Immediate Effects of PETTLEP-Based AOMI on Upper Limb Kinematics in Stroke Survivors

NCT07507552 | Not Yet Recruiting

• 1 other identifier: 2026/56
• Study Type: interventional
• Target: 28
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purpose of this study is to investigate the immediate effects of a mental practice technique, called Physical, Environment, Task, Timing, Learning, Emotion, Perspective (PETTLEP)-based Action Observation and Motor Imagery (AOMI), on arm movement in stroke survivors. Stroke often causes difficulty in moving the arm smoothly, leading patients to compensate by using their back or shoulder. In this study, participants will either receive a single session of the AOMI training (watching and mentally practicing a reach-to-grasp movement) or a control relaxation task. The researchers will use a smartphone-based motion capture system (OpenCap) to measure if the mental practice immediately improves the smoothness of the arm movement and reduces compensatory body movements.

Conditions

Stroke; Hemiplegia; Hemiplegia and/or Hemiparesis Following Stroke

Keywords

Motor imagery; Action observation; Stroke; OpenCap; Kinematics; Upper limb rehabilitation

Outcome Measures

Primary Outcomes (1)

• Change in Movement Smoothness (Number of Velocity Peaks)

  Movement smoothness of the affected upper limb will be evaluated using the OpenCap system (a markerless 3D motion capture system). It is calculated by the Number of Velocity Peaks (NVP) derived from the hand marker (3rd Metacarpal head) velocity profile during a standardized reach-to-grasp task. A reduction in NVP indicates increased movement smoothness and better motor control.

  Immediately before the intervention (baseline) and immediately after the single 25-minute intervention session.

Secondary Outcomes (5)

• Shoulder Girdle Elevation (Compensatory Strategy)

  Immediately before and immediately after the 25-minute intervention session.

• Trunk Displacement (Compensatory Strategy)

  Immediately before and immediately after the 25-minute intervention session.

• Gross Manual Dexterity - Box and Block Test (BBT)

  Immediately before and immediately after the 25-minute intervention session.

• Pain - Visual Analog Scale (VAS)

  Immediately before and immediately after the 25-minute intervention session.

• Movement Imagery Ability - Movement Imagery Questionnaire-3 (MIQ-3)

  Immediately before and immediately after the 25-minute intervention session.

Study Arms (2)

Experimental Group: PETTLEP-based AOMI

EXPERIMENTAL

Participants will receive a single 25-minute session of a scaffolded protocol featuring a 1:3 physical-to-mental practice ratio. The session includes sensory priming, action observation of a 1st-person video, and selective motor imagery with smoothness and trunk control constraints, followed by physical performance.

Behavioral: PETTLEP-based Action Observation and Motor Imagery (AOMI)

Control Group: Cognitive and Somatic Control

SHAM COMPARATOR

Participants will engage in a time-matched 25-minute session of non-motor tasks. This includes body scanning (paying attention to breathing and somatic sensations) and visuospatial navigation (a mental "Home Tour") to stimulate the visuospatial system without involving the motor system.

Behavioral: Cognitive and Somatic Control Tasks

Interventions

PETTLEP-based Action Observation and Motor Imagery (AOMI) BEHAVIORAL

A mental practice protocol involving sensory priming, action observation, and motor imagery of a reach-to-grasp task with selective functional constraints (Smoothness, Dissociation/Glued Back, and Relaxed Shoulder).

Experimental Group: PETTLEP-based AOMI

Cognitive and Somatic Control Tasks BEHAVIORAL

Structured operations including somatic attention (body scanning) and visuospatial control (spatial navigation) timed and paired to exhaust attention without motor system participation.

Control Group: Cognitive and Somatic Control

Eligibility Criteria

• Age: 40 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Female and male adults aged 40 to 80 years with a diagnosis of unilateral ischemic or hemorrhagic stroke.
• Residual voluntary movement activity of the affected upper limb.
• Mild to moderate spasticity (Modified Ashworth Scale ≤ 3).
• Adequate cognitive function to understand and follow verbal instructions (Mini-Mental State Examination ≥ 21).
• Medically stable patients, with no active or uncontrolled systemic illness.
• Ability to sit unsupported for at least 30 minutes and be able to perform brief cognitive-motor exercises.

You may not qualify if:

• Other central nervous system disorders (e.g., Parkinson's disease, multiple sclerosis, traumatic brain injury).
• Musculoskeletal or orthopedic conditions causing restriction of movement in the upper-limb (such as fixed contractures, severe joint deformities, shoulder subluxation).
• Severe sensory deprivation, visual neglect, or inattention that interferes with completion of the task or the ability to engage in motor imagery.
• Uncontrolled seizures, severe cardiovascular instability, or any other contraindication to imagery.

Sponsors & Collaborators

• Istinye University: lead

MeSH Terms

Conditions

Stroke; Hemiplegia

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Begüm Kara Kaya, Asst. Prof

  Istinye University

  STUDY DIRECTOR

Central Study Contacts

Abdelrahman Walid Sabee, BSc

CONTACT

+905379600520; 2433095024@stu.istinye.edu.tr

Begüm Kara Kaya, Asst. Prof.

CONTACT

+90 535 572 00 21; bkara@biruni.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Single-blind study
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist and Master's Student

Model Details: Two-arm parallel design comparing PETTLEP-based AOMI with a cognitive and somatic control group.

Study Record Dates

• First Submitted: March 27, 2026
• First Posted: April 2, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): March 20, 2027
• Study Completion (Estimated): March 20, 2027
• Last Updated: April 9, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share