Stroke With Hemiparesis
Conditions
Keywords
Rehabilitation, Fingers, Grasp, Strength, Hand Function, Motor Function, Post Stroke, Brain Infraction, Biomechanis, Neuronal Plasticity, Weight-Bearing
Brief summary
Motor learning can be affected by the sensory difficulties that may be experienced as a result of a stroke. This study will help us better understand what kinds of sensory information can help with the re-learning of grasping with the affected hand despite the sensory difficulties produced by the stroke.
Detailed description
The purpose of this study is to develop, refine and test the 'alternate hand training strategy' to facilitate adaptation, repetition and relearning to restore hand function after stroke. The three aims are: to restore adaptation (Aim 1), facilitate grasp efficiency and normal directional biases during repetition (Aim 2), and enhance the rate of learning to improve hand function and quality of life post stroke (Aim 3). Hypotheses: We hypothesize that alternate hand training will increase the rate of learning and lead to greater improvement in hand function. The results will inform dosing of therapy for optimal relearning.
Interventions
OTHERAlternate Hand Training or Affected Hand Training
Participants will receive a training intervention with either the Alternate Hand Training Strategy, or Affected Hand Training alone.
Sponsors
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
NYU Langone Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Ability to read/write in English * Age \> 18 yrs * Radiologically verified stroke \> 4 months old (3T structural MRI) * Moderate arm motor impairment (Fugl-Meyer Scale \< 60/66) * Ability to reach, grasp and lift the test objects with the affected side as assessed by the PI * Willingness to complete all clinical assessments and MRI, and comply with training protocols * Ability to give informed consent and HIPPA certificationsPlease list all
Exclusion criteria
for study:
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| For Phase 1: Adaptation of fingertip forces and movements during grasping. | 6 weeks | 5 experiments will be performed over 7 visits to examine the best approach to retrain adaptation. |
| For Phase 2: Change in Hand function | 6 weeks | Subjects will be randomized to Alternate Hand Training or Affected Hand Training arms and receive training twice a week for 6 weeks. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Phase 2 - Maintenance of hand function | 6 weeks after end of training | Recovery of hand function will be measured by repeating the pre-intervention clinical and grasping assessments 6-weeks after the end of training. |
Countries
United States
Outcome results
None listed