Approximately 80% of stroke survivors have hand impairment. A majority do not fully recover their hand function despite completing standard rehabilitation. Limited hand function results in learned non-use not only of the hand but also of the whole arm. This limited upper limb movement results in decreased independence and poor quality of life. It is known that training for proper movement patterns is important especially early in rehabilitation. The purpose of this project is to determine if training using hand exoskeleton to improve finger movement is feasible in stroke patients. Stroke survivors will receive training with 4 different control strategies to improve finger joint coordination.
Portable Neuromodulation Stimulator (PoNS) is non-invasive stimulation device placed on the tongue to stimulate those brain regions understood to be important for maintaining balance. This research study aims to collect evidence that PoNS therapy along with balance training improves postural and walking stability post-stroke.
Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation method often used to assess connectivity between the brain and specific muscles. This research study is aimed at finding the changes in the manner brain communicates with leg muscles post-stroke and its effects on movement coordination during walking.
Newborns who are born premature or suffer brain injury at birth are at risk for motor problems that may cause weakness in reaching and grasping on one side of the body. In older children, therapists may use a hand mitt and restraint for the stronger arm, to encourage use of the weaker side, called constraint-induced movement therapy (CIMT). Even with the high intensity therapy of CIMT, it typically takes between 40-120 hours total treatment time for most children to improve their motor skills. A non-invasive form of nerve stimulation, transcutaneous auricular vagus nerve stimulation (taVNS), stimulates a nerve by the ear that enhances learning motor skills. The purpose of this study is to evaluate the safety and effectiveness of taVNS to improve motor skills when paired with CIMT in infants with one-sided weakness at 6-18months of age.
We propose to enroll 150 individuals with acute stroke admitted to MUSC over the next 12 months and randomize them into increased frequency and usual care PT treatment groups. This study will be designed as a randomized control trial. Patients who agree to participate, will be assigned (at random) to either a treatment group which will receive more frequent intensive therapy services or to the control group (treatment as usual) which will receive the standard amount of therapy services currently provided in the hospital setting (~3-5 times per week). By studying the balance, walking and success of patients in the treatment group compared with the standard of care group- we hope to better understand the effect of more frequent physical therapy services on a patient's independence post stroke.
Hand and arm disability after stroke has a profound, negative impact on functional ability and independence. Basic science research suggests that recovery requires high repetitions of task-specific practice. Enough practice cannot be completed during therapy sessions, requiring patients to perform additional task practices at home on their own. Adherence to these home task practices is often limited and is likely a factor reducing the effectiveness of rehabilitation post-stroke. This project will create a system to objectively track stroke survivors' hand and arm task practice at home. The quantity and quality feedback from the system is expected to optimize effective task practice at home by patients. The system is expected to also enable adherence- and progress-driven clinic visits to maximize efficiency of therapy service.
This research is being done to help us understand whether and how the use of a drug, called escitalopram (a selective serotonin reuptake inhibitor or SSRI), may improve language therapy effectiveness, as measured when naming untrained pictures and describing pictures, in individuals with aphasia within three months after a stroke.
Another goal of part of this study is to investigate the particular concentration of certain molecules in the brain of people with following a stroke and how the SSRI might change this. This will allow us to better understand how brains change in people receiving language therapy.
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.
The purpose of this research project is to evaluate the effectiveness of a mobile health (mHealth) application in improving adherence to hydroxyurea therapy in patients with Sickle Cell Disease (SCD). Participants will be asked to install an application on their phone that will remind them to take their medication regularly. It notifies the participants when it is time to request a refill, it tracks their hydroxyurea use, and it gives them information on their medication. It also has resources that could be helpful for the ongoing care of their sickle cell disease. This is a 24-week project with 3 study visits. The first study visit will be at the beginning of the study period (enrollment or baseline visit), the second will be at approximately 12 weeks, and the third is at the end of the 24 weeks. At each visit, participants will complete a survey, share with us their experience with the application, and share with us where they refilled their medications. Some participants will also be asked to complete an interview at the end of their final study visit. Patient participants will receive a $25 Walmart Gift card at each of visits (including an additional $25 gift card for the optional interview) for their participation.