Stroke
Conditions
Brief summary
Stroke is a medical condition which causes the cessation of blood flow to the brain cells and results in cell death and ultimately can lead to motor disorders, perception disorders, language disorders, sensory disturbances.It is well known that stroke is the leading cause of death and one of the greatest causes of long-term motor disability in adults.The incidence of stroke is increasing day by day in low-income countries as compared to high-income countries because of the effects of not using evidence-based practice in health-related conditions in low-income countries. In the last few years, several approaches have been used for the recovery of hand dexterity after stroke. Among them, the Mirror therapy, task-oriented therapy, robot-assisted rehabilitation and action observation has gained greatest attention.Action observation training is one of the new developing rehabilitation technique that targets motor learning by the activation of mirror neurons and is the most important approach that targets the motor and functional recovery in stroke patients. In action observation training, the movements are produced because of the external stimuli in which actually the visual attention recruit the cerebellar-thalamic-cortical circuit of the brain. Action observation is based on activities of the motor neuron system and they discharge mostly in association with complex tasks as compared to simple tasks.
Interventions
OTHERAction Observation Therapy
following phases will be included in action observation therapy group: 1. upper limb active range of motion (AROM) exercises. 2. reaching movement or object manipulation. 3. upper limb functional tasks.
OTHERMirror Therapy
following phases will be included in mirror therapy group: 1. AROM exercises), 2. reaching movement or object manipulation, and 3. functional task practice
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Both male and female * Middle cerebral artery stroke * 1 to 6 months of stroke onset * Baseline score of the Fugyl Myer Assessment is between 20 and 60 for the upper limb. * Modified Ashworth scale with a score of 2 Ability to follow the study instructions-Mini mental state examination (MMSE) score \>25
Exclusion criteria
* Participants failing to fall in this category would be excluded from the study. * Patients who cannot perform the active movement of the upper limb in pre-stroke condition due to musculoskeletal problems * cardiopulmonary diseases which could hinder their ability to participate in the rehabilitation program in this study * Patient with impaired cognition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugel Meyer assessment scale for upper limb | week 6 | An assessment scale for post stroke hemiplegic patients and is performance-based impairment index. This scale is having 5 domains namely Motor functioning, Sensory Functioning, Balance, Joint Range of Motion and Joint pain. I divided the motor functioning for upper extremity into 0 to 66 points and evaluates mobility, speed and coordination |
| Box and Block Test (BBT) | week 6 | This test is used to evaluate the manual dexterity of post stroke patients. BBT is composed of wooden box with two equal compartments having 150 boxes in one compartment and patient is asked to move the boxes from one compartment to another within 60 seconds. Before starting the test an extra 15 seconds time is given to the patient for familiarization with the test. First the patient performed the activity with the healthy arm and then with the affected arm. Scoring is done on the basis of the number of boxes transferred from one compartment to another within 60 seconds |
| Functional Independence Measure (FIM) | week 6 | The FIM is a commonly used scale for assessing the performance in basic daily activities. It contains 18 items (i.e., 13 motor and 5 cognition items), and the total score ranges from 0 to 126 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stroke Impact Scale (SIS) version 3.0 | week 6 | The SIS 3.0 is a stroke-specific, patient-reported questionnaire for evaluating the function, participation, and health-related quality of life of stroke survivors. The SIS 3.0 has sound psychometric properties. It consists of 59 items, and higher scores indicate better function and greater participation. |
Countries
Pakistan
Contacts
Primary ContactSania Syed, MS NMPT*
Outcome results
None listed