Rehabilitation interventions including resistance training, functional and task-specific therapy, and gait or locomotor training have been shown to be successful in improving motor function in individuals with neurologic disease or injury. Recent investigations conducted in our laboratory indicate that intense resistance training coupled with task-specific functional training lead to significant gains in functional motor recovery. Similarly, gait rehabilitation involving intense treadmill training and/or task-specific locomotor training has been shown to be effective in improving locomotor ability. However, the underlying neural adaptations associated with these therapeutic approaches are not well understood. Our primary goal is to understand the motor control underpinnings of neurologic rehabilitation in order to apply this knowledge to future generations of therapeutic interventions.
RESTORE is a database of individuals who are interested in being contacted about future stroke research at the Medical University of South Carolina. Included in the database is health information and characteristics about the individual's health, stroke, and their recovery. The results of other stroke recovery studies the individual participates in at MUSC will also be in the database. The database and information included will lead to better and more targeted recruitment for stroke recovery projects.
Reflexes are important parts of our movements. When reflexes are not working well, movements are clumsy or even impossible. After stroke, reflex responses may change. Researchers have found that people can learn to increase or decrease a reflex response with training. Recently, we have found that rats and people with partial spinal cord injuries can walk better after they are trained to change a spinal cord reflex. Thus, learning to change a reflex response may help people recover after a nervous system injury. In this study, we aim to examine whether learning to change a spinal reflex through operant conditioning training can improve movement function recovery in people after stroke or other damage to the nervous system.
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.
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).
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.
ARCADIA is a multicenter, biomarker-driven, randomized, double-blind, active-control, phase 3 clinical trial of apixaban (Eliquis) versus aspirin in patients who have evidence of atrial cardiopathy and a recent stroke of unknown cause. 1100 subjects will be recruited over 6 years at 120 sites in the NINDS StrokeNet consortium. Subjects will be followed for a minimum of 1.5 years and a maximum of 7 years for the primary efficacy outcome of recurrent stroke and the primary safety outcomes of symptomatic intracranial hemorrhage and major hemorrhage other than intracranial hemorrhage.
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.
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.
Stroke survivors with arm paresis because of stroke use their "good" arm for daily activities, but in doing so may be self-limiting their own recovery of the "bad" arm. Traditional models of stroke rehabilitation fail to fully engage the survivor and care partner(s) in actively planning post-discharge habits that improve their capacity to live well over their entire lives. This study will test a cutting-edge in-person therapy + online training program designed to progressively transfer the responsibility of driving post-stroke recovery from the therapist to the survivor.