Impaired Interlimb Coordination During Locomotion in Individuals With Chronic Stroke: Contributors and Effect on Walking Function

Status: Recruiting
Location: See location...
Intervention Type: Device
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Individuals with chronic stroke have long-term walking problems that limit community engagement and quality of life, lead to secondary disabilities, and increase healthcare costs and burden. These walking issues often persist despite rehabilitation. One novel target for stroke gait rehabilitation is interlimb coordination-the phase-dependent cyclical relation of the legs. Interlimb coordination is altered during walking after stroke, compromising walking stability, phase transitions, and responses to perturbation and contributing to motor compensation. It is unclear what neural pathways contribute to impaired interlimb coordination after stroke and what impact this has on walking-related outcomes. This proposal consists of two aims to address these issues, with the long-term goal of developing therapeutic interventions to improve interlimb coordination and walking after stroke. Aim 1 will identify which neural sources contribute to impaired interlimb coordination after stroke. During bilateral, cyclical recumbent stepping (analogue of walking), interlimb coordination will be assessed as relative leg phasing. During the task, transcranial magnetic stimulation and peripheral nerve stimulation will be applied to assess supraspinal, interhemispheric, spinal interneuronal, and sensory pathways. The relation of interlimb coordination with these outcomes will be assessed to determine potential contributors. Aim 2 will test the association between interlimb coordination and walking after stroke. Interlimb coordination will be quantified during split-belt treadmill walking, and associations with walking speed, endurance, mobility, independence, daily activity, quality of life, and community engagement will be tested. An additional exploratory aim will determine the effect of targeted neuromodulation on lower limb interlimb coordination. Electrical stimulation will be applied to three locations in a cross-over study: the primary motor cortex (supraspinal/interhemispheric), thoracolumbar spine (spinal interneuronal), and peripheral nerves (sensory).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 25
Maximum Age: 90
Healthy Volunteers: f
View:

• Age: 25 - 90 years of age

• Monohemispheric stroke

• Chronic phase (\> 6 months post stroke)

• Ability to walk for at least 6 minutes at a self-selected comfortable speed

Locations
United States
Illinois
University of Illinois at Chicago
RECRUITING
Chicago
Contact Information
Primary
Brice T Cleland, PhD
bcleland@uic.edu
3129969056
Time Frame
Start Date: 2025-09-15
Estimated Completion Date: 2028-04-30
Participants
Target number of participants: 50
Treatments
Experimental: Supraspinal direct current stimulation
Participants will receive 2 mA direct current stimulation for 20 minutes, with the anode applied to the ipsilesional primary motor cortex and the cathode applied to the contralesional supraorbit.
Experimental: Spinal direct current stimulation
Participants will receive 2 mA direct current stimulation for 20 minutes, with the anode applied to the thoracic vertebra and the cathode applied to the non-paretic shoulder.
Experimental: Sensory direct current stimulation
Participants will receive 2 mA direct current stimulation for 20 minutes, with the anode and the cathode applied to the cutaneous superficial peroneal nerve.
Related Therapeutic Areas
Sponsors
Leads: University of Illinois at Chicago

This content was sourced from clinicaltrials.gov