Effects of Mental Imagery Training Combined With Task Oriented Training by EMG-Driven Soft Robotic Hand Stroke in Stroke

NCT07629011 | Recruiting

• 1 other identifier: 02261/ Ayesha Umer
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial is to determine the effects of robotic hand training in improving upper limb motor function and coordination with and without mental imagery training in chronic stroke patients

Conditions

Stroke

Keywords

Stroke rehabilitation; Mental imagery training; Task oriented training; upper limb rehabilitation; motor function

Outcome Measures

Primary Outcomes (3)

• Fugl-Meyer Assessment Upper Extremity (FMA-UE).

  Evaluate sensorimotor impairment after stroke, especially in the upper limb. 3 Sections, (A) UPPER EXTREMITY 1. Reflex Activity on paretic side (2 items) Bicep reflex Tricep reflex 2. Volitional movements within synergies pattern Flexion synergy ,Extensor synergy 3. Volitional movement mixing synergies 4. Volitional movement with little or no synergy (B) Wrist Stability at 15 dorsiflexion (DF) (Elbow at 90)Repeated (DF) (Elbow at 90) Stability at 15 dorsiflexion (DF) (Elbow at 0) Circumduction (C)Hand Mass Flexion ,Mass Extension GRASP Finger mass flexion /Finger mass extension Thumb adduction ,Opposition, Cylindrical grip ,Spherical grip Normal = Score 0-66 A UE /36 B Wrist /10 C Hand /14

  6 weeks

• Action research arm test (ARAT)

  The ARAT is an observer-rated, performance-based assessment designed to measure upper extremity function and dexterity, especially after stroke or other cortical injuries. 4 Subscale * Grasp (6 items) * Grip (4 items) * Pinch (6 items) * Gross movement (3 items). Total score = 57

  6 weeks

• Box and block Test (BBT)

  Measures gross manual dexterity and speed Equipment: Wooden box (≈ 53.7 × 25.4 × 8.5 cm) with a partition, plus 150-152 blocks (≈ 2.5 cm cubes) Primary score: Number of blocks successfully transferred in 60 seconds (per hand).Only blocks completely transferred count; dropped blocks are excluded

  6 weeks

Secondary Outcomes (1)

• Modified ashworth scale (MAS)

  6 weeks

Study Arms (2)

Mental imagery training with Robotic hand training Group

EXPERIMENTAL

Other: Mental imagery training combined with Robotic hand training

Robotic hand training

ACTIVE COMPARATOR

Other: Robotic hand training

Interventions

Mental imagery training combined with Robotic hand training OTHER

Participants will receive combined training of robotic hand-assisted task practice and mental imagery training over 7 weeks, 3 sessions per week, totaling 20 sessions. Each session (\~60 minutes) conducted in a quiet room with the patient seated upright (hips, knees, ankles at 90°, forearms on table). Training involves real-life object handling tasks using three grip types: 1. Spherical grip (cricket ball - 109g, 75mm) 2. Tripod grip (woodblock - 74g, 50mm) 3. Tip pinch grip (small cube - 8g, 25mm) For each task (15 minutes), MIT duration will be 10 minutes 1. 2 repetitions - Watch task video (first-person view) 2. 5 repetitions - Imagine performing the task (eyes closed, paretic hand) 3. 3 repetitions - Perform the task with soft robotic hand assistance 4. The above sequence is repeated twice per task.

Mental imagery training with Robotic hand training Group

Robotic hand training OTHER

Each session included a 5-minute warm-up, followed by three 15-minute EMG-driven, robot-assisted task blocks and two 5-minute breaks. Robotic Hand Tasks include: Real-life object handling using three grip types: 1. Spherical grip - Cricket ball (109g, 75mm) 2. Tripod grip - Woodblock (74g, 50mm) 3. Tip pinch grip - Small cube (8g, 25mm) Muscle Monitoring: EMG signals recorded from flexor digitorum, extensor digitorum, biceps brachii, and triceps brachii. Maximum Voluntary Contraction assessed before each session; EMG activation threshold set at 3×SD above baseline. Training Activities will include: Grasping, lifting, holding, transporting, and releasing objects with robotic assistance and verbal guidance. Each 15-minute block included \~30-40 repetitions per task.

Robotic hand training

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants clinically diagnosed with stroke in chronic stage (6 months after the onset of stroke) with a pure unilateral motor paresis after stroke.
• years of age.
• Sufficient cognition to follow simple instructions and understand the content and purpose of study (MMSE score 28)
• Able to sit up for at least 45 minutes.
• Detectable residual signals from the affected side's Flexor digitorum (FD) and Extensor Digitorum (ED) muscles.
• Modified Ashworth Scale (MAS) score of finger extensor less than or to 3
• Ability to provide informed consent

You may not qualify if:

• Patients with severe dysphasia with inadequate communication.
• Any additional medical or psychological condition affecting their ability to comply with the study protocol.
• History of other neurological disease or psychiatric disorders, including alcoholism and substance abuse

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Railway General Hospital

Rawalpindi, Punjab Province, 44000, Pakistan

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

• Ayesha Umer, MS-NMPT*

  Riphah International Unversity

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Arshad Nawaz Malik, PhD Rehab

CONTACT

03334503754; arshad.nawaz@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 2, 2026
• First Posted: June 5, 2026
• Study Start: April 1, 2026
• Primary Completion (Estimated): October 30, 2026
• Study Completion (Estimated): November 30, 2026
• Last Updated: June 5, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)