None listed
Conditions
Brief summary
We do not have adequate solutions for upper-limb recovery following stroke. Insufficient therapy is delivered during critical periods of recovery, despite stroke being a life-long disability. Upper-limb recovery is possible, with clear evidence that appropriate amounts of practice are important for improvement to occur. The purpose here is to deliver an intense burst of training, comprising 90h of rehabilitation over a 5-week period. We anticipate that people who receive this intense burst of training will achieve improved upper limb function.
Interventions
Participants will complete upper-limb sensorimotor rehabilitation addressing identified impairments to improve upper-limb function. Individualised programs will be based on initial assessments and rehabilitation goals. All participants will complete a 5-week program delivering 90 hours of therapy (18h per week) comprising: 1) An upper-limb group exercise class (ratio 4:1), 2) Rehabilitation technologies (for example, robotics, virtual reality, EEG EMG biofeedback, non-immersive gaming, functiona
Participants will complete upper-limb sensorimotor rehabilitation addressing identified impairments to improve upper-limb function. Individualised programs will be based on initial assessments and rehabilitation goals. All participants will complete a 5-week program delivering 90 hours of therapy (18h per week) comprising: 1) An upper-limb group exercise class (ratio 4:1), 2) Rehabilitation technologies (for example, robotics, virtual reality, EEG EMG biofeedback, non-immersive gaming, functional electrical stimulation and interactive multisensory gaming technologies, 3) task-specific training (1:1), 4) A home exercise program based on the Graded Repetitive Arm Supplementary Program (GRASP) or pre-recorded videos such as Different Strokes UK YouTube (informed by impairment level and patient preference). The 18h per week will be achieved by 13h delivered in person (based on tasks above) and 5h of home exercises (1h per weekday, recorded in an activity log). Adherence to both the in person and home program will be recorded. Each 5 week program will have a maximum of 4 patients. All therapy sessions will be delivered by a Physiotherapist and supported by Physiotherapy and Occupational Therapy students. There will be a minimum of 5 week washout between arms of the trial.
Sponsors
University of South Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
People with chronic stroke (greater than 3 months post ictus) will be recruited. Inclusion criteria: Aged at least 18 years, discharged from rehabilitation, any upper-limb sensorimotor impairment (determined by Fugl-Meyer Upper Limb assessment, scoring less than or equal to 62/66).
Exclusion criteria
Painful shoulder limiting ability to undertake rehabilitation, unstable medical conditions, inability to provide informed consent (determined by cognitive screening with MoCA (score at least 26). Those meeting an exclusion criterion may subsequently receive relevant medical input and be re-assessed for potential inclusion at a later time. For example, a patient may not meet eligibility for this study due to shoulder pain, but choose to seek relevant medical input and be re-evaluated for eligibility.
Outcome results
None listed