Interference During Motor Learning of Different Degrees of Freedom in the Paretic Upper Extremity of People With Stroke

NCT06249737 | Unknown

• 1 other identifier: interference_stroke
• Study Type: interventional
• Target: 99
• Locations: 1 country
• Sites: 2

Brief Summary

Post-stroke rehabilitation of the upper extremity is a challenge in neurorehabilitation. Selective training of different degrees of freedom (training of specific monoarticular movements and in one plane of movement of the upper extremity) to achieve true recovery could be a good approach. However, it is not known how the training should be structured to avoid interference between the different movements trained, hindering the motor learning process during neurorehabilitation. This research aims to determine the effect on performance and kinematic control of a selective movement control task during one- or three-days training of 2 different degrees of freedom, close or distant in cortical representation, of the upper extremity in people with early subacute and chronic phase of stroke. The hypothesis is that in the upper extremity of subacute or chronic phase stroke survivors, learning 1 target DoF is interfered by training another DoF of the same joint. In contrast, learning 1 DoF from a different, distant joint does not interfere with learning the target DoF in a training session. Likewise, this interference is diminished in multiple training sessions. On the other hand, in early post-stroke phase, within the first 5 weeks, the gain in kinematic control of each controlled DoF is greater than in later post-stroke phases (between 9 to 12 weeks of evolution or chronic phase). An experimental design of 4 days of training, of approximately 60 minutes per day, will be carried out in people who are within the first 3 months after a stroke or in a chronic stage. There will be 3 intervention groups that will train the shoulder flexion movement of the paretic upper extremity and another movement, which can be of the same affected upper extremity or another of the contralateral lower extremity.

Conditions

Stroke

Keywords

stroke recovery; motor learning; upper extremity recovery; learning interference

Outcome Measures

Primary Outcomes (2)

• 1 day performance changes

  Based on the expected trajectory and the actual trajectory of the videogame, the difference between these trajectories will be calculated to compare the changes of each trained DoF between the performance made at the beginning of one day of training, at the end of that same day and between the second day (retention test).

  day 2

• 3 days performance changes

  Based on the expected trajectory and the actual trajectory of the videogame, the difference between these trajectories will be calculated to compare the changes of each trained DoF t the beginning of the first day of training andafter completing the four days of training.

  day 4

Secondary Outcomes (2)

• 1 day smoothness changes

  day 2

• 3 days smoothness changes

  day 4

Study Arms (3)

Control Group

EXPERIMENTAL

This group will train the DoF target (shoulder flexo-extension) and DoF dorsi-ankle flexion of the contralateral lower extremity.

Behavioral: Training

Proximal Interference Group

EXPERIMENTAL

This group will train the DoF target and shoulder abduction-adduction DoF.

Behavioral: Training

Distal Interference Group

EXPERIMENTAL

This group will train the DoF Tf and the wrist flexion-extension DoF.

Behavioral: Training

Interventions

Training BEHAVIORAL

Each participan will train the kinematic control of each degree of freedom, according to each arm, playing a videogame using an inertial sensor.

Control Group; Distal Interference Group; Proximal Interference Group

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Stroke diagnosis
• Muscular strength according to the MRC scale of 2 or more in the shoulder flexor, shoulder abductor and wrist extensor muscles.

You may not qualify if:

• Presence of another neurological or musculoskeletal disease that affects the mobility of the paretic upper extremity
• Inability to follow instructions
• Spasticity graded as 3 or more on the Modified Ashworth scale of flexor muscles of the upper extremity
• Signs of cerebellar damage such as the presence of ataxia or dysmetria in the upper extremity

Sponsors & Collaborators

• University of Valencia: lead

Study Sites (2)

Universitat de Valencia

Valencia, Valencia, 46010, Spain

RECRUITING

Unitat de dany Cerebral Adquirit

Valencia, 46014, Spain

RECRUITING

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Officials

• Trinidad Bruna-Melo, MSc

  Universitat de Valencia

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Trinidad Bruna-Melo, MSc

CONTACT

+34657278264; tribrume@uv.alumni.es

María Luz Sánchez-Sánchez, Ph.D

CONTACT

+34672423273

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ph.D, PT

Model Details: There will be 3 intervention groups where they will train the movement of different DoF of the affected upper extremity (the DoF target and other DoF of the shoulder or wrist) or the DoF target and other DoF of the contralateral lower extremity (to maintain the practice dose among all groups)

Study Record Dates

• First Submitted: January 31, 2024
• First Posted: February 8, 2024
• Study Start: January 22, 2024
• Primary Completion: July 31, 2025
• Study Completion: July 31, 2025
• Last Updated: February 8, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

ES (2)