Why is this research needed?
Stroke survivors often have problems walking which can reduce their independence, and lead to lower daily activity increasing risk of further stroke and health problems.
A promising treatment to improving walking after stroke is called ‘auditory rhythmical cueing,’ which encourages stroke survivors to walk to the rhythm of a sound beat. This treatment improves walking after stroke in the hospital, but has not been tested later on at home where recovery could continue.
Research is needed to find out if the treatment can be used to benefit stroke survivors living at home, without unintended harms.
Dr Moore said, “Walking is affected in up to 80% of stroke survivors. There is an urgent need to develop low-cost interventions that can be given in the home and community to solve this problem. But most promising research into ‘auditory rhythmical cueing’ is in a laboratory settings. We need this research to understand how it could be used where stroke survivors actually live, in the home and community.”
What is the research aiming to do?
The ACTIVATE study aims to understand if it’s possible for stroke survivors to take part in an ‘auditory rhythmical cueing’ walking programme at home. This paves the way for larger tests to show if the new treatment at home improves walking and is good value for money in the NHS, so it can be made widely available to stroke survivors.
How will they do this?
The researchers will invent a new ‘auditory rhythmical cueing’ treatment programme, called ACTIVATE, by listening to the views of stroke survivors, carers and health professionals to understand the best ways to give the treatment at home. This will include making training materials for healthcare professionals and patients. They will then test if it’s possible to give the new treatment to a small group of stroke survivors.
Dr Moore and her colleagues made the new treatment, ACTIVATE, to meet the needs of stroke survivors that need to improve their walking abilities once at home, and health care professionals that may work with them. This includes videos and workbooks that show stroke survivors doing the exercises.
By testing the new treatment, they showed that it’s possible and safe to use with stroke survivors at home. Stroke survivors were able to, and wanted to, follow the treatment programme. In the stroke survivors that took part, most said the programme was helpful and they would recommend it. This successfully lays the foundation for a larger study to show if, and how much the new treatment improves walking abilities, and its cost-effectiveness in order for it to be recommended in the NHS.
Dr Moore said, “The ACTIVATE trial has provided the vital foundations to show whether this relatively simple treatment could help stroke survivors to improve their walking ability at home and in the community”.
Anna, who cares for her partner that had a stroke said “I’m pleased to see imaginative and 'off the walls' ideas are being explored and successfully! I wish my partner had access to this idea. He loves to dance and can get caught up in the movement forgetting his legs don’t walk the way they used to.”