Stroke, Stroke Rehabilitaion
Conditions
Keywords
mirror therapy, Randomized Controlled Trial, Stroke, Cognitive Orientation to Daily Occupational Performance Occupational Therapy, somatosensory, participation, activity daily of life, occupational therapy
Brief summary
This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training. A total of 45 individuals with subacute and chronic stroke will be randomly assigned to one of three groups. Each group will receive 4 weeks of intervention (5 sessions per week), followed by a 3-month follow-up period. Outcomes related to motor function, somatosensory function, activities of daily living, participation, and quality of life will be assessed at baseline, after intervention, and at follow-up. The study aims to determine which intervention approach is more effective in improving functional outcomes in individuals with stroke.
Detailed description
Stroke is one of the leading causes of disability worldwide, often resulting in motor, sensory, and cognitive impairments. Rehabilitation approaches that enhance neuroplasticity are essential for improving functional recovery. This randomized controlled trial aims to compare the effectiveness of mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training (RBT), in individuals with stroke. Participants will be recruited from a physical therapy and rehabilitation unit and will be randomly assigned into three groups: MT, CO-OP, and COT. All groups will receive robotic balance training as a priming intervention prior to therapy sessions. Each intervention will be administered for 4 weeks, 5 days per week. In addition, a transfer package will be applied to enhance the generalization of therapeutic gains to daily life activities. Outcome measures will include motor function, somatosensory function, occupational performance, activities of daily living, participation, self-efficacy, and quality of life. Assessments will be conducted at baseline, post-intervention, and at a 3-month follow-up. The findings of this study are expected to provide evidence for the comparative effectiveness of different rehabilitation approaches in stroke and contribute to clinical decision-making.
Interventions
BEHAVIORALMirror Therapy
Mirror therapy involves the use of a mirror to create a visual illusion of movement of the affected limb by observing the reflection of the unaffected limb. Task-oriented activities are performed to improve motor function and sensory integration in individuals with stroke.
CO-OP is a client-centered, performance-based approach that uses cognitive strategies to enable skill acquisition. Participants identify meaningful goals and use guided discovery and problem-solving strategies to improve task performance.
BEHAVIORALConventional Occupational Therapy
Conventional occupational therapy includes task-oriented interventions such as reaching, grasping, coordination training, strengthening exercises, and activities aimed at improving functional independence in daily living.
OTHERRobotic Balance Training
Robotic balance training is used as a priming intervention before therapy sessions. It includes repetitive, task-specific movements involving weight shifting, postural control, and balance training to enhance motor responses.
Sponsors
Hacettepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Bu açık etiketli bir çalışmadır. Uygulanan müdahalelerin niteliği nedeniyle herhangi bir körleme yöntemi kullanılmamıştır.
Intervention model description
Participants will be randomly assigned to one of three parallel groups: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), or conventional occupational therapy (COT). All groups will receive robotic balance training prior to intervention sessions. Interventions will be applied for 4 weeks, followed by a 3-month follow-up.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \- Individuals diagnosed with ischemic or hemorrhagic stroke * Age 18 years and older * Subacute (3-6 months post-stroke) or chronic stage (6-12 months post-stroke) * Brunnstrom Motor Recovery Stage ≥3 for upper extremity, ≥4 for hand, and ≥4 for lower extremity * Mini-Mental State Examination (MMSE) score ≥24 * No severe visual, orthopedic, or additional neurological impairments * Not participating in another study during the research period * Voluntary consent to participate in the study
Exclusion criteria
* \- Poor motor coordination or major medical problems that would prevent participation * Presence of Wernicke's aphasia * Botulinum toxin injection within the last 3 months * Psychiatric conditions that may interfere with participation (e.g., depression, ongoing psychiatric treatment, low motivation)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Motor Assessment (FMA) | Baseline, post-intervention (4 weeks), and 3-month follow-up | The Fugl-Meyer Assessment will be used to evaluate motor function in individuals with stroke. Higher scores indicate better motor function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Revised Nottingham Sensory Assessment (rNSA) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess somatosensory function including tactile sensation and proprioception. |
| Canadian Occupational Performance Measure (COPM) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess Occupational Performance . |
| Modified Barthel Index (MBI) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess activity daily of life |
| Stroke Impact Scale (SIS) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess quality of life |
| Stroke Self-Efficacy Questionnaire (SSEQ) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess self-efficacy |
| Community Integration Questionnaire (CIQ) | Baseline, post-intervention (4 weeks), and 3-month follow-up | Used to assess paticipation |
Countries
Turkey (Türkiye)
Contacts
CONTACTNURTEN BİLGİN, PhD Student
PRINCIPAL_INVESTIGATORGokcen Akyurek, Associate Professor
Hacettepe University
Outcome results
None listed