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Neuroplastic Changes Due to an Exercise Intervention That Aid in Lower Limb Recovery After Subcortical Stroke

18. august 2026 opdateret af: Lisa Krishnamurthy, Emory University

This study aims to develop imaging-based biomarkers to assess which chronic stroke participant with lower extremity disability may respond or resist high intensity interval training (HIIT).

Previous research suggests that physical exercise training is safe and could help improve the walking speed of non-ambulatory stroke survivors. However, inter-individual variability in response to exercise is extraordinarily high regardless of adherence, and predictors of response remain elusive.

Chronic stroke survivors with lower limb disability resulting in slow walking speeds will participate in 12 weeks of cycling exercise at Emory University under the guidance of a physical exercise instructor, 3 days a week, for 25-60 minutes. During some of the exercise sessions, the investigators will collect blood lactate with a finger prick. Brain scans with an MRI before and after the 12 weeks of exercise will be done; motor function tests that include walking, sitting down, standing up, and turning around will be collected. Participants' memory and thinking will be assessed, and participants will fill out questionnaires about their health before and after their stroke, and well as questions about their diet.

The participation will last between 14-16 weeks (up to 42 study visits).

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study will enroll 55 participants with chronic subcortical stroke in the 12-week HIIT intervention. Each chronic subcortical stroke participant will be asked to participate in the overall study protocol with pre-, during-, and post-intervention measurements. The HIIT consists of three weekly 25-60 minute cycling sessions for 12 weeks at Emory University, administered by a trained exercise physiologist, for a total of 36 HIIT sessions. To accommodate stroke participants with lower limb disability, the study team will use a wheelchair accessible whole body trainer that uses a cycling motion. Each exercise session will start with a 5 minute warm up, followed by 20 minutes or more of moderate to intense cycling. Each session, the time will increase by one minute. The trained exercise physiologist may ask the participant to cruise (cycle at a comfortable pace), sprint (cycle faster), or climb (increase gear) in order to generate intervals of moderate and high intensity exercise during the session. The goal is to work the participant in a heart rate reserve (HRR) of 60-90%. The heart rate will constantly be monitored during the session. During HIIT sessions 1, 4, 7, 10, and 28 the participant's blood lactate will be measured via finger prick 7 times each session (for a total of 35 finger pricks) to assess if their lactate threshold is surpassed during HIIT. One week before the intervention and one week after, the participant will be asked to take part in an assessment of lower extremity motor function including walking speed, and a 90-minute MRI session for a brain scan. The overall goal of this study is to determine if the investigators can identify neurophysiological and imaging-derived biomarkers to predict whether a chronic subcortical stroke patient with lower extremity disability will respond to a 12-week HIIT intervention. Supported by preliminary data, the study team will build a model to consider the combined effects of blood lactate, baseline GABA, baseline CBF, baseline leg weakness, pre-stroke fitness, baseline VO2-max, age, sex, and comorbidities to predict improvements in walking speed after 12 weeks of HIIT.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

55

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Lisa Krishnamurthy, PhD
  • Telefonnummer: 404-712-5332
  • E-mail: lkrish2@emory.edu

Studiesteder

  • Forenede Stater
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30322
        • Rekruttering
        • Emory Rehabilitation Hospital
        • Kontakt:
      • Atlanta, Georgia, Forenede Stater, 30322
        • Rekruttering
        • Emory University Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • chronic left or right subcortical stroke as defined by 6 months or more after a cardiovascular accident
  • lower extremity motor impairment due to stroke that causes a walking speed of less than 0.6 m/s during a 10m walk,
  • age 18-80 years old, and
  • Screen pass of the Stress test or Physician sign-off from the participant's health care team that they are cleared for a 12 week exercise intervention

Exclusion Criteria:

  • MRI contraindications, including implanted cardiac pacemakers and severe claustrophobia
  • any neurodegenerative condition other than stroke that may lead to lower extremity impairment
  • visual or auditory impairment that may hinder study procedures, and
  • any medical condition that would preclude from participation in a physical exercise intervention program.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: HIIT intervention in chronic subcortical stroke participants
The HIIT consists of three weekly 25-60 minute cycling sessions for 12 weeks at Emory University, administered by a trained exercise physiologist, for a total of 36 HIIT sessions.
Adfærdsmæssigt: HIIT intervention

Three weekly 25-60 minute cycling sessions for 12 weeks for a total of 36 HIIT sessions.

Each exercise session will start with a 5 minute warm up, followed by 20 minutes or more of moderate to intense cycling. Each session, the time will increase by one minute.

The trained exercise physiologist may ask the participant to cruise (cycle at a comfortable pace), sprint (cycle faster), or climb (increase gear) in order to generate intervals of moderate and high intensity exercise during the session.

During HIIT sessions 1, 4, 7, 10, and 28 the participant's blood lactate will be measured via finger prick 7 times each session (for a total of 35 finger pricks) to assess if their lactate threshold is surpassed during HIIT. One week before the intervention and one week after, the participant will be asked to take part in an assessment of lower extremity motor function including walking speed, and a 90-minute MRI session for a brain scan.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Walking Speed Assessed by the 10-Meter Walk Test (10MWT)
Tidsramme: 12 weeks post-intervention
Walking speed will be measured using the 10-Meter Walk Test (10MWT). Participants will be instructed to walk a measured 10-meter distance at their comfortable walking speed. The time required to traverse the designated distance will be recorded using a stopwatch, and walking speed will be calculated as distance divided by time and expressed in meters per second (m/s). Higher values indicate faster walking speed and improved ambulatory function.
12 weeks post-intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Functional Mobility Assessed by the Timed Up and Go Test (TUG)
Tidsramme: 12 weeks post-intervention
Functional mobility will be measured using the Timed Up and Go (TUG) test. Participants will be instructed to rise from a standard chair, walk 3 meters at a safe and comfortable pace, turn around, walk back to the chair, and sit down. The time required to complete the task will be recorded using a stopwatch and expressed in seconds (s). Lower completion times indicate better functional mobility and dynamic balance.
12 weeks post-intervention
Walking Endurance Assessed by the 6-Minute Walk Test (6MWT)
Tidsramme: 12 weeks post-intervention
Walking endurance will be measured using the 6-Minute Walk Test (6MWT). Participants will be instructed to walk as far as possible along a designated walkway for 6 minutes at a self-selected pace, with rest periods permitted as needed according to standardized testing procedures. The total distance walked during the 6-minute period will be recorded and expressed in meters (m). Greater distances indicate better walking endurance and functional exercise capacity.
12 weeks post-intervention
Change in Resting-State Functional Connectivity of the Cognitive-Motor Network Assessed by MRI
Tidsramme: Baseline, 12 weeks post-intervention
Brain function will be assessed using resting-state functional magnetic resonance imaging (rsfMRI) acquired before and after the 12-week high-intensity interval training (HIIT) intervention. Functional connectivity will be quantified using echo-planar time-resolved imaging (EPTI) and expressed as z-transformed correlation values.
Baseline, 12 weeks post-intervention

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Blood Lactate Levels
Tidsramme: Baseline, 12 weeks post-intervention
Blood lactate levels in Millimoles per liter (mmol/L) will be measured at baseline and post-intervention.
Baseline, 12 weeks post-intervention

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Emory University

Samarbejdspartnere

American Heart Association

Efterforskere

  • Ledende efterforsker: Lisa Krishnamurthy, PhD, Emory University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

1. marts 2027

Studieafslutning (Anslået)

1. marts 2027

Datoer for studieregistrering

Først indsendt

17. juni 2026

Først indsendt, der opfyldte QC-kriterier

17. juni 2026

Først opslået (Faktiske)

23. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

18. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025P010166

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Raw images and interstitial processed images (including lesion masks), as well as demographic and motor testing data.

IPD-delingstidsramme

The data will become available 6 months after the last participant's data is collected

IPD-delingsadgangskriterier

Data will be made available to investigators at research institutions, for secondary analyses, upon written request.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL

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