Rehabilitation, Stroke
Conditions
Keywords
upper limb, hand, rehabilitation, biofeedback, modern technologies
Brief summary
The aim of the research will be to evaluate the effects of upper limb rehabilitation using modern Pablo Tyromotion technologies in people after stroke in the late period.
Detailed description
Prior to the study, an assessment of the reliability, reproducibility and validity of the devices among stroke individuals will be carried out. The research will be conducted among people who have suffered a stroke in the late period. The subjects will be allocated, by random selection, to two groups: The study group will complete a conventional rehabilitation program supplemented with biofeedback exercises using the Pablo Tyromotion device. The control group will participate in conventional rehabilitation without biofeedback exercises. Patients will undergo ongoing rehabilitation at the Donum Corde Rehabilitation and Medical Care Center (four weeks). The first examination will be performed on the day of admission, the second on the day of discharge, and the third (control) one month after discharge, during a follow-up visit. Measurements will be performed three times for all participants: * assessment of hand and finger muscle strength * calculated body mass index (BMI) * proprioceptive testing (mirror test, Thumb Location Test) * rehabilitation outcome assessment * functional capacity - Barthel Index, ADL * Ashworth muscle tone (spasticity) * hand dexterity using the Box and Blocks test * hand grip function according to the Frenchay scale * motor function of the hand and upper limb according to the Fugl-Meyer Motor Assessment Scale for Upper Extremity
Interventions
OTHERRehabilitation program using upper limb function training with the Pablo Tyromotion device and conventional physiotherapy.
Rehabilitation program using upper limb function training with the Pablo Tyromotion device and conventional physiotherapy. The rehabilitation program will last 4 weeks from Monday to Friday.
Sponsors
University of Rzeszow
Donum Corde Rehabilitation Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Intervention model description
Before starting the study, the reliability, repeatability and validity of the Pablo Tyromotion device will be assessed among people after stroke, followed by random selection into two groups (research group and control group).
Eligibility
Sex/Gender
ALL
Age
45 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* informed, voluntary consent of the patient * age 45-80 years * elementary (basic) gripping ability * degree of paresis of the upper limb and hand 4 -5 on the Brunnström scale * degree of disability on the Rankin scale 3 * spastic tension of the upper limb, paresis hand not more than 3 on the modified Ashworth scale * current health condition confirmed by a medical examination, allowing participation in tests and exercises
Exclusion criteria
* lack of informed, voluntary consent of the patient * second or subsequent stroke, hemorrhagic stroke, stroke of the brainstem and cerebellum * disorders of higher mental functions limiting comprehension and carrying out tasks during exercises * visual field disturbances * mechanical and thermal injuries that may limit the grasping function of the hand * concomitant neurological, rheumatological and orthopedic diseases, including permanent - contractures that may affect the grasping ability and locomotion * unstable medical condition * failure to complete a 3-week rehabilitation stay
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Motor capacities of the upper limb, according to Fugl-Meyer Motor Assessment Scale | First examination - before the start of the rehabilitation program | It consists of 33 items assessing motor function and reflexes. The patient can score a maximum of 66 points, where each item on the scale is rated as: 0=unable, 1=partially able, or 2=fully able to perform the movement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hand grip strength | First examination - before the start of the rehabilitation program | measurements to be performed with a dynamometer The dynamometer registers strength lower than up to 90 kg |
| pinching strength of the fingers | First examination - before the start of the rehabilitation program | measurements to be performed with a pinch meter. The pinch meter registers strength lower than up to 22 kg |
| Assessment of functional status was assessed using the Barthel Index. The subjects could score the maximum of 100 points. | First examination - before the start of the rehabilitation program | Activities of daily living were assessed using Barthel Index. The subjects could score the maximum of 100 points. A maximum of 100 points can be obtained on the Barthel scale. There are three assessment ranges: getting from 0 to 20 points. means total dependence, from 20 to 80 points. means that to some extent the patient needs help from others, and the assessment in the border is 80 to 100 points. means that with a little help the patient can function alone. 0-20 points patient's condition "light" 21-85 points - "medium-heavy" patient condition 86-100 points - patient condition "very heavy" |
| Manual skills, assessed with Box and Blocks test; | First examination - before the start of the rehabilitation program | The test uses a wooden box, divided into two equal parts by a partition, as well as 150 blocks. The subject moves as many blocks as possible from one part of the box to the other during 60 seconds. |
| Assessment of proprioception Thumb Localizing Test (TLT) | First examination - before the start of the rehabilitation program | Thumb Localizing Test (TLT). (A) positioning of the paretic UE by the examiner. (B) four spaces in which the paretic UE is placed. Distal spaces are not far from the trunk because the reaching limb should be able to reach them without difficulty. (C) rating of positive results |
| First examination - before the start of the rehabilitation program | First examination - before the start of the rehabilitation program | Assessments were performed with eyes closed. Proprioception of the elbow joint was assessed in the 60° elbow flexion position using a plastic Jamar goniometer. The initial fixed axis of the goniometer was set at the lateral epicondyle of the humerus, and the mobile axis was set parallel to the radius, in accordance with the methodology of the study of joint position sensation in the elbow |
| Handgrip function, according Frenchay scale | First examination - before the start of the rehabilitation program | The scale consists of 7 tasks (pass/fail grading); the patient is awarded 1 point for each activity performed successfully, or 0 points for a failure to perform. The maximum score of seven points may be achieved for the performance of the tasks. Higher score corresponds to better manual skills. The scale measures the proximal control of the upper limb and the manual skills. |
Countries
Poland
Contacts
CONTACTJustyna K Leszczak, PhD
PRINCIPAL_INVESTIGATORJustyna Leszczak, PhD
Univeristy of Rzeszów,
Outcome results
None listed