Unilateral Wrist Extension Training After Stroke

NCT03268798 | Completed

• 1 other identifier: D015017-2011-2015
• Study Type: interventional
• Target: 24
• Locations: 0 countries
• Sites: N/A

Brief Summary

Following stroke, muscle weakness and impaired motor function are expressed in both the more (MA; paretic) and less affected (LA; non-paretic) sides. Although the efficacy of resistance training is well recognized, training the MA limb directly may be initially difficult due to muscular weakness. "Cross-education" is training one side of the body increases strength in the untrained and opposite side. This concept can be applied in strength training when training the more affected sides cannot be initiated. Recently, our lab found six weeks of dorsiflexion resistance training in the LA leg improved the strength of both trained and untrained legs of chronic stroke participants. The current project explored if cross-education exists in the upper limb in chronic stroke participants and if there are related changes in cortical and spinal cord plasticity. We hypothesized that unilateral strength in the less affected arm could enhance wrist extension strength bilaterally with related neural adoption and improved clinical function.

Conditions

Stroke

Keywords

stroke; strength training; rehabilitation

Outcome Measures

Primary Outcomes (1)

• Changes in wrist extension force

  To test if training could improve wrist extension strength, maximal wrist extension force were measured in both arms during the 3 baseline pretests, 1 post-test. There was a week in between each baseline tests, post-test will be performed within one week after the training finished. To test if the force changes maintained after training, follow-up test was performed 5 weeks after training finished.

  Week1-3: baselines were measured once per week for three times; Week 4-8: training(no measurement was taken); Week 9: post-test; Week 13: follow-up test

Secondary Outcomes (7)

• Changes in the modulation of spinal-mediated muscle reflexes

  Week1-3: baselines were measured once per week for three times; Week 4-8: training(no measurement was taken); Week 9: post-test;

• Neural adaptation in the corticospinal pathway

  Week1-3: baselines were measured once per week for three times; Week 4-8: training(no measurement was taken); Week 9: post-test;

• Upper limb impairment assessments

  Week1-3: baselines were measured once per week for three times; Week 4-8: training(no measurement was taken); Week 9: post-test;

• Upper limb function assessments

  Week1-3: baselines were measured once per week for three times; Week 4-8: training (no measurement was taken); Week 9: post-test; Week 13: follow-up test

• Ten-meter walking test

  Week1-3: baselines were measured once per week for three times; Week 4-8: training (no measurement was taken); Week 9: post-test;

Study Arms (1)

Wrist extension training

EXPERIMENTAL

Device: Unilateral wrist extension training

Interventions

Unilateral wrist extension training DEVICE

Participants will join a five-week training protocol with 3 sessions per week. During each session, 5 sets 5 maximal wrist extension training will be performed on participants less affected side.

Wrist extension training

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Over 6 months post-stroke;
• One side of arm shows muscle weakness
• Pass the screening test of Physical Activity Readiness Questionnaire
• Pass the screening test for dementia
• Free from dementia (score \< 24 on the Montreal Cognitive Assessment) and any other contradiction for TMS test

You may not qualify if:

• Had medication affecting muscle tone within the past 3 months
• Wear a pacemaker

Sponsors & Collaborators

• University of Victoria: lead
• University of British Columbia: collaborator

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Officials

• E.Paul Zehr

  Rehabilitation Neuroscience Laboratory, University of Victoria

  PRINCIPAL INVESTIGATOR

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: Professor

Study Record Dates

• First Submitted: August 24, 2017
• First Posted: August 31, 2017
• Study Start: March 1, 2015
• Primary Completion: July 1, 2017
• Study Completion: July 1, 2017
• Last Updated: August 31, 2017

Record last verified: 2017-08