Rehabilitation has traditionally focused on the acute stages of stroke and although about 90% of people with chronic stroke ambulate with impaired coordination, there has been only limited effort directed toward remediating the chronic motor loss remaining after patients are discharged from therapy. The proposed project is to investigate an intervention, supported by the principles and theories of massed practice, learned non-use and neuroplasticity, for individuals with chronic deficits of gait, balance, and mobility as a result of stoke. This project will determine the effect of this novel and intensive intervention, referred to as Intensive Mobility Training (IMT), comparing the effects of IMT to that of a control group. The sample for this study is 42 individuals with chronic stroke, who have been discharged from conventional therapy. Both groups will receive intensive training, 3 hours per day for 10 days (30 total hours), with the IMT group receiving locomotor training for one hour of their therapy, thereby determining the essential components needed for this intensive intervention. The outcome measures to be collected are inclusive across the World Health Organization’s International Classification of Functioning, Disability and Health, including measurements of body function and structure, activity, and participation that measure gait, balance and mobility.

An understanding of which patients are likely to benefit most from treatment approaches is crucial, but limited data exist to answer this question. The ability to determine prognosis on the basis of functional ability can lead to a more rational use of treatment approaches. The secondary aim is to identify predictors of successful treatment-assisted recovery.

This study investigates an intensive and novel combination of therapeutic interventions that may be promising in decreasing chronic impairments and disabilities in those with chronic stroke. If an appropriate intervention can be determined resulting in significant improvements with only a two-week, albeit intensive, intervention; this study may have the potential to initiate a change in the delivery and access of therapy services to the over 2.5 million individuals living with chronic motor deficits from stroke.

STROKE RESEARCH STUDY
Intensive Mobility Training (IMT) for Stroke

The following contains information regarding a research study being offered by the University of South Carolina.

In order to participate, you must:

• Have had a stroke more than 6 months ago
• Be able to walk 10 feet with or without assistance
• Be able to stand with or without support for 2 minutes
• Be able to participate in 3 hours of therapy for 10 consecutive weekdays
• Be at least 18 years of age

If you are interested in participating, you will be screened by the University of South Carolina, Department of Physical Therapy Rehabilitation Lab Staff to see if you meet all necessary qualifications.

The purpose of this study is to see if 10 days of a new physical therapy treatment, called Intensive Mobility Training, can produce improvements in walking, balance, and mobility for individuals who have had a stroke.

IMT for Stroke:

• IMT stands for Intensive Mobility Training and refers to a treatment approach that encourages you to use your lower extremities to perform various leg activities that challenge your balance and coordination.
• For this study you will be placed into one of two groups and randomly assigned to one group or the other. You will not be able to choose your group. The 2 groups will receive different modes of IMT therapy; however, the intensity of the two therapies will be the same.
• Prior to the therapy, you will be asked to attend an evaluation session that will last approximately 3 hours. You will perform tests that evaluate your ability to use your lower extremities. Tasks will include activities such as standing, walking, stepping over or around obstacles, and going up and down stairs.
• Following the evaluations, you will undergo 10 days of IMT. The sessions will last approximately 3 hours and will be held on Monday thru Friday at the University of South Carolina.
• You will be asked to perform activities that challenge you, but you are able to do with some help. Possible activities include: gait training, sit-to-stand, stair climbing, various balance activities, range of motion, stretching activities, strengthening activities, coordination tasks, and treadmill training with body-weight support. Below are some examples of activities that may occur during the 3 hour session. Therapy is geared to your individual level of function.
• Re-evaluation sessions: After the 10 days of training, you will be asked to repeat all testing that you performed before the training and then to return 3 months later for another testing session. These testing sessions will again last approximately 3 hours.
• The overall commitment to this study is 18 days plus a 3 month follow-up.
• Benefits to you may include: improved knowledge about your abilities, and possible improvement in movement control. In addition, the information obtained from this study may help improve the treatment of individuals with chronic stroke.
• Participation in this study is entirely voluntary. There is no direct cost for participation in this research study; however, you may incur costs for travel or lodging depending on how far away you live. There is no charge for the therapy.

For more information concerning this research study,
please contact the Rehabilitation Lab at 803-777-2627 or email
RehabLab@gwm.sc.edu