Focus of attention to improve sit-to-stand after chronic stroke

Focus of Attention Effect on Sit to Stand Symmetry in Individuals Post Chronic Stroke: A Randomized Cross-over Trial

This trial tests whether giving people with chronic stroke internal or external focus cues helps them use their affected leg more and maintain an upright trunk during sit-to-stand.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 20 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Western Carolina University (Academic / other)
• Locations: 1 site (Cullowhee, North Carolina)
• Trial ID: NCT07460804 on ClinicalTrials.gov

What this trial studies

Adults more than six months after stroke with mild-to-moderate deficits will be screened (NIHSS, MOCA, Star Cancellation) and described with the Fugl-Meyer lower-extremity score before baseline testing. Sit-to-stand will be measured on a pressure mat and gait will be recorded on a GAITRite walkway at baseline, five minutes, and one hour after training. Participants will receive training emphasizing either an internal focus (body movement) or an external focus (movement effect) and retention and transfer to affected-leg weight bearing during gait will be tested. The single-site protocol at Western Carolina University excludes people who cannot perform sit-to-stand or walk the required distance or who have severe cognitive, perceptual, orthopedic, or other neurologic conditions that affect the task.

Who should consider this trial

Good fit: Ideal candidates are adults >6 months post-stroke with mild to moderate deficits (NIHSS 0–15) who can stand from a standard chair and walk 20 feet with or without an assistive device, have sufficient cognition (MOCA ≥10), and speak English.

Not a fit: Those with severe cognitive impairment, contraversive pushing, significant neglect, orthopedic or other neurologic conditions affecting sit-to-stand, inability to perform the required standing or walking tasks, non-English speakers, minors, pregnant people, or prisoners are excluded and unlikely to benefit.

Why it matters

Potential benefit: If successful, the approach could help people after stroke use their affected leg more during sit-to-stand and improve short-term transfer to walking, potentially improving daily mobility.

How similar studies have performed: Prior motor-learning studies often show an external focus improves performance and retention, but evidence specifically for sit-to-stand training in chronic stroke is limited.

Eligibility criteria

Inclusion Criteria:

* Stroke \>6 months
* Mild to moderate stroke (NIHSS scores 0-15)

Exclusion Criteria:

* Unable to perform sit to stand from a standard height 20" chair without physical assistance
* Unable to walk 20 feet with or without an assistive device at a contact guard to independent level
* Individuals with severe cognitive impairment (\<10/30 on the Montreal Cognitive assessment)
* Contraversive pushing (\> 1 on the Scale for Contraversive Pushing)
* Neglect as evidenced by \<44/54 on the star cancellation test
* Any orthopedic conditions that impact their ability to transition from sit to stand will be excluded from the study.
* Any other neurologic conditions that impact their ability to transition from sit to stand will be excluded from the study.
* Minors, prisoners, pregnant women will also be excluded.
* Non English speaking individuals due to lack of interpretation resources.

Where this trial is running

Cullowhee, North Carolina

• Western Carolina University — Cullowhee, North Carolina, United States (Recruiting)

Study contacts

• Study coordinator: Ashley Watamura, PT, DPT, PhD

Conditions Stroke; Motor learning; Focus of attention; Sit to stand