Table 2.
1 | Name: | Task-specific gait training (TSGT) group. |
2 | Rationale: | Walking is a priority for many stroke survivors, confirmed by studies undertaken to define a national research agenda, which identified physical therapy to address balance and gait (walking) post-stroke within the top 10 research priorities [James Lind Alliance, (9)]. There is strong evidence that task-specific walking practice can be used to improve walking after stroke (50). |
3 | Materials: | Based upon a review of the literature and a focus group with experienced clinicians a few pieces of equipment will be required including theraband, football, chair, foam cushion, gym ball a stair or step and a wobble board. |
4 | Procedures: | 30 min of TSGT will be supervised by the research therapist, with 20 sessions being delivered over a 4–6-week intervention period. The TSGT will be undertaken immediately after the mobilization and tactile stimulation (MTS) for the MTS group. The TSGT will be undertaken whilst wearing a TI on the contralesional side and a smooth insole on the other side, for the TI group |
5 | Provided by: | The TSGT will be delivered by a research therapist (Band 6), with experience of working with stroke patients. A log will be kept of which research therapist provides which treatment for each participant and this information will be analysed on completion of the trial. |
6 | Mode of delivery: | The research therapist will provide the TSGT in a 1:1 situation. |
7 | Location: | The TSGT will take place in either an inpatient clinical setting within an NHS organisation or a University research setting or the participant's own home. |
8 | When and how much: | All participants in both groups/arms of the trial will receive 20 sessions of 30 min of TSGT within a 4–6-week period. |
9 | Tailoring: | Although a standardised protocol will be followed for the TSGT the research therapist will choose appropriate exercises and adapt them as required to suit the requirements of each individual participant, due to differences in presentation following a stroke. This reflects how TSGT would usually be implemented in conventional rehabilitation. Details of actual intervention delivered will be recorded on the treatment schedule. |
10 | Modifications: | Any modifications to the TSGT protocol will be monitored and reported appropriately. |
11 | Intervention adherence and fidelity- planned: | Intervention adherence and fidelity will be analysed. Strategies to improve fidelity and adherence include 1:1 intervention plus encouragement and motivation strategies by the research therapist during the TSGT, as in usual therapy rehabilitation. A log will be kept detailing, for each participant, which research therapist has delivered the TSGT. |
12 | Intervention adherence and fidelity—how well (actual): | The case report files completed by the research therapists will give an indication of adherence to the intervention. The focus groups will enable further opportunity of assessing the adherence, fidelity, and acceptability of the intervention. |
MTS, Mobilization and tactile stimulation; TSGT, Task-specific gait training.