Stroke
Conditions
Keywords
Task-Oriented Training, Hand-Arm Bimanual Intensive Therapy, Gross and Fine Motor Skills, Activities of Daily Living
Brief summary
Stroke is a rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than a vascular origin. Among various rehabilitation strategies, Task-oriented training of low to moderate intensity and Hand-Arm bimanual intensive therapy have shown their promising results in stroke rehabilitation. So, this study aims to determine the comparative effects of Task-oriented and Hand-Arm bimanual intensive therapy on Gross and Fine motor skills of Upper Limb and Activities of Daily Living in Post-Stroke Patients.
Detailed description
This randomized clinical trial will be conducted at District Headquarter Hospital Nankana Sahib on 30 stroke patients, randomly assigned to two groups through seal opaque method. Group A will receive task-oriented training and Group B will undergo hand-arm bimanual therapy over an 8-week period. Outcome measures will include Action Research Arm Test for gross movement of upper limb and fine motor functions will be assessed using the Nine Hole Peg Test, while the Barthel Index will be used for daily activity performance. Pre and post-intervention assessments will be used to analyze and compare the effects of interventions. Data will be analyzed using the SPSS version 25. Statistical significance will be set at p=0.05. The normality of data will be checked by Shapiro wilk test (p-value 0.05). Difference between groups will be analyzed through Independent sample t-test/Mann-Whitney Test within group comparison will be analyzed through Paired sample t-test/Wilcoxen Signed-Rank test depending upon the normality of data.
Interventions
Frequency: 3 session/week for 8 weeks Intensity: 5 reps/session Duration: 30 minutes, increasing to 45 minutes by the end of week 8 Exercises: * Reaching * Push-pull tasks * Grasping * Wiping tasks * Weight-bearing on hands * Lifting an object (2 sets×5 reps of each exercise) Gradually increasing duration and intensity each week.
Frequency: 3 session/week for 8 weeks Intensity: 5 reps/session Duration:30 minutes, increasing to 45 minutes by the end of week 8 Exercises: * Rolling a ball * Opening containers * Towel folding * Lifting and placing objects * Cutting with scissors * Zipping and buttoning * Peeling fruits (2 sets×5 reps of each exercise) Gradually increasing duration and intensity each week.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
An independent assessor, who is blinded to the group allocations, will be responsible for evaluating outcomes.
Intervention model description
randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
45 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* • Age 45-70 * Gender (both male and female) * Pre diagnosed First-time stroke patients (ischemic or hemorrhagic) * Time since stroke: ≥3 months * Mild to moderate upper limb impairment (ABILHAND Questionnaire: Less than 50% of items rated as "impossible.") * Moderate functional independence in basic activities (Barthel Index score ≥ 60) * Ability to follow commands (MMSE \> 24 or equivalent cognitive screening)
Exclusion criteria
* • Severe spasticity (Modified Ashworth Scale score ≥ 3) or contractures * Other neurological conditions (Alzheimer's disease, Parkinson and dementia) * Unstable medical conditions (diabetes and hypertension) that may interfere with participation * Participation in any other structured upper limb rehabilitation or experimental therapy within the past 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gross Motor Skills | Baseline and post 8 weeks | Action Research Arm Test |
| Fine Motor Skills | Baseline and post 8 weeks | Nine Hole Peg Test |
| Activities of Daily Living | Baseline and post 8 weeks | Barthel Index Scale |
Countries
Pakistan
Contacts
CONTACTImran Amjad, PhD
PRINCIPAL_INVESTIGATORAiza Yousaf, MS-OMPT
Riphah International University
Outcome results
None listed