- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02225990
Implementation of Comprehensive Stroke Rehabilitation Therapy for Enhanced Quality of Life (QualPro)
Implementation of Gait Coordination, Mobility, and Fitness Training for Enhanced Quality of Life and Participation in Life Roles
Study Overview
Status
Conditions
Detailed Description
This comprehensive intervention targets the impairments preventing recovery to normal and safe gait, mobility, function, and life role participation (quality of life). It has been tested in chronic stroke survivors and found efficacious.
The QualPro protocol will include three phases, all of which contain components previously mentioned. The QualPro protocol includes implementation of gait coordination training to address weakness, impaired endurance, and dyscoordination. The protocol will include implementation of balance training for falls prevention composed of Yang style, 24-posture, short-form Tai Chi. Additionally, the QualPro protocol will include implementation of aerobic training for fitness, health, and endurance of stroke survivors, which will be composed of low-volume, high intensity interval training (HIIT) on a cycle ergometer. Strength exercises will also be included. All exercises will address weakness, impaired endurance, and dyscoordination.
The long-range financial goal of this research study is to realize the cost savings of implementing the proposed combination of interventions that will preclude much of the very costly and downwardly spiraling sequellae currently observed after stroke, and that currently costs managed care and insurance companies an exorbitant and unnecessary amount of precious resources.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Florida
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Gainesville, Florida, United States, 32606
- UF Health Rehab Center- Magnolia Parke
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Gainesville, Florida, United States, 32606
- UF Health Shands Rehab Hospital
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Gainesville, Florida, United States, 32608
- Brain Rehabilitation Research Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Cognition sufficiently intact to give valid informed consent to participate.
- Sufficient endurance to participate in rehabilitation sessions.
- Ability to follow 2 stage commands.
- Medically stable
- Age > 21 years
- Impaired ambulation as follows: inability to flex the knee and ankle in the sagittal plane, in a normal manner so the foot clears the floor; inability to control normal knee angle during single limb weight bearing during stance phase.
- Trace contraction of hip, knee, and ankle flexors and extensors.
- Passive range of motion (ROM) at hip, knee, ankle greater than or equal to normal gait kinematics.
- Reported comfort of surface FES at a stimulus level producing a visible or palpable muscle contraction of ankle dorsiflexors.
- Greater than 3 weeks post-stroke.
- Living in the community and able to travel to training and assessment sites.
- Approval of participation by primary care physician
Exclusion Criteria:
- Acute or progressive cardiac, renal, respiratory, neurological disorders or malignancy.
- Active psychiatric diagnosis or psychological condition, or active drug/alcohol abuse.
- Lower motor neuron damage or radiculopathy.
- More than one stroke.
- Cerebellar dysfunction.
- Fugl-Meyer lower limb motor sub-score greater than 32.
- Severe obesity (body mass index > 35)
- For the chronic group: current participation in physical therapy or cardiopulmonary rehabilitation.
- Significant visual impairment affecting capability to gauge movement accuracy.
- Current enrollment in any clinical trial
- Planning to relocate out of the greater Gainesville, FL area during the study period
- Unable to communicate sufficiently with study personnel
- Clinical judgement regarding safety or non-compliance
- Refusal to be recorded by video for gait assessment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Standard of Care, Sub-Acute
This group will receive standard of care stroke rehabilitation therapy.
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This group will receive standard of care stroke rehabilitation therapy.
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Active Comparator: Standard of Care, Chronic
This group will receive standard of care stroke rehabilitation therapy.
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This group will receive standard of care stroke rehabilitation therapy.
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Experimental: Experimental Group, Sub-Acute
This group consists of sub-acute stroke patients who are between three weeks and six months post-stroke and will receive the QualPro protocol.
If the participant is an inpatient at Shands Rehabilitation Hospital at the beginning of the study, his/her first three weeks of research therapy sessions will take place at the Shands Rehabilitation Hospital.
After being discharged, the remainder of the study sessions will take place at either UF Health Rehab Center- Magnolia Parke or in the North Tower (6th floor) physical therapy department of Shands Hospital.
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For the sub-acute experimental group, the intervention schedule will be as follows: six months of individual therapy five times weekly (1 - 2.5 hours/session); 6 months of 'refresher' individual therapy twice monthly (1 - 2.5 hours/session) + group therapy up to three times weekly (1 hour/session); and 1 year of group therapy, up to three times weekly (1 hour/session) + 1 'refresher' individual therapy session every 3 months for a total study duration of 2 years.
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Experimental: Experimental Group, Chronic
This group consists of chronic stroke patients who are greater than six months post-stroke and will receive the QualPro protocol.
The study sessions will take place at either UF Health Rehab Center-Magnolia Parke or in the North Tower (6th floor) physical therapy department of Shands Hospital.
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For the chronic experimental group, the intervention schedule will be as follows: six months of individual therapy five times weekly (1 - 2.5 hours/session); 6 months of 'refresher' individual therapy twice monthly (1 - 2.5 hours/session) + group therapy up to three times weekly (1 hour/session); and 1 year of group therapy, up to three times weekly (1 hour/session) + 1 'refresher' individual therapy session every 3 months for a total study duration of 2 years.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient response to QualPro intervention in the clinical environment
Time Frame: 24 months
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Implementation of the comprehensive QualPro protocol into clinical practice will be done in order to determine patient outcomes during interventions of gait coordination, balance, mobility, and fitness training.
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24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cost savings of implementation of the QualPro Protocol
Time Frame: 24 Months
|
Information with respect to the cost of standard care and cost of the proposed care model will be collected and compiled in order to determine feasibility in the clinical environment.
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24 Months
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Janis J. Daly, PhD, MS, University of Florida
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB201400568
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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