Stroke Clinical Trial
Official title:
Modified Constrained - Induced Movement Therapy Compared to Intensive Bimanual Training for Subacute Stroke Patients. A Randomized Controlled Trial
The purpose of the study is to evaluate the benefit of two different treatment approaches for the hemiplegic arm, modified Constraint-Induced Movement Therapy and task-related bimanual training.
Detailed description:
Constrained-Induced Movement Therapy seems to be an efficacious treatment approach for a
certain subgroup of patients with moderate to mild hemiparesis after stroke. Still it
remains unclear whether the training intensity or restriction of the better arm plays the
bigger role. CIMT or mCIMT is usually compared to standard care of lower intensity with no
constraint of the better arm, or other treatments that do not focus on functional
(task-specific) training for the hemiplegic arm. Bimanual training, implying training of
activities requiring use of both arms, may however, be even more effective than mCIMT,
provided that the training is of similar intensity. The purposes of this study are:
1. To compare the functional effect of mCIMT to bimanual training of equal intensity in
order to examine if one of the treatment approaches is superior to the other regarding
the regaining of motor abilities.
2. Based on fMRI scans of a subgroup of patients, to examine whether cortical
reorganization after stroke differs depending on the type of treatment received (mCIMT
vs bimanual training).
3. To examine the rationale for implementing new treatment approaches in primary- and
secondary health care, and thereby contribute to improved coordination between
specialist and municipal health care systems.
Patients in both groups will participate in a 4 week training program, either mCIMT or
bimanual. In both groups cognitive techniques will be used to increase adherence. The
patients will be examined when screening, before and after the intervention, and 3 months
after completed intervention.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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