People living with stroke have a high risk of falling and this risk increases as mobility improves over the first year post-stroke. Despite the high number of falls, there is a lack of interventions to prevent falls after stroke. One possible solution is to alter nerve activity through delivery of a stimulus, such as electrical stimulation. The purpose of this study is to describe and compare clinical, biomechanical and nerve-related outcomes between individuals with stroke who receive RBT with tSCS and those who receive RBT with sham tSCS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
16
Participants will don a safety harness that is secured to an overhead track. Each balance training session will involve 60 minutes of reactive balance training (RBT). For both intervention arms, trancutaneous spinal stimulation will be set up, including placing electrodes and setting stimulation amplitudes.
KITE Research Institute, Toronto Rehabilitation Institute - University Health Network
Toronto, Ontario, Canada
RECRUITINGMini-Balance Evaluation Systems Test
Time frame: From enrollment to the 12-week post-intervention follow-up
Spinal excitability for the tibialis anterior, soleus, biceps femoris and rectus femoris
To assess spinal excitability, double-pulse TSCS will be applied. Spinal motor thresholds will first be determined for each of the following muscles on the affected side: tibialis anterior (TA), soleus (SOL), biceps femoris (BF), and rectus femoris (RF).
Time frame: From enrollment to the 12-week post-intervention follow-up
Corticospinal excitability of the affected soleus and tibialis anterior
TMS will be delivered using a magnetic stimulator with a double-cone coil
Time frame: From enrollment to the 12-week post-intervention follow-up
Gait and standing spatiotemporal data
Collected using the Zeno Walkway Gait Analysis System
Time frame: From enrollment to the 12-week post-intervention follow-up
Activities-specific Balance Confidence (ABC) Scale
Items are rated on a scale from 0-100% confidence. Sixteen items of the standard ABC are used to calculate a mean. Five personalized items (i.e. tasks of important to each individual participant) are used to calculate a separate mean. The minimum score is 0%, the maximum score is 100%; the higher the score, the greater the confidence.
Time frame: From enrollment to the 12-week post-intervention follow-up
Lean-and-Release Test
A test of reactive balance in the forward direction. Observational and kinematic (i.e. force plate, marker) data are collected.
Time frame: From enrollment to the 12-week post-intervention follow-up
Technology Acceptance Model Questionnaire
A questionnaire exploring participants' perceptions of transcutaneous spinal cord stimulation combined with reactive balance training. Participants are asked to rate each statement (e.g. I enjoyed using electrical stimulation combined with balance training) on a 5-point Likert scale with the following options: Strongly disagree, Disagree, Neutral, Agree, Strongly Agree. A mean score and SD for each section will be calculated. A higher score represents greater perceived usefulness, ease of use and efficacy of the intervention.
Time frame: Immediately post-intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.