Tracking Neural Synergies After Stroke.

Shirley Ryan AbilityLab

Status

Active, not recruiting

Conditions

Stroke

Study type

Observational

Funder types

Other

Identifiers

NCT04805866

STU00214290

Details and patient eligibility

About

The purpose of this study is to identify neural muscle synergies of patients post-stroke and track them during an inpatient acute rehabilitation. To this end, the researchers will use an innovative approach based on the identification of large populations of motor units from recordings of surface high-density electromyography (HD-EMG).

Full description

The researchers will focus on the identification of neural muscle synergies of leg and thigh muscles during postural and locomotor tasks in patients post stroke. To this end, the researchers will recruit 20 patients participating in inpatient rehabilitation at Shirley Ryan AbilityLab in the early subacute phase after stroke and 20 age-matched healthy controls. The researchers will ask them to perform postural tasks and walking trials at their preferential speed. All assessments will be performed by a licensed physiotherapist as per the standard of care once a week during three weeks of inpatient rehabilitation at the Shirley Ryan AbilityLab. During these tasks, the researchers will record HD-EMG signals from four muscle groups (Quadriceps, Hamstrings, Triceps Surae, Tibialis anterior).

Enrollment

36 patients

Sex

All

Ages

18 to 85 years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

Healthy participants:

Inclusion Criteria:

Age 18-85 years old
Ambulatory with or without an assistive device
Ability to stand unassisted for at least 15 min
Informed consent provided by participant
English speaking

Exclusion Criteria:

Inability to communicate with researchers
Lower extremity joint pain, contractures
Major sensory deficits, or cardiovascular or respiratory symptoms contraindicative of walking
History or evidence of orthopedic, muscular, or physical disability
Taking current medications that may affect balance
History or evidence of vestibular, auditory, or proprioceptive impairment
History or indication of orthostatic hypotension
History of any neurological disease
Open wounds on surfaces in contact with HD-EMG electrodes
Concurrent participation in other lower limb research studies that according to the PI is likely to affect study outcome or confound results
Pregnancy

Patients:

Inclusion Criteria:

Age 18-85 years old
Unilateral, supratentorial ischemic or hemorrhagic stroke within the past six months
Medical clearance from primary medical team (signed Medical Clearance form)
Unassisted sitting balance at edge of mat or hospital bed ≥ 30 seconds
Baseline Visible muscle contraction in hip flexors, knee extensors, and ankle dorsiflexors ( ≥1 MMT) or manual resistance against one muscle group (>3 MMT)
Adequate cognitive function as determined by the NIH scale: score ≤1 on question 1b and score =0 on question 1c
Informed consent provided by participant or POA
English speaking

Exclusion Criteria:

Severe aphasia limiting ability to express needs or discomfort verbally or nonverbally
Severe behavioral neglect
History of prior stroke
Concurrent neurologic condition (i.e PD, TBI, MS, etc.)
History of peripheral nerve injury
Joint contracture or significant spasticity in the lower limbs (Modified Ashworth Scale ≥3)
Severe knee, hip, or ankle osteoarthritis
Severe osteoporosis as indicated by physician medical clearance
Open wounds on surfaces in contact with HD-EMG electrodes
Unstable spine or unhealed fractures
Weight bearing precautions
Unresolved deep vein thrombosis (DVT)
Concurrent participation in other lower limb research studies that according to the PI is likely to affect study outcome or confound results
Pregnancy