Action Selection and Arm Rehabilitation After Stroke

NCT02785419 | Completed

• 1 other identifier: Pro00032516
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

After stroke, individuals often have persistent difficulty using the arm and hand in everyday functional tasks that reduces quality of life. Currently available rehabilitation techniques are not adequate and new protocols are needed that are based on an understanding of how brain regions work together to produce skilled movement. This research project aims to improve our understanding of how the brain controls movement after stroke and determine whether a period of motor practice that targets specific brain regions through the addition of action selection demands leads to improved arm function. We hypothesize that arm motor function and the ability to efficiently activate the action selection motor circuit during movement will improve after training.

Conditions

Stroke

Keywords

Rehabilitation; Upper Extremity; Physical Therapy

Outcome Measures

Primary Outcomes (3)

• Action Research Arm Test

  Behavioral assessment of arm function. Scores range from 0 to 57 with a higher score equating to better function.

  Change from baseline to end of treatment (3 weeks)

• Brain activation during functional MRI

  Brain activation during movement will be captured with functional MRI. Analyses will investigate changes in magnitude of activation.

  Change from baseline to end of treatment (3 weeks)

• Brain connectivity during functional MRI

  Brain activation during movement will be captured with functional MRI. Analyses will investigate changes in connectivity between brain regions.

  Change from baseline to end of treatment (3 weeks)

Secondary Outcomes (6)

• Upper Extremity Fugl-Meyer Motor Assessment

  Change from baseline to end of treatment (3 weeks)

• Stroke Impact Scale Hand Domain

  Change from baseline to end of treatment (3 weeks)

• Box & Blocks Test

  Change from baseline to end of treatment (3 weeks)

• 9-Hole Peg Test

  Change from baseline to end of treatment (3 weeks)

• Grip Strength

  Change from baseline to end of treatment (3 weeks)

Study Arms (1)

Arm Training with Action Selection

EXPERIMENTAL

Task-oriented, functional arm training with the addition of action selection cues to practice. All participants receive the same arm training intervention.

Behavioral: Arm Training with Action Selection

Interventions

Arm Training with Action Selection BEHAVIORAL

Treatment occurs in 1.5 hour sessions, 5 times a week for 3 weeks. In each treatment session, you will practice functional tasks with your weaker arm and hand. Additionally, you will be given cues on a computer screen that dictate your movement response (action selection). Practice will be scaled to match your current level of function and progressed over time as able.

Also known as: Functional task practice, Arm rehabilitation

Arm Training with Action Selection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• At least 18 years old
• Had stroke at least 6 months ago
• Right-hand dominant prior to stroke
• Some continued arm and hand weakness
• Some ability to move the arm and hand that is weaker from the stroke

You may not qualify if:

• Acute medical issues that would interfere with participation
• Another neurologic diagnosis that may impact movement (e.g. Parkinson's Disease)
• Cannot undergo MRI scanning
• Severe apraxia or hemispatial neglect
• Pain in the arm that interferes with movement
• Difficulty maintaining attention or following directions

Sponsors & Collaborators

• University of South Carolina: lead

Study Sites (1)

University of South Carolina

Columbia, South Carolina, 29208, United States

Location

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: May 9, 2016
• First Posted: May 27, 2016
• Study Start: December 8, 2015
• Primary Completion: December 1, 2020
• Study Completion: December 1, 2020
• Last Updated: July 23, 2021

Record last verified: 2021-07

Locations

US (1)