Targeted Strength Training To Improve Functional Walking Capacity Of Adolescents And Young Adults With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$263,449.00
Summary
Cerebral palsy is the most common cause of disability in children. Caused by damage to the brain in early childhood cerebral palsy leads to muscle weakness and difficulties in walking. There is no cure for cerebral palsy, but we can help the weak muscles . The purpose of this trial is to establish that exercises to strengthen the weakest muscles will help the walking ability of teenagers and young adults with cerebral palsy, as they make the transition to independence and adulthood.
Task-specific Strength Training For Mobility Following Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$184,768.00
Summary
I am a senior physiotherapist working in the traumatic brain injury (TBI) unit at Epworth Rehabilitation. We have identified and described the nature and extent of walking problems following TBI. Previous researchers focused on the impact of balance disorders on walking. Our research found that balance disorders are prevalent; the main cause of walking problems is muscle weakness. We will compare balance and muscle strengthening exercises to determine which has a greater impact on walking.
Does Aerobic Or Resistance Training Improve Walking Ability In Chronic Stroke Patients?
Funder
National Health and Medical Research Council
Funding Amount
$152,036.00
Summary
The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether ....The majority of stroke patients discharged from rehabilitation are often housebound. The criterion which most often limits individuals with stroke from achieving 'community ambulation' is the inability to walk long distances. Current views suggest that an exercise program aimed at improving lower limb strength and aerobic fitness will improve walking ability in those stroke patients with mild to moderate disability. However, there are no reported studies that have rigorously investigated whether either of these approaches, singularly or combined, is effective for augmenting walking ability in chronic stroke patients. We will use a randomised, double-blinded controlled trial to determine which of strength training, aerobic training or a combination of the two is the most effective approach for improving walking endurance, measured by the 6-minute walk test, in individuals with mild-to-moderate stroke. In addition, we will determine the benefits of each program to subjects' cardiorespiratory fitness, lower limb strength, mobility and psychological function. Subjects will be randomly allocated to one of 4 groups: 1) Aerobic exercise (and sham strength training); 2); Strength training (and sham aerobic training); 3) Combined strength and aerobic training; and 4) Control (sham strength and aerobic training. Sham treatment for strength training is stretching and calisthenics, and for aerobic exercise is passive motorised cycling. All subjects will attend small group sessions for 10 weeks, with 3 sessions per week, and each session about 1 hour duration. The findings from this study are critical in identifying the most effective and efficient approach to improving stroke patient's walking endurance. Improvement in walking endurance will enable many persons following stroke to achieve the level of 'community ambulation'. Last, it will contribute to the 'evidence-based' scientific framework for treatment of stroke patients.Read moreRead less
Improving Mobility After Traumatic Brain Injury With Ballistic Strength Training
Funder
National Health and Medical Research Council
Funding Amount
$661,430.00
Summary
Traumatic Brain Injury (TBI) is the leading cause of disability amongst young adults, many of whom have difficulty walking. Muscle weakness is the main cause of these walking problems, but previous trials have failed to improve walking performance. We have developed new strengthening exercises which focus on how quickly the muscles can contract, rather than just how strong they are. These exercises can increase muscle power by 60-74% and are likely to improve people’s ability to walk.
Orthostatic Tolerance During FES-evoked Stepping In Paraplegia: A Safety And Viability Study
Funder
National Health and Medical Research Council
Funding Amount
$244,900.00
Summary
In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES ....In the past 30 years, there has been growing interest in the potential benefits of functional electrical stimulation (FES) of the paralysed leg muscles as a means of restoring movement in the lower limbs. FES uses electrical impulses generated by a stimulator to elicit purposeful muscle contractions via skin-surface electrodes placed over the muscles. Although traditionally limited to health-related activities such as stationary cycling exercise, recent bioengineering advances in the area of FES present the SCI person with a means of restoring upright mobility and reinstating functional tasks. Yet, while this technological innovation remains promising for optimising functional outcomes after SCI, there remains a distinct lack of knowledge of the physiological stresses placed upon the individual. In this preliminary safety and viability study, the physiological implications central to enhanced upright mobility will be investigated during FES-evoked prolonged stepping. The responses during FES-stepping will be contrasted with the responses observed during stepping performed without FES. The study will investigate the blood pressure responses during FES-gait, but also address possible physiological mechanisms underlying those blood pressure responses. The findings from this study will identify whether there is a phsiological limitation to the performance of FES-evoked functional mobility. Current physiotherapy practice recognises blood pressure control and orthostatic hypotension as a significant barrier to functional standing and stepping, yet little is known about the physiology underpinning the condition. If FES does present a limitation to the performance of upright functional activities, this study will also assist in devising alternative physiotherapy gait training regimens.Read moreRead less
A RCT Of Power Training And Treadmill Training To Improve Walking Ability In Sub-acute Stroke Patients.
Funder
National Health and Medical Research Council
Funding Amount
$403,041.00
Summary
Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of trea ....Stroke causes weakness, incoordination, and reduced aerobic fitness, all of which impact significantly on walking ability and other related functions, such as balance. The current management of stroke patients is inadequate in improving patients' walking ability to a level that promotes independence in the community, as it does not address the impairments at the physiological level necessary to implement significant change. A relatively new approach to walking following stroke is the use of treadmill walking. However, this form of training does not address the weakness following stroke. Therefore we propose to demonstrate the efficacy of a relatively new modality 'treadmill training with power training', at higher intensity over a greater number of sessions than would be received currently with 'usual care' or treadmill training only. To ensure that persons continue to maintain the level of improvement from an intensive exercise program, we will also implement a behavioural change for long-term maintenance of exercise behaviour in a less supervised environment. A randomized, single-blinded, control trial will be used. Subjects will be randomly allocated to 'treadmill training + power training', 'treadmill training', or usual care (i.e. control). Subjects in the two training groups will also receive 'usual care'. Subjects in the treadmill and treadmill + power training groups will attend training sessions for 10 weeks, with 3 sessions per week. Subjects will then be provided with a home exercise package to continue with their exercises. The findings from this study are critical in identifying whether, by addressing the 3 major impairments following stroke at doses which are known to produce physiological change in other frail populations, the stroke patient can achieve independence in walking and walk sufficient distances, both of which are important to the stroke patient.Read moreRead less
Substantial portions of the Australian population have some difficulty walking. People affected include children with cerebral palsy, people who've had injuries playing sport and older people with Parkinson's disease, osteoarthritis or who have had a stroke. The cost of managing arthritic conditions alone was estimated at $2.2 Billion for 2001. Gait analysis uses high technology video cameras, force transducers, muscle activity sensors and computers to record how people walk and is now being use ....Substantial portions of the Australian population have some difficulty walking. People affected include children with cerebral palsy, people who've had injuries playing sport and older people with Parkinson's disease, osteoarthritis or who have had a stroke. The cost of managing arthritic conditions alone was estimated at $2.2 Billion for 2001. Gait analysis uses high technology video cameras, force transducers, muscle activity sensors and computers to record how people walk and is now being used more and more commonly across Australia. The technology is very similar to that now being used to capture how people move for the movie industry. The technology allows us a better understanding of how people are moving and therefore of what treatments they are likely to benefit from. Melbourne now has four Gait Analysis facilities working with different patient groups and each with an international reputation for its work. These groups have combined to form the CCRE in Gait Analysis and Gait Rehabilitation under the leadership of Professor H Kerr Graham (Royal Children's Hospital) and Professor Bob Iansek (Kingston Centre, Southern Health).Read moreRead less
Training Dual Task Performance During Gait In Parkinson Disease
Funder
National Health and Medical Research Council
Funding Amount
$386,980.00
Summary
Difficulty performing more than one task at a time is a common and disabling problem experienced by people with Parkinson's Disease (PD), a progressive neurological condition that affects the ability of people to perform well-learned movements like walking with normal speed and size. This research will investigate how to best train people with PD to dual-task when walking. Teaching people with PD how to dual task will enhance their everyday activities and has potential to reduce falls incidence.
NaviGAIT: New Software To Simplify Interpretation Of Gait Analysis Data
Funder
National Health and Medical Research Council
Funding Amount
$179,905.00
Summary
NaviGAIT is a new software package to support interpretation of gait analysis data. It is based upon Gait Profiling, a new technique to reduce the complexity of such data. At present data intepretation is restricted to a few expert clinicians. The new software will allow non-expert clinicians to interpret data and hence make gait analysis more accessible, cheaper and more clincally useful. A module of NaviGAIT specifically for children with cerebral palsy will be the first to be developed.