality of life.. Specifically, the integrated intervention includes components to address (1) balance and fall prevention (Otago), (2) strengthening and mindfulness (Yoga), and importantly, (3) affective state and social support which are crucial to maintaining motivation (Behavioral Activation). Moreover, these 3 best practices interventions will be enhanced by integrating physical activity data tracking to complement self-report measures, the former of which will be available in real time for patient and provider review, with parameter violations (eg, non-activity during scheduled activity time; overall activity level lower for a set period of time) triggering brief telehealth sessions to address any problems. Finally, participant qualitative feedback will be captured through voice/video recorded diaries focusing on experienced pain, fatigue, sleep, personal reactions to the project and physical activity as well as technology issues they may encounter.
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.