Cerebrovascular Accident Clinical Trial
Official title:
Effects of Robot-Assisted Therapy in Sequential Combination With Constraint-Induced Therapy in Stroke Rehabilitation
The findings of this project will contribute to the understanding of a comprehensive probe for investigation of the effects of monotherapy versus combination rehabilitation intervention after stroke, including the topics of possible underlying mechanisms of motor recovery as well as the beneficial and adverse effects of intense rehabilitation therapy, prognostic factors of the outcomes, and clinimetric properties of the instruments. The overall findings of this project will be significant in the era of knowledge translation and guide the development of innovative and effective interventions for individualized stroke rehabilitation.
The overall goal of this research project will be to provide scientific evidence of the
robot-assisted therapy in sequential combination with distributed constraint-induced therapy
(RT + dCIT)versus monotherapy of the robot-assisted therapy (RT), distributed
constraint-induced therapy (dCIT), and a dose-matched control therapy (DMCT)in stroke
rehabilitation. The specific aims of this proposed research are identified as follows:
1. The investigators will investigate the treatment effects of RT + dCIT compared to RT,
CIT, and DMCT on motor ability, muscle function, sensory function, daily performance,
real-world arm activity, quality of life, and motor control variables at before
treatment, midterm assessment, and after treatment. In addition to study of treatment
benefits, physiological responses as the potential adverse effects including
post-exertional fatigue, post-exertional pain, and a biomarker of oxidative stress will
be also examined in this project. The investigators hypothesized that the therapeutic
regimen combining RT with dCIT will contribute to more significantly reduction in
impairment and disability for stroke patients than the other intervention groups.
2. The investigators will investigate if the clinical characteristics or behavioral
markers of stroke patients will influence the outcomes after interventions. The
proposed potential predictors will be chronicity, side of lesion, muscle tone, motor
ability of distal part of upper limb, and amount of affected hand use.
3. The investigators will examine whether the improved scores after each treatment reach
clinically important changes in order to establish the clinical significance relevant
for individualized medicine. The investigators will also assess and compare the
clinimetric properties (e.g., validity, responsiveness, minimal detectable change, and
minimal clinically important difference) of the rehabilitation outcomes to inform
selection of instruments.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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