Stroke
Conditions
Keywords
Incentive training, Attention, Hand dexterity, stroke
Brief summary
Attention and hand dexterity are interdependent, with deficits in one often worsening the other. Post-stroke, reduced attention impairs hand dexterity, hindering daily activities, while poor hand function further limits attentional focus. Despite progress in rehabilitation, strategies addressing both remain limited. Purpose: This study explored the impact of incentive-based attention training on hand dexterity in stroke patients.
Detailed description
Forty male patients with hemorrhagic infarction stroke, aged 45-60 years, were randomized into two equal groups. The control group (Group A, n=20) underwent hand dexterity exercises for 60 minutes per session, while the intervention group (Group B, n=20) received a combination of 30 minutes of hand dexterity exercises and 30 minutes of attention training using the Rehacom system. Both groups completed three training sessions per week for eight weeks (24 sessions). Outcomes were assessed pre- and post-training using the Mindful Attention Awareness Scale (MAAS), Hand Grip Dynamometer, Rehacom system, and Purdue Pegboard Test (PPBT).
Interventions
BEHAVIORALStandard Physical Therapy for Hand Dexterity in Stroke Patients
Standard physical therapy program for stroke patients targeting hand dexterity. Conducted 3 times/week for 8 weeks (60 min/session), exercises included wrist and forearm movements, object manipulation, ball gripping, and putty-based hand strengthening.
BEHAVIORALRehacom Attention Training + Physical Therapy
Combined intervention: 30 minutes of computerized attention training using the Rehacom system, followed by 30 minutes of standard hand dexterity physical therapy. Conducted 3 times/week for 8 weeks. Rehacom provided task-based cognitive training with visual, auditory, and performance feedback in a controlled lab setting.
Sponsors
Princess Nourah Bint Abdulrahman University
Keele University
Cairo University
Queen Margaret University
Delta University for Science and Technology
Misr University for Science and Technology
South Valley University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
MALE
Age
45 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. ) Male patients diagnosed with chronic hemorrhagic infarction stroke 2. ) Stroke diagnosis confirmed through CT or MRI scans 3. ) Referred by a neurologist or neurosurgeon 4. ) Right-handed 5. ) Aged between 45 and 60 years 6. ) Stroke duration ranging from 6 months to 1 year 7. ) Mini-Mental State Examination (MMSE) score of 24 or higher 8. ) Montreal Cognitive Assessment (MoCA) score above 21, indicating no significant cognitive impairment 9. ) Mild spasticity (Grade 1 or 1+ on the Modified Ashworth Scale) 10. ) Brunnstrom's Stage 4 or 5 of recovery
Exclusion criteria
1. ) Unstable medical conditions (e.g., diabetes mellitus or hypertension) 2. ) Language deficits that could impair cooperation 3. ) Blindness or deafness 4. ) Severe cognitive impairments affecting task performance 5. ) Presence of brain tumors
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hand dexterity assessment using the Purdue Pegboard Test (PPBT) | 8 Weeks | The Purdue Pegboard Test (PPBT) is a timed neuropsychological assessment used to evaluate fine motor skills, finger dexterity, and bimanual coordination by measuring how quickly a person can place small pegs into holes using one or both hands. |
| Hand grip dynamometer (JAMAR) | 8 weeks | The JAMAR hand dynamometer is a reliable and widely used tool for measuring grip strength, featuring a peak-hold needle and adjustable handle settings to accommodate different hand sizes and ensure consistent, accurate readings. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rehacom system | 8 Weeks | The Rehacom system is a CE-certified, software-based cognitive rehabilitation tool that personalizes training and assessment in domains like attention, memory, and logic. This study utilizes its attention-concentration module to evaluate the cognitive performance of stroke patients through detailed reaction-time metrics and adaptive difficulty levels. |
| The Mindful Attention Awareness Scale (MAAS)( 6 is high 6 , 1 is low) | 8 Weeks | The MAAS (Mindful Attention Awareness Scale) is a 15-item self-report tool that measures an individual's open and receptive awareness of present-moment experiences, with strong psychometric validity and associations with emotional, behavioral, and health outcomes; it can be completed in under 5 minutes, with higher scores indicating greater mindfulness and lower scores reflecting more frequent mind-wandering or inattentiveness. |
Countries
Egypt
Outcome results
None listed