Fast Muscle Activation and Stepping Training (FAST) Post-stroke (FAST)

Effectiveness of Fast Muscle Activation and Stepping Training (FAST) on Balance and Mobility Post-stroke

The purpose of this study is to determine whether FAST (Fast muscle Activation and Stepping Training) exercises will improve walking balance in individuals after stroke to a greater extent than usual care.

Hypothesis: The primary hypothesis is that improvements in walking balance will be larger following 12 sessions of FAST exercise retraining compared to usual care in persons in the sub-acute phase after stroke.

Study Overview

• Status: Completed
• Conditions: Stroke; Hemiparesis
• Intervention / Treatment: Behavioral: Usual Care; Behavioral: FAST protocol

Detailed Description

It is estimated that 75-80% of individuals who have had a stroke will survive the acute event and be left with residual disability. Regaining independence in standing and walking is of utmost importance for patients recovering from stroke. Walking balance requires muscles in the legs and trunk to contract quickly if people lose their balance. Physical therapy plays a key role in the rehabilitation of walking balance in individuals after stroke. Given that maintaining one's balance requires fast muscle activity, rehabilitation post-stroke should focus on speed of movement. Thus we are proposing to compare a program that emphasizes speed of movement, Fast muscle Activation and Stepping Training versus an active control (usual care).

• Study Type: Interventional
• Enrollment (Actual): 55
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • North Vancouver, British Columbia, Canada, V7L 2L7
      • Lions Gate Hospital
    • Vancouver, British Columbia, Canada, V5P 3L6
      • Holy Family Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 19 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Study population: Subjects with a diagnosis of stroke

Inclusion Criteria:

• first stroke (<6 months ago)
• presence of hemiparesis in the lower extremity
• minimum Berg Balance Score (BBS) of 30/56
• cognitive ability to give informed consent

Exclusion Criteria:

• bilateral stroke, or a previous stroke in the other hemisphere
• severe co-morbidity that is likely to dominate the pattern of care
• co-existing peripheral neuropathies or disorders of the vestibular apparatus
• musculoskeletal problems
• global aphasia or receptive aphasia

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Usual care; The usual care will consist of strength training, endurance, range of motion, patient education, weight shifting in standing and gait re-training.	Behavioral: Usual Care; The Usual Care program will consist of 2 sessions a week for 45 minutes for a 6 week duration.
Experimental: FAST protocol; The Fast muscle activation and stepping training will be the Experimental arm of this trial. This program will be exercises emphasizing speed of movement.	Behavioral: FAST protocol; The Fast muscle activation and Stepping Training (FAST protocol) will be exercises emphasizing speed, small squats and protective steps, that will be progressed. This program will be 2 sessions a week for 45 minutes for 6 weeks in duration.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Community Balance and Mobility Scale	Pre treatment and Post treatment (6 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Gait assessment	Self selected speed and changes in electromyography	Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
Physiological balance assessment by internal and external perturbations	Electromyography and Center of pressure changes	Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
Activities-specific Balance Confidence Scale		Pre treatment, Post treatment (6 weeks) and Retention (+1 month after treatment)
Community Balance and Mobility Scale		Post treatment and Retention (+1 month after treatment)

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Heart and Stroke Foundation of Canada
• Investigators: Principal Investigator: S. Jayne Garland, PT, PhD, University of British Columbia

Publications and helpful links

General Publications

• Miller KJ, Hunt MA, Pollock CL, Bryant D, Garland SJ. Protocol for a randomized controlled clinical trial investigating the effectiveness of Fast muscle Activation and Stepping Training (FAST) for improving balance and mobility in sub-acute stroke. BMC Neurol. 2014 Oct 10;14:187. doi: 10.1186/s12883-014-0187-y.
• Peters S, Ivanova TD, Lakhani B, Boyd LA, Garland SJ. Neuroplasticity of Cortical Planning for Initiating Stepping Poststroke: A Case Series. J Neurol Phys Ther. 2020 Apr;44(2):164-172. doi: 10.1097/NPT.0000000000000311.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2012
• Primary Completion (Actual): March 31, 2017
• Study Completion (Actual): June 30, 2017

Study Registration Dates

• First Submitted: April 5, 2012
• First Submitted That Met QC Criteria: April 5, 2012
• First Posted (Estimated): April 9, 2012

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 27, 2026
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Keywords: Physical Therapy; Exercise therapy
• Additional Relevant MeSH Terms: Neurologic Manifestations; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Stroke; Paresis
• Other Study ID Numbers: H12-00837

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO