Stroke
Conditions
Keywords
Rehabilitation, Upper Extremity
Brief summary
This study will examine the feasibility of providing task-oriented arm training in standing or during walking in individuals with movement deficits due to stroke. Participants will received 24 sessions of arm training in standing over an 8-week period that focus on arm and hand function.
Detailed description
Residual motor deficits are common after stroke and often have a negative impact on the performance of functional activities and overall quality of life. A frequently reported contribution to these functional limitations is an inability to incorporate the weaker arm and hand into daily activities. While rehabilitation interventions can improve arm functional capacity, these improvements often do not translate into increased real-world arm use which is often reduced after stroke. The performance of skilled arm and hand movements in standing requires precise coordination between upper extremity movement and balance control. Many everyday functional tasks that require the arm are performed in standing (e.g. opening a door or meal preparation at the kitchen counter), however, training of arm function in rehabilitation is often done in sitting. An important rehabilitation approach may be to create a training environment that resembles the way the arm is used in everyday life (i.e. standing). This study will examine the feasibility of providing task-oriented, functional arm training in standing and during walking in individuals with motor deficits due to stroke.
Interventions
BEHAVIORALArm training in standing
Arm training will be provided in one hour sessions, 3 time per week for 8 weeks. In each session, you will practice functional tasks with your weaker arm and hand in standing or during walking. Practice will be scaled to match your current level of function and progressed over time as able.
Sponsors
University of South Carolina
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* At least 18 years old * Had a stroke at least 6 months prior to enrollment * Show evidence of continued arm and hand weakness * Have some ability to move the arm and hand that is weaker from the stroke * Be able to stand with minimal assistance or less without support of the weaker arm for at least 2 minutes * Be able to follow two-step commands.
Exclusion criteria
* Acute medical issues that would interfere with participation * Another neurologic diagnosis that may impact movement (e.g. Parkinson's Disease) * Severe apraxia or hemispatial neglect * Pain that interferes with arm movement or standing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Action Research Arm Test | Change from Baseline to 8 weeks | Clinical measure of arm and hand function |
| Treatment intensity | 8 weeks | Total number of arm repetitions per session and the percent of arm repetitions completed in standing or walking |
| Sessions Completed | 8 weeks | Total number of treatment sessions completed |
| Fatigue | 8 weeks | Mean change in self-reported fatigue from the start to the end of each intervention session |
| Arm Use Measured with Accelerometers | Change from Baseline to 8 weeks | Arm use measured during a typical day using accelerometers worn on the wrist |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Activities Specific Balance Confidence Scale | Change from Baseline to 8 weeks | Patient-reported measure of balance confidence. Score ranges from 0 to 100 with higher being better |
| Stroke Impact Scale Hand Domain Subscale | Change from Baseline to 8 weeks | Patient-reported measure of hand related quality-of-life. Score ranges from 0 to 100 with higher being better. |
| Upper Extremity Fugl-Meyer | Change from Baseline to 8 weeks | Clinical Measure of arm and hand impairment |
| Box & Blocks Test | Change from Baseline to 8 weeks | Clinical measure of hand function |
| Nine-Hole Peg Test | Change from Baseline to 8 weeks | Clinical measure of hand dexterity |
| Timed Up and Go | Change from Baseline to 8 weeks | Clinical measure of mobility and balance |
Other
| Measure | Time frame | Description |
|---|---|---|
| Berg Balance Scale | Change from Baseline to 8 weeks | Clinical measure of balance. 14-item performance measure with a maximum score of 56; higher score is better. |
| Arm Use Measured with Accelerometers | Change from Baseline to 12 weeks | Arm use measured during a typical day using accelerometers worn on the wrist |
| Action Research Arm Test | Change from Baseline to 12 weeks | Clinical measure of arm and hand function |
| Stroke Impact Scale Mobility Subscale | Change from Baseline to 8 weeks | Patient-reported measure of mobility related quality-of-life. Score ranges from 0 to 100 with higher being better |
| Functional Gait Assessment | Change from Baseline to 8 weeks | Clinical measure of balance |
Countries
United States
Outcome results
None listed