What Makes a Responder, a Responder? Biomarkers to Help Identify Responders and Resistors to High-intensity Interval Training for Lower Extremity Chronic Stroke
VA Office of Research and Development
Summary
Stroke survivors with lower limb disability can improve their walking speed with high-intensity interval training (HIIT) rehabilitation therapy. However, some individuals may not respond to HIIT even when fully adherent to the program. To address this, the investigators propose to build a predictive model that identifies if a Veteran with chronic subcortical stroke will improve their walking speed with HIIT by incorporating blood lactate as an early predictor of exercise response, and inhibitory neurotransmitter gamma-aminobutyric acid (GABA) and regional cerebral blood flow (CBF) as predictors of the brain's potential to respond, while also taking into consideration other factors such as comorbidities, demographics, and fitness levels.
Description
Most chronic subcortical stroke survivors have difficulty walking, but few predictors can help identify if a patient will respond to an exercise regimen and improve their function. To enhance precision rehabilitation for chronic subcortical stroke patients, personalized aerobic exercise interventions are crucial. This requires the development of innovative technologies that can identify the essential neurobiological factors to predict intervention response and enable clinicians to determine individualized rehabilitation targets. Lactate is one exciting new target that acts as a molecular messe…
Eligibility
- Age range
- 18–89 years
- Sex
- All
- Healthy volunteers
- No
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 * Veteran status Exclusion Criteria: * MRI contraindications, including implanted cardiac pacemakers and severe claustrophobia * any neurodegenerative condition other than stroke that may lead to lower extremity impairment * a visual or auditory impairment that may hinder study procedures * any medical condition that would preclude participation in a ph…
Interventions
- OtherHigh Intensity Interval Training (HIIT)
HIIT consists of three weekly 25-60 minute cycling sessions for 12 weeks at the Atlanta VA, administered by a trained exercise physiologist, for a total of 36 HIIT sessions.
Location
- Atlanta VA Medical and Rehab Center, Decatur, GADecatur, Georgia