COMPELLED BODY WEIGHT SHIFT THERAPY IN INDIVIDUALS WITH STROKE

描述（由申请人提供）：活动能力严重受损是中风的主要后果。因此，在美国，每年有超过70万人中风，他们的运动能力受到限制，生活质量受到影响。事实上，偏瘫患者经常通过其未受累的下肢承受大部分体重。站立和负重的不对称已被认为是行走能力的一个预测指标。因此，实现姿态和步态的对称被认为是康复的一个重要目标。然而，旨在增强中风后运动功能和促进独立性的治疗干预措施相当有限。我们已经开发了一种新技术，初步研究表明可以显著改善步态模式，减少中风患者的失能性运动缺陷，并提高他们的独立性。这项技术被称为强迫体重转移（CBWS）疗法，包括在几周内通过使用鞋垫抬起未受影响的下肢。在此期间，患者在参加物理治疗和常规日常活动的同时，更方便匀称的负重。拟议的研究建立在一项初步研究的结果基础上，该研究表明CBWS治疗对慢性单侧中风患者有显着益处。实验设计将脑卒中后1年以上的患者随机分为两组。实验组接受CBWS治疗结合常规物理治疗，为期6周，对照组仅接受常规物理治疗。两组的近期和长期（4个月后）结果将进行比较。具体目的是：(1)比较CBWS治疗与单纯常规治疗在改善步态和对称负重方面的疗效；(2)评价cbws治疗后是否持续改善。这项研究具有至关重要的意义，因为如果研究成功，研究结果可以用来重新关注传统的康复策略，旨在帮助慢性中风患者在行动和日常生活活动方面实现最大的独立性。

DESCRIPTION (provided by applicant): Profoundly impaired mobility is a major consequence of stroke. As a result, a large number of more than 700,000 people in America sustaining a stroke each year have limitations in motor ability and compromised quality of life. It is a fact that individuals with hemiparesis frequently bear the majority of their body weight through their uninvolved lower extremity. Asymmetry of stance and weight bearing has been recognized as a predictor of the ability to ambulate. Therefore, achieving symmetry of stance and gait is considered an important goal of rehabilitation. However, therapeutic interventions designed to enhance motor function and promote independence following stroke are quite limited. We have developed a new technique that preliminary studies suggest can substantially improve gait pattern, reduce the incapacitating motor deficit of stroke patients, and increase their independence. The technique, termed Compelled Body-Weight Shift (CBWS) therapy, involves lift of the nonaffected lower extremity through the use of a shoe insert over a period of several weeks. During this time, more symmetrical weight bearing is facilitated while patients participate in physical therapy as well as regular daily activities. The proposed research builds on findings from a pilot study that demonstrated significant gains in individuals with chronic unilateral stroke following CBWS therapy. The experimental design randomly assigns patients who are more than 1 year post-stroke to two groups. The experimental group will receive CBWS therapy combined with conventional physical therapy for a period of six weeks, the control group will only receive conventional physical therapy. Immediate and longer-term (four months out) results from both groups will be compared. The specific aims are: (1) to test the efficacy of CBWS therapy compared to conventional therapy alone in improving gait and symmetry of weight bearing; (2) to evaluate whether the improvement is sustained post-CBWS therapy. This research is of paramount significance because, if successful, the outcomes from the study could be used to refocus conventional rehabilitation strategies aimed at helping chronic stroke patients to achieve maximal independence in mobility and activities of daily living.