Perceptual-motor Interaction to Improve Bimanual Coordination After Stroke

NCT03755076 | Completed Early Phase 1 Results

• 2 other identifiers: 1 R01 HD095992-01A1R01HD092481
• Study Type: interventional
• Target: 79
• Locations: 1 country
• Sites: 1

Brief Summary

Significant difficulty in incorporating the weaker arm in daily activities after stroke is, in part, driven by difficulty in engaging both arms interactively in a coordinated manner. The current study aims to determine the nature of bimanual coordination deficits after stroke and takes initial steps to test a novel theory-driven approach to improve interactive bimanual coordination in patients with stroke. This project will advance stroke rehabilitation by identifying novel, scientifically-based strategies to improve the engagement of the weaker arm in coordinated and interactive bimanual actions of daily life, thus improving quality of life in individuals after stroke.

Conditions

Stroke

Outcome Measures

Primary Outcomes (2)

• Maximum Cross-correlation Coefficient

  Cross-correlation between tangential velocity profiles of the two hands was used to index spatial and temporal coordination between hands. Cross-correlation measures similarities of two distinct time series as a function of the displacement of one relative to the other. Repeated correlations between the two hand velocity profiles were obtained as the velocity profile of one hand was successively lagged. The maximum cross correlation coefficient obtained gave a measure of similarity between the two profiles, indexing spatial coordination. The better the arms moved in space, the higher the score they got, called the cross-correlation coefficient (CCr). CCr values range from zero to 1; with values close to 1 means the arms were moving very well together.

  After 20 minutes of training under each perceptual cue condition

• Between Hands Time-lag

  Temporal coordination is about how well both arms move at the same time. Temporal coordination was quantified as the time lag at which the peak cross-correlation coefficient was obtained via cross-correlation analysis. If one arm moves a little later than the other, there's a time delay (or time lag). Shorter the delay, the better the timing between the arms. If the delay is positive, it means the weaker or less-used arm is moving after the stronger one.

  After 20 minutes of training under each perceptual cue condition

Study Arms (2)

Neurotypical Control

EXPERIMENTAL

Neurotypical healthy age-matched controls.

Behavioral: Perceptual cuing

Stroke survivor

EXPERIMENTAL

Stroke survivors with mild-to-moderate motor impairments

Behavioral: Perceptual cuing

Interventions

Perceptual cuing BEHAVIORAL

Participants were provided four perceptual cues (or feedback) in a pseudorandom order: (a) indiscriminate, (b) Altered gain, (c) Coordination, (d) Dual: altered gain and coordination

Neurotypical Control; Stroke survivor

Eligibility Criteria

• Age: 21 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Clinical diagnosis of unilateral stroke
• ability to reach along a diagonal direction at least 80% of their arm length while fully supported on a frictionless surface and trunk constrained.
• Mini-mental scale score \> 26, OR s score of 4 or above on auditory verbal comprehension part of the Western Aphasia Battery to ensure intact comprehension and following commands.
• (e) no evidence of hemispatial neglect tested by a line bisection test.

You may not qualify if:

• bilateral stroke,
• complete paralyses,
• basal ganglia/cerebellar stroke,
• pain or stiffness in upper extremity that will interfere with the task or inability to follow task instructions.

Sponsors & Collaborators

• Albert Einstein Healthcare Network: lead
• University of Pennsylvania: collaborator
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): collaborator

Study Sites (1)

Moss Rehabilitation Research Institute

Elkins Park, Pennsylvania, 19027, 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

Limitations and Caveats

The study included moving a virtual brick without any haptic feedback. The virtual object was used to ensure systematic manipulation of perceptual cues at this early phase of translational research. Thus future studies need to determine if these findings may be applicable in real-world tasks. We included individuals with mild-to-moderate impairments; thus, these findings may not apply to those with more severe motor and cognitive impairments.

Results Point of Contact

• Title: Dr. Shailesh Kantak
• Organization: Albert Einstein Healthcare Network

skantak@ranchoresearch.org

562-385-7111

Study Officials

• Shailesh S Kantak, PhD, PT

  Moss Rehabilitation Research Institute

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: early phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Institute Scientist

Model Details: Participants will perform bilateral arm movements in a virtual reality environment under different perceptual conditions to identify a condition that improves coordination between arms.

Study Record Dates

• First Submitted: October 25, 2018
• First Posted: November 27, 2018
• Study Start: April 19, 2019
• Primary Completion: January 3, 2024
• Study Completion: January 3, 2024
• Last Updated: August 14, 2025
• Results First Posted: August 14, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)