Motor Skill Acquisition Between Individuals With Neurological Disorders and Healthy Individuals

NCT ID: NCT04503187

Last Updated: 2020-08-07

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 130 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2013-04-04
• Study Completion Date: 2024-12-31

Brief Summary

Stroke survivors frequently show persistent gait deficits in their chronic stages even after years of intensive rehabilitation. This may be caused by diminished capability of re-acquiring motor skills post stroke. Thus, the overall purpose of this research project is to examine stroke survivors' capability of learning a novel leg task over 3 visits, 1-2 weeks apart. The capability of learning a new skill is then correlated with the individual's neurological functions (nerve activity and movement coordination) and her/his gait performance (gait speed, gait symmetry, and force production).

Detailed Description

The walking after stroke called "hemiparetic gait" is characterized by slow and asymmetrical steps with poor motor control on the paretic leg while paradoxically increasing the cost of energy expenditure. Biomechanical evidence shows that impaired gait performance for people with chronic stroke is not solely the result of the loss of muscle strength, but involves complicated movement discoordination across multiple joints in the affected leg. This has been taken to indicate a persistent motor control deficit in the paretic leg post stroke. Recent imaging studies suggest that the persistent motor control deficit after stroke may be the result of the disruption of motor memory consolidation, a process by which a newly-learned motor skill is transformed from a fragile state to a stable state and is "saved" in our brain afterward. This indicates that the same brain area responsible for controlling motor activity is also involved in memorizing newly-learned skills during the early stage of motor learning. Presence of persistent motor control deficits in the chronic stage may be attributed to the fact that damage to the brain cortex significantly impacts the ability of acquiring motor skills and consequentially defers the improvement of motor function, including gait.

Conditions

Stroke; Multiple Sclerosis

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Chronic Stroke

Participants who suffered a single event of cerebral vascular accident at least six months ago before study enrollment.

Visuomotor leg reaching task

Intervention Type: BEHAVIORAL

Similar to a hand reaching task in which participants were asked to reach to a tea-cup, in a visuomotor leg reaching task, participants will be seated and given real-time visual feedback about their leg movements via a cursor display on a computer screen. The task is to control a foot mouse/marker attached to the foot and move the cursor from a start location to the target displayed on a wall screen. Three different targets, equidistant from the start location at top, top-left, and top-right screen positions, will be used for leg reaching. In each trial, one of three targets will be randomly presented and subjects will be instructed to make forward, or rightward, or leftward foot reaches to guide the cursor to one of the targets. Throughout the entire experiment, subjects are blocked from viewing leg movements by a cardboard.

Multiple Sclerosis

Participants who has been diagnosed with multiple sclerosis

Visuomotor leg reaching task

Intervention Type: BEHAVIORAL

Similar to a hand reaching task in which participants were asked to reach to a tea-cup, in a visuomotor leg reaching task, participants will be seated and given real-time visual feedback about their leg movements via a cursor display on a computer screen. The task is to control a foot mouse/marker attached to the foot and move the cursor from a start location to the target displayed on a wall screen. Three different targets, equidistant from the start location at top, top-left, and top-right screen positions, will be used for leg reaching. In each trial, one of three targets will be randomly presented and subjects will be instructed to make forward, or rightward, or leftward foot reaches to guide the cursor to one of the targets. Throughout the entire experiment, subjects are blocked from viewing leg movements by a cardboard.

Healthy control

Age-matched healthy adults who are self-reported healthy and has no known musculoskeletal, neuromuscular, and cardiovascular diseases.

Visuomotor leg reaching task

Intervention Type: BEHAVIORAL

Similar to a hand reaching task in which participants were asked to reach to a tea-cup, in a visuomotor leg reaching task, participants will be seated and given real-time visual feedback about their leg movements via a cursor display on a computer screen. The task is to control a foot mouse/marker attached to the foot and move the cursor from a start location to the target displayed on a wall screen. Three different targets, equidistant from the start location at top, top-left, and top-right screen positions, will be used for leg reaching. In each trial, one of three targets will be randomly presented and subjects will be instructed to make forward, or rightward, or leftward foot reaches to guide the cursor to one of the targets. Throughout the entire experiment, subjects are blocked from viewing leg movements by a cardboard.

Interventions

Visuomotor leg reaching task

Similar to a hand reaching task in which participants were asked to reach to a tea-cup, in a visuomotor leg reaching task, participants will be seated and given real-time visual feedback about their leg movements via a cursor display on a computer screen. The task is to control a foot mouse/marker attached to the foot and move the cursor from a start location to the target displayed on a wall screen. Three different targets, equidistant from the start location at top, top-left, and top-right screen positions, will be used for leg reaching. In each trial, one of three targets will be randomly presented and subjects will be instructed to make forward, or rightward, or leftward foot reaches to guide the cursor to one of the targets. Throughout the entire experiment, subjects are blocked from viewing leg movements by a cardboard.

Intervention Type: BEHAVIORAL

Other Intervention Names

Leg reaching task

Eligibility Criteria

Inclusion Criteria

• Healthy adults have no ongoing neurological, musculoskeletal issues.
• Individuals with chronic stroke had medical history of a unilateral stroke occurring ≥ 6 months prior to enrollment.
• Individuals have multiple sclerosis disease diagnosed by his/her physician
• MRI or CT evidence from the imaging report shown that the stroke and multiple sclerosis disease primarily involve cortical and subcortical regions.
• Individuals with chronic stroke have hemiparesis involving the lower extremity.
• Individuals with chronic stroke or multiple sclerosis have no passive range of motion limitation in bilateral hips and knees. Limitation of ankle passive range of motion to 10 degrees of dorsiflexion or less.
• Visual acuity can be corrected by glasses or contact lens to 20/20.
• Able to walk independently with/without assistant devices for 10 meters.
• Able to maintain standing position without any assistance for more than 30 sec.
• Evaluation of cognitive status: Mini-mental status examination (MMSE) score ≥ 24.

Exclusion Criteria

• Pregnant women.
• MRI or CT evidence of involvement of the basal ganglia or cerebellum, or evidence of any other brain damage or malignant neoplasm or tumors.
• Have any metal implants, cardiac pacemakers, or history of seizures.
• Ongoing orthopedic or other neuromuscular disorders that will restrict exercise training.
• Any vestibular dysfunction or unstable angina.
• Significant cognitive deficits (inability to follow a 2-step command) or severe receptive or global aphasia*

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Texas Woman's University

OTHER

Sponsor Role: lead

Responsible Party

Shih-Chiao Tseng

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Shih-Chiao Tseng, PT, PhD

Role: PRINCIPAL_INVESTIGATOR

Texas Woman's University School of Physical Therapy

Locations

Texas Woman's University

Houston, Texas, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Shih-Chiao Tseng, PT, PhD

Role: CONTACT

stseng@twu.edu

713-794-2309

Facility Contacts

Shih-Chiao Tseng, PT, PhD

Role: primary

stseng@twu.edu

703-794-2309

Provided Documents

Document Type: Informed Consent Form

View Document

Other Identifiers

TWU Houston#17203

Identifier Type: -

Identifier Source: org_study_id