No studies concerning the relation between energy expenditure and balance control in stroke patients during dynamic conditions are published so far. Therefore, the aims of this study are;(1) To investigate the effect of balance manipulations on…
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Source
Brief title
Condition
- Central nervous system vascular disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Main outcome: Energy costs (J/kg/m)
Secondary outcome
In all conditions parameters of gait will be calculated as: walking speed
(m/s), cadence (stride/s), stride length (m), step width (m) and symmetry
(paretic stance phase (s) * non-paratic stance phase (s)).
In the Ps and Pns condition the performance on the pattern walking task will be
quantified as the error in foot placement, which will be measured as the amount
of variation of the position of Center of Pressure with respect to the
projected foot prints
Background summary
Post-stroke fatigue is a major problem in stroke patients. A factor that might
contribute to this fatigue is higher levels of energy expenditure in stroke
patients during walking. The exact cause of this fatigue remains unknown. Since
impaired balance control is often present in stroke patients who regain walking
ability, it is of interest to investigate the influence of balance impairments
on energy expenditure in stroke patients during walking.
The relation between energy expenditure and balance control is allready been
investigated in static conditions in healthy persons as well as stroke
patients. Energy expenditure increases significantly when balance is perturbed
in healthy subjects as well as stroke patients. The energy expenditure tends to
increase more in stroke patients compared to healthy subjects when balance
control is perturbed. Since we expect balance to be challenged more during a
dynamic task compared to a static task, this trend might become significant in
a dynamical situation.
Study objective
No studies concerning the relation between energy expenditure and balance
control in stroke patients during dynamic conditions are published so far.
Therefore, the aims of this study are;
(1) To investigate the effect of balance manipulations on energy expenditure
during walking in stroke patients compared to healthy controls
(2) To determine whether differences in energy expenditure correlate with
different measures of balance control.
Study design
During the experiment, participants are asked to walk on a treadmill. During
different walking trials, walking stability will be manipulated while energy
expenditure will be assessed.
Energy expenditure measurements will be performed in four different conditions,
which will be randomly distributed;
(1) walking without support (Wns)
(2) walking with support (Ws)
(3) walking without support while walking stability is perturbed (Pns)
(4) walking with support while walking stability is perturbed (Ps).
In the Wns condition, participants walk on the treadmill without any manual or
mechanical support. The Ws condition consists of walking on the treadmill while
walking stability is facilitated by instructing the participants to hold the
handrail of the treadmill (without excessive weight bearing on this handrail).
In the Pns and Ps condition walking stability will be perturbed. Perturbations
will be applied by projecting the participants* own walking pattern, measured
during Wns, in the form of virtual footprints on the surface of the treadmill.
Participants are asked to walk within the projection of these foot prints.
Each trial will have duration of four minutes. For stroke patients it can be
difficult to walk independently for four minutes. For this reason handrail
support is allowed in the first two minutes of each trial when steady state has
to be reached and no data are collected yet. Data will be collected in the last
two minutes of each trial. Between each trial, participants will be able to
rest until they feel comfortable enough to start the next trial. Participants
will be asked to wear comfortable shoes.
Study burden and risks
Subjects walk four times four minutes on a treadmill at self selected speed. In
two conditions balance will be perturbed. In case of a loss of balance subjects
are required to grab the handrail of the treadmill. In addition, subjects wear
a safety harness, fixed to the ceiling, which will catch them in case of a
fall. This will also engage the emergency break. One of the investigators will
be close to the subject to assist if necessary.
With these precautions the risk of falling and injury is minimized.
Participation in this research does therefore not include serious risks. Both
physical and mental burden for participants of this study is low.
Relweg 51
1949 EC Wijk aan Zee
Nederland
Relweg 51
1949 EC Wijk aan Zee
Nederland
Listed location countries
Age
Inclusion criteria
- Age: 35-75 years old
- Able to walk independently indoors for 4 minutes (minimal FAC 3)
- Maximum score on Berg Balance Scale of 50 (for patientgroup)
Exclusion criteria
- cognitive or communicative disorders that can affect the protocol (Mini Mental State Examination * 24),
- visual impairments that can affect the protocol
- attention impairments that can affect the protocol
- severe cardiovascular diseases that contra indicate moderately intense exercise
- other co-morbidities that could affect balance control or energy expenditure during walking
- medication that could interfere with balance control or energy expenditure during walking.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL32034.029.10 |