Date of Award

1-1-2021

Embargo Period

5-1-2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Health Professions

First Advisor

Steven A. Kautz

Second Advisor

Mark G. Bowden

Third Advisor

Craig A. Velozo

Abstract

Stroke continues to be a leading cause of disability. Many individuals who suffer a stroke will receive specialized rehabilitation designed to maximize recovery and restore independence with daily activities. Yet, recovery is still highly variable with heterogeneity in treatment response that is still poorly understood. In recent years, the growing burden of stroke has pushed for moving away from a “one size fits all” approach with the concept of precision or personalized rehabilitation to generate evidence for clinicians to provide the right care, to the right patient, at the right time. The collection of research in this dissertation addresses key areas of personalized rehabilitation related to standardized outcome measurement, identification of biomarkers, and individualized response to treatment parameters in three parts. Part I illustrates how principals of item response theory can be used to inform a personalized measurement approach through clinical applications of Rasch analysis. Part II demonstrates how muscle coordination is linked with biomechanical variables of walking performance that can be used as potential biomarkers of recovery. Lastly, Part III shows how interindividual differences in treatment response could inform individualized prescription for transcranial direct stimulation for recovery of walking post-stroke as an example of how to approach personalized rehabilitation.

Rights

All rights reserved. Copyright is held by the author.

Download

Share

COinS