Grant: CIHR Fellowship

Effectiveness of stroke rehabilitation is important; there are about 62,000 strokes in Canada every year and more than 400,000 people living with long-term disability from stroke(1). These numbers are expected to double in the next 20 years(1). Stroke survivors say that regaining walking ability is a top priority; but, reduced balance often limits community levels of mobility(2). Today's stroke rehabilitation treatment decisions are guided by observing physical limitations to balance and walking, and not by brain measures. Differences in how much balance recovery someone achieves likely stems from the brain's ability to recover after stroke. Functional near-infrared spectroscopy (fNIRS) is an imaging technology that can help us understand how the brain recovers balance after stroke, and may help identify those people who will benefit from an exercise intervention. fNIRS is special in that it can be used while people are moving in tasks like standing and balancing. At this point, it is not known whether a recording with fNIRS can give us a brain activity profile that can predict who will improve their balance, prior to starting an exercise intervention. So, the goals of our randomized clinical trial, is to test which regions of the brain and how they interact, produce high levels of balance recovery with the Fitness And Mobility Exercise (FAME) program for stroke(3). If we can find a fNIRS brain activity profile, instead of treating patients based on physical limitations, we will identify which individuals benefit from an exercise program like FAME. Given that stroke damages the brain, involving brain measures to guide treatment decisions could increase effectiveness of stroke rehabilitation. (1) Canadian Partnership for Stroke Recovery Annual Report 2017-2018, https://www.canadianstroke.ca/en/about-us/annual-reports/annual-report-2017-18-making-impact (2) Marigold et al. J Am Geriatr Soc 2005;53(3):416-23. (3) Pang et al. J Am Geriatr Soc; 2005;53(10):1667-74.