The Influence of Cortical Lateralization on Selective Motor Control of the Arm Swing During Independent Walking After Stroke.

Обзор

The upper limbs play an essential role for safe and efficient walking in healthy persons and persons post-stroke. Nevertheless, in current post-stroke gait rehabilitation (research) the upper limbs are barely targeted. To address this gap, my project aims to investigate the selective motor control of the upper limbs during walking and the contribution of the cortical activity to the arm swing in independent walkers after stroke. To gain insight in the direct effects of stroke on the arm swing, the primary motor control of the arm swing will be evaluated by determining muscle synergies (i.e group of muscles working together as a task-specific functional unit). Additionally, the cortical activity (EEG-analysis) during walking of persons post-stroke will be compared to healthy controls and the relationship between stroke-induced changes in cortical activity and arm swing deviations will be assessed. Furthermore, I will evaluate whether improvements in cortical activity relate to improvements in primary motor control of the arm swing. This innovative project will be the first to investigate the direct coupling between the cortex and the muscle synergies in persons post-stroke during independent walking to investigate the arm swing. These fundamental insights in the primary motor control of the arm swing and the contribution of the cortical activity will allow to develop targeted interventions aiming to improve arm swing and as such optimize post-stroke gait rehabilitation. Research questions: 1. How can muscle synergies explain arm swing alterations in independent walkers after stroke? 2. How do stroke-induced changes in cortical activity relate to arm swing deviations in persons after stroke? 3. Are changes in primary motor control of the upper limb during walking related to normalization of brain activity in independent walkers after stroke?

Вмешательства

• Другое Walking on a treadmill
  Participants have to walk without holding handrails and without bodyweight support for at least 200 gait cycles. They are asked to walk at comfortable walking speed while watching forward to a screen without virtual reality projection. Arm should be next to the body to allow arm swing if possible.

Первичные конечные точки

• Number of muscle synergies [Срок оценки: Single point of assessment at inclusion]
• Number of muscle synergies [Срок оценки: Single point of assessment 3 months after inclusion (only for stroke survivors)]
• Weight of muscle synergies [Срок оценки: Single point of assessment at inclusion]
• Weight of muscle synergies [Срок оценки: Single point of assessment 3 months after inclusion (only for stroke survivors)]
• Brain symmetry index (BSI) [Срок оценки: Single point of assessment at inclusion]
• Brain symmetry index (BSI) [Срок оценки: Single point of assessment 3 months after inclusion (only for stroke survivors)]

Вторичные конечные точки (4)

• Upper limb kinematics [Срок оценки: Single point of assessment at inclusion]
• Upper limb kinematics [Срок оценки: Single point of assessment 3 months after inclusion (only for stroke survivors)]
• Cortico-synergy coherence [Срок оценки: Single point of assessment at inclusion]
• Cortico-synergy coherence [Срок оценки: Single point of assessment 3 months after inclusion (only for stroke survivors)]

Критерии участия

Stroke

Критерии включения

• First-ever and cerebral stroke
• Able to walk at least 10 minutes (FAC ≥ 3)
• Presence of upper limb paresis (NIHSS item 5a/b > 0)

Критерии исключения

• Other neurological disorders

Healthy controls

Критерии включения

• Older than 18 years
• Able to walk at least 10 minutes

Exlusion criteria:

• Pregnancy

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Другое

Центры проведения

Бельгия · 1 центр

• Ghent University Hospital — Ghent

Идентификаторы

NCT: NCT06442579 · ONZ-2024-0089 · 11PEU24N

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗