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| Name | Class |
|---|---|
| Lehigh Valley Health Network | OTHER |
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The purpose of this research is to study the improvements from walking practice that is vigorous enough to keep participants' heart rate over a certain target level during their physical therapy sessions. The investigators want to know about improvements in participants' walking function and mental health after 20 interventions. The study also aims to evaluate if participants' mental health, social support, and health literacy affect their attendance at physical therapy sessions.
The purpose of this research is to study the improvements from walking practice that is vigorous enough to keep participants' heart rate over a certain target level during their physical therapy sessions. The investigators want to know about improvement in participants' walking function and mental health after 20 interventions. The study also aims to evaluate if participants' mental health, social support, and health literacy affect their attendance at physical therapy sessions.
The findings from this study will help the researchers and clinicians decide how to help people with stroke better. Further, the findings will determine how depressive symptoms, health literacy, and other factors such as language and education affect attendance to therapy.
About 24 subjects will take part in this research.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High intensity gait training | Experimental | Participants will receive 20 sessions of vigorous walking practice. These sessions are 2-3 times a week. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High intensity gait training | Behavioral | Participants will practice walking that is vigorous enough to keep their heart rate over a certain level during their physical therapy sessions. During the sessions, participants will walk and step vigorously enough to keep the heart rate between 60-80% of their maximum heart rate. Maintaining this heart rate during exercise helps to improve heart health and walking, which can affect people after a stroke. |
| Measure | Description | Time Frame |
|---|---|---|
| 3-meter backwards walk test | Measures backward gait velocity | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| 6-minute walk test | Measures aerobic capacity and endurance | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| 10-meter walk test | Measures forward gait velocity | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Surface electromyography (EMG) | Electromyographical recording of 8 leg muscles () is done during forward and backward walking tests.The EMG will be recorded during 3-meter Backward Walk Test, 6-minute Walk Test, and 10-meter Walk Test in all participants | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Berg Balance Scale | a 14-item objective measure that assesses static balance and fall risk in adults. Berg balance scale scoring ranges from 0 to 56, with higher scores mean a better outcome. | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Functional Gait Assessment | This scale assess postural stability during walking and assesses an individual's ability to perform multiple motor tasks while walking. Scoring for each FGA item ranges from 0 for severe impairment to 3 for normal performance. The highest score possible is 30, with higher scores correlating better gait function. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Soo Yeon Sun, PhD | Alvernia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lehigh Valley Health Network Outpatient Neurologic Rehab | Allentown | Pennsylvania | 18104-2310 | United States |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Borg Rating Scale of Perceived Exertion (RPE) | RPE is used to prescribe and monitor exercise intensity and correlates well with physiological measures of exercise intensity, including heart rate. The Borg Rating Scale of Perceived Exertion will be measured in all participants at the completion of 6 Minute Walk test. It ranges from 6 to 20, where 6 means "no exertion at all" and 20 means "maximal exertion." A lower score indicates a better exercise endurance. | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Patient Health Questionnaire (PHQ-9) | Depressive symptom questionnaire. As a severity measure, the PHQ-9 score can range from 0 to 27, since each of the 9 items can be scored from 0 (not at all) to 3 (nearly every day). A lower score indicates less depressive symptoms. | Pre-, mid- (week 5) and post-intervention (within 2 weeks after the conclusion of intervention) |
| Rate of patient attendance (Compliance) to physical therapy | Greater than or equal to 80% attendance to physical therapy is considered compliance to physical therapy. | Participant's attendance to physical therapy is tracked throughout the intervention sessions. |
| Newest Vital Sign | The NVS is a 6-question screening tool that identifies participants' risk of low or limited health literacy based on interpreting an ice cream nutrition label. It is available from Pfizer Pharmaceutical Company. The level of health literacy for each individual will be categorized based on the scores: a score of 0-1 suggests a high likelihood of limited literacy, a score of 2-3 indicates the possibility of limited literacy, and a score of 4-6 almost always indicates adequate literacy. This categorical variable will be used to determine the association with adherence to physical therapy. | Pre-intervention (baseline) |
| Multidimensional Scale of Perceived Social Support (MSPSS) | The MSPSS is a 12-item self-administered scale that measures social support. It contains 12-items, rated on a 7-point Likert-type scale, ranging from 1 "very strongly disagree" to 7 "very strongly agree." The scale was divided into 3 subscales: family, friends, and significant other, with each section consisting of 4 items. The response scale ranges from 12 to 84. Higher scores indicate a greater family social support. | Pre-intervention (baseline) |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |