Feasibility and Potential Efficacy of High-Intensity Gait Training in Individuals with Cerebellar Damage
High-Intensity Walking Training for Brain Movement Control
T. George Hornby
Brief description of study
The purpose of this research study is to investigate which type of physical therapy intervention best improves mobility, function, and other measures of health for individuals with damage to the cerebellum, which is a specific region of the brain.
Detailed description of study
- Participation in this study will last approximately 5 months and involves 5 testing sessions and 40 training sessions with all testing and training occurring at the Rehabilitation Hospital of Indiana.
- Of the five testing sessions, the first two will occur before training begins and happen approximately one week apart. The third testing session will occur after all of the training sessions for the first type of physical therapy are completed. The fourth testing session will occur before the second type of physical therapy begins, while the fifth will occur after it ends.
- There are two different types of physical therapy being performed in this research study and enrolled participants will ultimately receive up to 20 training visits of each type of physical therapy. In one type, training sessions will focus on walking practice in different environments (e.g., treadmill, stairs, overground) while targeting higher heart rates and generally perceived as 'hard' to 'very hard' by the individual. In the other type, training sessions will focus on practicing balance activities performed on various stable and unstable surfaces and potentially involve the upper and lower extremities.
- The order of the physical therapy interventions will be randomized (i.e., coin flip) and participants will have the opportunity to complete up to 20, one-hour training sessions over 8 weeks, before taking a break of at least 1 month, and then returning to complete up to 0, one-hour training sessions over an additional 8 weeks of the other training intervention.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Stroke, Brain injury, Cerebellar dysfunction
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Age: 18 years - 85 years
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Gender: All
Eligible individuals must be 18-85 years of age and greater than 6 months following a stroke or brain injury affecting the cerebellum or have a diagnosis of cerebellar dysfunction. They also must demonstrate at least moderate levels of ataxia (i.e., deficits in coordination) on clinical assessment, be able to walk a short distance with their usual assistive device and no more than minimal physical assistance for balance at a reduced speed, weigh less than 350 pounds, the ability to follow a three step command, and have written medical clearance from an appropriate medical provider. Individuals are not able to participate in this study if they have uncontrolled health, orthopedic, or neurologic conditions that make it unsafe to participate in the research activities. Individuals currently participating in physical therapy and those that have received botox injections in a leg within the last three months and those that demonstrate large differences in their performance during the first two testing sessions may not be eligible.
This study investigates the use of high-intensity gait training for people with cerebellar damage. Cerebellar damage can occur due to stroke, brain injury, or other conditions affecting the cerebellum, which is a part of the brain that helps control movement. The purpose of this study is to see if high-intensity stepping training is safe and feasible for these individuals and to compare its effectiveness to conventional training in improving walking endurance.
Participants will be randomly assigned to either high-intensity stepping training or conventional training. They will attend up to 20 training sessions over 8 weeks. After this period, they will take a break for at least one month before switching to the other type of training for another 8 weeks. Testing will be conducted before, during, and after each training period to assess progress.
- Who can participate: Adults aged 18 to 85 with cerebellar damage who can walk 10 meters and follow instructions can join. Medical clearance is needed.
- Study details: Participants will practice walking at different intensities in training sessions. They will switch training types after a washout period (a break period between treatments).
- Study timelines and visits: The study will last 8 weeks per training period. The study requires 20 visits.
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