What do Stroke Survivors Actually Learn When Regaining Walking Ability After Stroke? The TARGET Phase I Study

NCT ID: NCT03728036

Last Updated: 2022-09-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

66 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-11-01

Study Completion Date

2022-02-07

Brief Summary

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Phase I: Exploring what stroke survivors exactly learn when recovering the ability to stand and walk.

Detailed Description

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GENERAL:

Pre-clinical research has pointed towards a time window of enhanced responsiveness to therapy early after stroke. For example, training has led to substantial recovery if initiated 5 or 14, but not 30 days post-stroke in a rodent model (Biernaski 2004). It is suggested that this early period is characterized by heightened levels of plasticity and that training can exploit this leading to improved outcome. The typically observed non-linear recovery pattern in stroke survivors (Kwakkel 2004) might suggest that similar mechanisms are induced in the human brain, however clinical research on this is disappointingly sparse.

In two closely inter-related phases, we aim to examine the biomechanical changes related to walking recovery in general (Phase I) and the specific effects of robot-assisted training (Phase II). By that, we aim to detect a time window in stroke survivors which resembles the same characteristics as observed in animal models. To initiate gait training at an early stage, when patients usually present severe weakness and balance deficits, a mobile exoskeleton is used which is developed to provide intensive walking practice.

OBJECTIVES:

(I.a) Is there a distinct time window of behavioral restitution (i.e., returning towards pre-stroke movement patterns) underlying early walking recovery?

(I.b) Are improvements in standing and walking throughout the first 6 months post-stroke explained by behavioral restitution or learning to use compensation strategies?

Conditions

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Stroke Paresis Gait, Hemiplegic

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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conventional rehabilitation

The investigated cohort will be exposed to 'standard care' including conventional rehabilitation therapy.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* First-ever, MRI- or CT-confirmed, ischemic or hemorrhagic, anterior circulation stroke
* Age: 18 - 90 years
* Baseline assessments within the first 14 days after stroke onset
* Weakness of the lower limb (NIHSS item \>0 at 72 hours post-stroke)
* Pre-morbid independence in activities of daily living (mRS \</=2) and gait (FAC \>3)
* Able to communicate and comprehend
* Sufficient motivation to participate
* Provided a written informed consent

Exclusion Criteria

* No other neurological condition affecting motor functions of the lower limbs
* Pre-existing musculoskeletal impairment severely affecting the gait pattern
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Antwerp

OTHER

Sponsor Role collaborator

Universiteit Antwerpen

OTHER

Sponsor Role lead

Responsible Party

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Jonas Schröder

Principle investigator, PhD researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jonas Schröder, PhD Student

Role: PRINCIPAL_INVESTIGATOR

Dept. Rehabilitation Sciences & Physiotherapy, University of Antwerp, Belgium

Wim Saeys, Prof. Dr.

Role: STUDY_DIRECTOR

Dept. Rehabilitation Sciences & Physiotherapy, University of Antwerp, Belgium

Steven Truijen, Prof. Dr.

Role: STUDY_CHAIR

Dept. Rehabilitation Sciences & Physiotherapy, University of Antwerp, Belgium

Gert Kwakkel, Prof. Dr.

Role: STUDY_CHAIR

Dept. Rehabilitation Medicine, VU University Medical Center, Amsterdam, Netherlands

Locations

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Antwerp University Hospital

Antwerp, , Belgium

Site Status

RevArte Rehabilitation Hospital

Antwerp, , Belgium

Site Status

GZA Ziekenhuis - campus St Augustinus & Campus St Vincentius

Wilrijk, , Belgium

Site Status

Countries

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Belgium

References

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Schroder J, Saeys W, Embrechts E, Hallemans A, Yperzeele L, Truijen S, Kwakkel G. Recovery of Quiet Standing Balance and Lower Limb Motor Impairment Early Poststroke: How Are They Related? Neurorehabil Neural Repair. 2023 Aug;37(8):530-544. doi: 10.1177/15459683231186983. Epub 2023 Aug 19.

Reference Type DERIVED
PMID: 37596887 (View on PubMed)

Other Identifiers

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1S64819N

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

JS-1

Identifier Type: -

Identifier Source: org_study_id

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