Enhancing Physical Therapy Best Practice for Improving Walking After Stroke
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Chuhya Hung, MSc PT
- Phone Number: 604-714-4117
- Email: Chihya.Hung@ubc.ca
Study Contact Backup
- Name: Shannon Lim, PhD
- Phone Number: 604-714-4117
- Email: shannon.lim@ubc.ca
Study Locations
-
-
British Columbia
-
Vancouver, British Columbia, Canada, V5Z2G9
- University of British Columbia
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Admitted by inpatient or day stroke rehabilitation
- Improved walking is a rehabilitation goal
- Within 12 weeks post hemorrhagic or ischemic CVA with hemiparesis (confirmed by medical chart or motor assessment)
- Able to ambulate at least 5 steps. May use assistive and/or orthotic device and maximum one person assist
- Overground walking speed slower than normal
- Able to understand and follow directions
- Greater than or equal to 19 years of age
- Medically stable
Exclusion Criteria:
- Pre-stroke health included a serious gait disorder or disease that affected ambulation (musculoskeletal conditions, amputation, surgery/arthroplasty in the last 6 months, etc.)
- Pre-stroke health included a neurological condition (such as Parkinson's disease or Multiple Sclerosis) or other serious medical condition (active cancer, uncontrolled diabetes)
- Excessive pain in the body/joint preventing participation in an exercise intervention
- Participating in an experimental drug field study
- Participating in another formal exercise rehabilitation clinical trial
- Expected to receive <2 weeks daily in-/out- patient rehabilitation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Usual Physical Therapy Care
Physical Therapists continue usual care
|
Usual physical therapy
|
|
Experimental: Enhanced Physical Therapy Usual Care
Best practice implemented
|
The protocol is focused on the completion of a minimum of 30 minutes of weight-bearing, walking-related activities that progressively increase in intensity informed by heart rate and step counters over 4 weeks.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Six-minute walk Test
Time Frame: 4 weeks
|
This test measures distance a participant can walk in 6 minutes.
|
4 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Six-minute walk test
Time Frame: 12 months post-stroke
|
This test measures distance a participant can walk in 6 minutes.
|
12 months post-stroke
|
|
Blood pressure
Time Frame: 4 weeks & 12 months post-stroke
|
Blood pressure measures physiological effects of the intervention
|
4 weeks & 12 months post-stroke
|
|
Euro-QOL 5D-5L
Time Frame: 4 weeks & 12 months post-stroke
|
This test is the most widely used instrument to measure quality of life.
|
4 weeks & 12 months post-stroke
|
|
Modified Rankin Scale (mRS)
Time Frame: 4 weeks & 12 months post-stroke
|
This scale measures the degree of disability.
Score range: minimum 0 to maximum 6. Lower score means a better outcome.
|
4 weeks & 12 months post-stroke
|
|
Physical Activity Scale for the Elderly (PASE)
Time Frame: 12 months post-stroke
|
This test assesses physical activity, including leisure, household, and occupational activity.
Score range: minimum 0 to maximum 400 or more.
Higher score means a better outcome
|
12 months post-stroke
|
|
Step activity monitor
Time Frame: 12 months post stroke
|
The number of steps per day over 3 days
|
12 months post stroke
|
|
Montreal Cognitive Assessment
Time Frame: 4 weeks & 12 months post-stroke
|
This test measures levels of cognitive function.
Min 0, max 30, with higher scores reflecting better cognition.
|
4 weeks & 12 months post-stroke
|
|
Short Performance Physical Battery
Time Frame: 4 weeks & 12 months post-stroke
|
This test measures lower extremity function.
Min value 0, max value 12. Higher scores reflect better lower extremity function
|
4 weeks & 12 months post-stroke
|
|
Patient Health Questionnaire-9 (PHQ-9)
Time Frame: 4 weeks & 12 months post-stroke
|
This test screens for depression.
Min 0, max 27.
Higher values reflect more severe symptoms.
|
4 weeks & 12 months post-stroke
|
|
Gait speed
Time Frame: 4 week and 12 month post-stroke
|
self-paced gait speed in metre/second
|
4 week and 12 month post-stroke
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Janice J Eng, PhD, University of British Columbia
Publications and helpful links
General Publications
- Tang WK, Lu H, Leung TWH, Fong KNK, Chan SKY, Liew VWJ. A double-blind randomized control trial of transcranial direct current stimulation in post-stroke fatigue. Front Neurol. 2026 May 7;17:1658764. doi: 10.3389/fneur.2026.1658764. eCollection 2026.
- Ackerley S, Hung SH, Sheehy L, Donkers SJ, Timofeeva P, Best KL, Peters S, Park SS, Ouellet B, Ezeugwu VE, Milot MH, Sakakibara BM, Eng JJ, Connell LA. Exploring factors influencing implementation across the explanatory-to-pragmatic trial continuum: a sequential qualitative integration of delivering higher-intensity walking exercise within inpatient stroke rehabilitation. Implement Sci Commun. 2026 Jan 8;7(1):44. doi: 10.1186/s43058-025-00812-y.
- Hung SH, Ackerley S, Connell LA, Bayley MT, Best KL, Donkers SJ, Dukelow SP, Ezeugwu VE, Milot MH, Peters S, Sakakibara BM, Sheehy L, Yao J, Eng JJ. Real-World Experiences of Therapy Staff Implementing an Intensive Rehabilitation Protocol in Canadian Stroke Inpatient Rehabilitation Settings: A Multi-Site Survey Study. Phys Ther. 2025 Oct 1;105(10):pzaf111. doi: 10.1093/ptj/pzaf111.
- Yan Y, Eng JJ, Hung SH, Bayley MT, Best KL, Connell LA, Donkers SJ, Dukelow SP, Ezeugwu VE, Milot MH, Sakakibara BM, Sheehy L, Wong H, Yao J, Peters S. Aerobic minutes and step number remain low in inpatient stroke rehabilitation. PLoS One. 2025 Jul 28;20(7):e0328930. doi: 10.1371/journal.pone.0328930. eCollection 2025.
- Peters S, Hung SH, Bayley MT, Best KL, Connell LA, Donkers SJ, Dukelow SP, Ezeugwu VE, Milot MH, Sakakibara BM, Sheehy L, Wong H, Yang Y, Yao J, Eng JJ. Safety and effectiveness of the Walk 'n Watch structured, progressive exercise protocol delivered by physical therapists for inpatient stroke rehabilitation in Canada: a phase 3, multisite, pragmatic, stepped-wedge, cluster-randomised controlled trial. Lancet Neurol. 2025 Aug;24(8):643-655. doi: 10.1016/S1474-4422(25)00201-7.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Infarction
- Necrosis
- Ischemia
- Pathological Conditions, Signs and Symptoms
- Behavior
- Stroke
- Cerebral Infarction
- Brain Ischemia
- Brain Infarction
- Motor Activity
Other Study ID Numbers
Other Study ID Numbers
- H19-02809
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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