Ischemic stroke, transient ischemic attack (TIA)
Conditions
Interventions
Group 1: Ischemic stroke / transient ischemic attack (TIA), with a focus on newly occurring mild to moderate arm/hand impairments of the upper extremity
comparison with patients without clinically detectable motor impairment of the upper extremity.
Sponsors
Klinik für Vaskuläre Neurologie, UniklinikBonn
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Capacity to provide informed consent. 2. Age = 18 years. 3. Clinical diagnosis of ischemic stroke or transient ischemic attack (TIA). 4. Presence of either a) newly occurring mild to moderate arm/hand impairment in the context of the current event, defined as a motor deficit of the upper extremity on admission examination (NIHSS Motor Arm score 0–2) and/or a subjectively reported new impairment of the arm/hand (e.g., fine motor skills, strength, coordination), or b) no motor impairment of the upper extremity. 5. Symptom onset = 14 days before study enrollment. 6. Sufficient ability to cooperate in order to complete the video assessments, e.g., adequate language comprehension and no aphasia, neglect, apraxia, or cognitive impairment that would prevent valid performance of the tasks. 7. Willingness to undergo standardized video recording of upper-extremity motor tasks and to allow scientific analysis of the resulting movement features in accordance with the informed consent, including pseudonymized analysis of standardized video recordings for the derivation of quantitative movement features.
Exclusion criteria
Exclusion criteria: 1. Lack of capacity to provide informed consent or inability to provide comprehensive information/obtain informed consent. 2. Insufficient ability to cooperate, such that the video-/tablet-based tasks cannot be performed validly, e.g., severe aphasia with lack of instruction comprehension, pronounced neglect, severe apraxia, significant cognitive impairment/delirium. 3. Pre-existing relevant arm/hand functional impairment of the upper extremity, e.g., previous hemiparesis, severe osteoarthritis, relevant contractures, known peripheral nerve lesion, or amputation-/prosthesis-related limitation, which would substantially confound attribution to the current event or interpretation of the measurements. 4. Acute non-neurological impairment of the upper extremity that substantially limits performance or interpretation, e.g., fracture, severe pain, acute inflammation/immobilization. 5. Pronounced movement disorders that dominate the measurement and complicate interpretation with regard to paresis, e.g., severe tremor or severe dyskinesia. 6. Severe systemic disease/clinical instability that precludes participation for safety or organizational reasons.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Phenotypic description of arm and hand motor function based on predefined features derived from standardized examinations of the upper extremity, using standardized clinical, video-based and, where applicable, tablet-based assessments. The aim is to characterize both differences between clinically defined levels of impairment and additional patterns within these groups. The feature domains considered include, in particular: • arm-holding function and side asymmetry • movement quality and coordination • speed and variability • compensatory movement patterns • signs of fatigability • distal hand function and fine motor skills The video- and tablet-based assessments serve as complementary quantitative layers within a multimodal phenotyping approach. | — |
Secondary
| Measure | Time frame |
|---|---|
| * Association of motor feature profiles with structured neurological findings as well as with distal hand function and fine motor skills. These include, in particular, structured clinical single-item findings of the upper extremity, including strength grades of predefined muscle groups of the arm and hand, deep tendon reflexes, muscle tone, and complementary performance measures of distal hand function and fine motor skills derived from the standardized tasks. * Association of motor feature profiles with patient-reported functional impairment of the upper extremity and health-related quality of life, assessed using the EQ-5D-5L and the Stroke Impact Scale – Hand Function Domain. * Exploratory association of motor feature profiles with lesion location and additional imaging findings from routine clinical CT/MRI. * Exploratory intra- and interindividual changes in the assessed motor features and patient-reported outcomes between baseline and the optional follow-up after approximately 90 days. | — |
Countries
Germany
Contacts
Public ContactSebastian Stösser
Klinik für Vaskuläre Neurologie, Uniklinik Bonn
Outcome results
None listed