Exercise Primed Stroke Rehabilitation

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · May 3, 2021

Keywords

ClinConnect Summary

This clinical trial, called Exercise Primed Stroke Rehabilitation, is exploring how combining aerobic exercise with physical rehabilitation can help improve recovery for stroke survivors. Stroke often leads to lasting challenges, including difficulty with movement, thinking, and feelings of depression. By looking at how regular aerobic exercise might enhance the effects of rehabilitation, the study aims to help stroke survivors regain physical and mental abilities more effectively.

To be eligible for this study, participants should be between 50 and 90 years old and have had a stroke at least six months prior. They need to have some movement in their affected arm and be able to follow simple instructions. Participants can expect to engage in both aerobic exercises and rehabilitation activities, with close monitoring by healthcare professionals. This research is particularly important for veterans, as it seeks to improve their rehabilitation experiences and outcomes after a stroke.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • experienced unilateral stroke at least 6 months prior;
• • voluntarily shoulder flexion of the affected arm 20 degrees with simultaneous elbow extension 10 degrees;
• • moderate arm movement impairment (UE Fugl-Meyer Assessment \> 21 but \< 52 points;
• • passive range of motion in paretic shoulder, elbow, wrist, thumb and fingers within 20 degrees of normal;
• • 50-90 years of age;
• • ability to communicate as per the therapists' judgement at baseline testing;
• • ability to complete and pass an exercise tolerance test; 8) Box \& Block test score of at least 3 blocks in 60 seconds with the affected arm.
• Exclusion Criteria:
• • lesion in brainstem/cerebellum as these may interfere with visual-perceptual/cognitive skills needed for motor re-learning;
• • presence of other neurological disease that may impair motor learning skills;
• • orthopedic condition or impaired corrected vision that alters reaching ability (e.g., prior rotator cuff tear without full recovery);
• • paretic arm pain that interferes with reaching;
• • unable to understand or follow 3-step directions;
• • severe cognitive impairment (MoCA score 17);
• • severe aphasia;
• • inability to read English,
• • history of congestive heart failure, unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during ADL's;
• • Severe hypertension with systolic \>200 mmHg and diastolic \>110 mmHg at rest;
• • History of COPD or oxygen dependence;
• • History of DVT or pulmonary embolism within 6 months;
• • Uncontrolled diabetes with recent weight loss, diabetic coma, or frequent insulin reactions;
• * UBACC score \< 15; and for brain stimulation procedures only:
• • electronic or metallic implants;
• • history of seizures;
• • women of child bearing potential.