Action Observation as a Rehabilitation Intervention for Stroke

NCT05001958 | Completed

• 1 other identifier: H21185-GT
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

One way to help a stroke survivor learn how to use their arm and hand again is to have them watch and replicate "normal" arm and hand movements. This type of intervention is called action observation (AO) and has emerged as a potentially powerful therapeutic tool to improve stroke rehabilitation for the weakened arm and hand. AO involves the patient's visual observation of video recorded intact body movements with the intent to perform the same task with their weakened arm and hand. There is behavioral evidence in stroke survivors that movement skills usually gained through physical practice can also be acquired through observation of the skill alone. In preliminary research performed in Dr. Lewis Wheaton's lab at Georgia Tech, AO has been successfully implemented for persons with arm and hand amputations learning how to use their prostheses. AO training in patients with amputations revealed that their movement is improved when they focus their eye gaze on specific aspects of the movement in the video that may maximally benefit the patient. It is unknown if these eye gaze patterns may serve as the mechanism behind AO and differ among those with mild or moderate movement impairments due to stroke. In this study, the investigators seek to identify if experience with AO in stroke survivors with varying levels of impairment has a similar emergence of eye gaze patterns found in people with amputations. The investigators hypothesize that AO augments visuomotor strategies to help support improved movement and enhance rehabilitation strategies in stroke survivors with mild and moderate impairments. The goal of this work is to utilize eye gaze tracking approaches to understand this phenomenon. In addition, the investigators will identify the feasibility of implementing and assessing AO on eye gaze in stroke survivors.

Conditions

Stroke

Outcome Measures

Primary Outcomes (2)

• Eye gaze pattern

  Eye gaze patterns will be collected with a Pupil Labs Eye Camera (Berlin, Germany; 200 Hz, binocular) throughout the experiment. The participants will don eye tracking glasses that feature two pupil cameras which track the participants' pupils relative to the world, which records what participants see in their line of vision. Eye gaze will identify areas of interest of the SRTT (movement task).

  Eye gaze recorded in one day during the 3 blocks of video watching (action observation)

• Arm and hand movement with the Serial Reaction Time Test (SRTT)

  The participants' arm and hand movement will be analyzed when the participants perform the SRTT action using a Sensor Ascension trakSTAR system (Motion Monitor, Chicago). Electromagnetic sensors (MotionMonitor, Chicago) will be placed at key locations on the participant's arm and hand that they are using to complete the SRTT.

  Arm and hand movement recorded in one day during the 3 blocks of physical performance of the SRTT

Study Arms (1)

Action observation

EXPERIMENTAL

Behavioral: Action observation

Interventions

Action observation BEHAVIORAL

Participants will view a video of a task performed by a non-disabled actor and then the participants perform the task from the video with their weaker arm \& hand.

Action observation

Eligibility Criteria

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

You may qualify if:

• stroke experienced at 18 years of age or older
• not undergoing any physical rehabilitation during the time enrolled in this study
• mild to moderate impairments in the more affected arm and hand (i.e., movement and coordination scores on the Fugl-Meyer Assessment between 20 and 55)
• no cognitive impairments (mini-mental state examination ≥ 24/30)
• normal or corrected vision (National Institutes of Health Stroke Scale = 0)

You may not qualify if:

• any uncorrected impairment to the visual field, such as spatial neglect or inattention (i.e., decreased awareness/perception of objects or people in a section of the visual field) (National Institutes of Health Stroke Scale \> 1)
• inability to communicate and participate effectively for assessments and intervention sessions (mini-mental state examination and National Institutes of Health Stroke Scale) upper arm and hand movement impairment that is severe (Fugl-Meyer Assessment \< 20) or non-existent (Fugl-Meyer Assessment \> 55)

Sponsors & Collaborators

• Georgia State University: lead
• Georgia Institute of Technology: collaborator

Study Sites (1)

Georgia Tech

Atlanta, Arkansas, 30332, 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 Officials

• Veronica T Rowe, PhD, OTR/L

  Georgia State University

  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: Assistant Professor

Study Record Dates

• First Submitted: August 3, 2021
• First Posted: August 12, 2021
• Study Start: October 1, 2021
• Primary Completion: December 1, 2022
• Study Completion: December 31, 2022
• Last Updated: June 1, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)