Cortical Priming to Optimize Gait Rehabilitation Post Stroke

Project: Research project

Project Details

Description

Achieving functional ambulation post stroke continues to be a challenge for stroke survivors, clinicians and researchers. The proposed study builds on our exciting previous work where we examined the feasibility of a clinically implementable walking program which involves high intensity speed-based treadmill training (HIISTT) in combination with cortical priming to improve walking speed of stroke survivors. Cortical priming has emerged as a promising adjuvant to enhance the outcomes of motor training. Our research team has pioneered and successfully developed cortical priming for the lower limb motor cortex using non-invasive transcranial direct current stimulation (tDCS) and ankle motor skill training. In this study, our goal is to quantify the effectiveness of an 8-week cortical priming plus HIISTT intervention in comparison to sham priming plus HIISTT. Clinical measures of walking, balance and quality of life, neurophysiological changes of descending and interhemispheric corticomotor excitability measured with transcranial magnetic stimulation (TMS), and aerobic measures will be examined before, immediately after and 3-months post training. There has been a growing interest in understanding responsiveness to training to personalize stroke rehabilitation. We also aim to understand variability in recovery and responsiveness to training using patient-specific parameters such as patient demographics, lesion information, corticomotor excitability and the presence of genetic variations such as brain derived neurotrophic factor (BDNF) polymorphism. With our innovative mechanistic approach to enhance walking recovery, we seek to optimize gait rehabilitation post stroke and characterize relationships between neural mechanisms, motor function and genetic variations. Improved gait will enable stroke survivors to be more independent in the community and advance their quality of life, which is relevant to the mission of the NIH.
StatusActive
Effective start/end date8/1/217/31/25

Funding

  • University of Illinois at Chicago (18583 // 5R01HD075777-07)
  • National Institute of Child Health and Human Development (18583 // 5R01HD075777-07)

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