Stroke
Conditions
Keywords
Stroke, Upper Limb Rehabilitation, Task-Oriented Training, Hand Function, Focal Vibration, Proprioception, Muscle Tone
Brief summary
This study aims to investigate the effects of task-oriented upper limb training combined with focal vibration on hand function, proprioception, and muscle tone in patients with stroke. Participants will be randomly assigned to either an experimental group receiving task-oriented training with concurrent focal vibration or a control group receiving task-oriented training alone. The intervention will be conducted over 6 weeks. Outcome measures will be assessed before and after the intervention.
Detailed description
Stroke often results in impairments in upper limb function, including reduced motor control, altered muscle tone, and deficits in proprioception. These impairments can significantly limit functional use of the affected limb in daily activities. Task-oriented training has been widely used in stroke rehabilitation to improve motor function through repetitive and goal-directed tasks. However, recovery may be limited when sensory input is insufficient. Enhancing sensory feedback, particularly proprioceptive input, may facilitate sensorimotor integration and improve functional outcomes. Focal vibration applied to muscle or tendon has been shown to stimulate muscle spindle afferents, thereby enhancing proprioceptive input to the central nervous system. When applied during active task performance, focal vibration may further augment motor learning and functional recovery. This study is designed as a randomized controlled trial to investigate the effects of task-oriented upper limb training combined with focal vibration. Participants will be randomly assigned to either an experimental group receiving task-oriented training with concurrent focal vibration applied to wrist extensor muscles or a control group receiving task-oriented training alone. The intervention will be conducted for 6 weeks. Outcome measures will include upper limb motor function, proprioception, manual dexterity, and muscle tone, assessed before and after the intervention. The findings of this study may provide evidence for the effectiveness of combining focal vibration with task-oriented training to enhance upper limb recovery in patients with stroke.
Interventions
PROCEDUREask-oriented upper limb training combined with focal vibration
Participants in the experimental group will receive task-oriented upper limb training combined with focal vibration applied to the wrist extensor muscles during task performance. The intervention will be administered for 30 minutes per session, 2 times per week, for 6 weeks, and no vibration will be applied during rest periods.
PROCEDUREActive Comparator: Task-Oriented Upper Limb Training Alone
Participants in the control group will receive task-oriented upper limb training without the application of focal vibration, with the device attached to the wrist extensor muscles. The intervention will be administered for 30 minutes per session, 2 times per week, for 6 weeks.
Sponsors
Jisu Kim
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Participants will be blinded to group allocation.
Intervention model description
Participants will be randomly assigned to either an experimental group receiving task-oriented upper limb training combined with focal vibration or a control group receiving task-oriented upper limb training alone.
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Individuals diagnosed with stroke at least 3 months prior * Individuals with sufficient cognitive function (Mini-Mental State Examination \[MMSE\] score ≥ 24) * Individuals able to maintain a seated position independently and perform upper limb functional tasks (Trunk Control Test \[TCT\] ≥ 50) * Individuals with muscle tone of the affected upper limb of Modified Ashworth Scale (MAS) Grade ≤ 2 * Individuals with Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scores between 20 and 50 * Individuals able to grasp and move objects with the affected upper limb and with muscle strength of Manual Muscle Test (MMT) Grade ≥ 3 * Individuals with impaired proprioception in the affected hand (defined as a score \< 2 on the wrist or thumb position item of the FMA-UE)
Exclusion criteria
* Individuals within 3 months after stroke onset * Individuals with fractures, severe soft tissue injuries, or contraindications to focal vibration * Individuals with severe sensory hypersensitivity or complex regional pain syndrome (CRPS) * Individuals who received treatments affecting upper limb function within the past 3 months (e.g., botulinum toxin injection, surgery, nerve block)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Assessment for Upper Extremity (FMA-UE) | Baseline and immediately after 6 weeks of intervention | The Fugl-Meyer Assessment for Upper Extremity (FMA-UE) will be used to evaluate motor function of the affected upper limb. The total score ranges from 0 to 66, with higher scores indicating better motor function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Joint Position Sense (JPS) | Baseline and immediately after 6 weeks of intervention | Joint position sense (JPS) will be assessed using an electronic goniometer by measuring the absolute error between a target joint angle and the reproduced angle. Lower error values indicate better proprioceptive function. |
| Thumb Localization Test (TLT) | Baseline and immediately after 6 weeks of intervention | The Thumb Localization Test (TLT) will be used to assess proprioceptive function of the affected upper limb. Participants will be asked to locate and grasp the thumb of the affected hand with the unaffected hand while their eyes are closed. Performance will be scored on a 4-point scale, with higher scores indicating greater impairment. |
| Action Research Arm Test (ARAT) | Baseline and immediately after 6 weeks of intervention | The Action Research Arm Test (ARAT) will be used to assess upper limb functional ability. The test consists of 19 items divided into four subscales: grasp, grip, pinch, and gross movement. Each item is scored on a 4-point scale (0-3), with a total score ranging from 0 to 57. Higher scores indicate better upper limb function. |
| Box and Block Test (BBT) | Baseline and immediately after 6 weeks of intervention | The Box and Block Test (BBT) will be used to assess gross manual dexterity of the affected upper limb. Participants will be instructed to move as many blocks as possible from one compartment of a box to another within 60 seconds. The score is the number of blocks transferred, with higher scores indicating better manual dexterity |
| Modified Ashworth Scale (MAS) | Baseline and immediately after 6 weeks of intervention | The Modified Ashworth Scale (MAS) will be used to assess muscle tone of the affected upper limb. Spasticity is graded on a 6-point scale ranging from 0 to 4, including a 1+ grade, with higher scores indicating greater spasticity. |
Countries
South Korea
Contacts
CONTACTJisu Kim, PT
Outcome results
None listed