Cerebral Stroke Clinical Trial
Official title:
Training and Non-Invasive Brain Stimulation in Chronic Stroke Reduce Abnormal Hand Synergy
Verified date | November 2021 |
Source | Johns Hopkins University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This study plans to determine whether training can change abnormal flexion synergy in chronic stroke patients.
Status | Completed |
Enrollment | 20 |
Est. completion date | December 30, 2020 |
Est. primary completion date | December 30, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 21 Years to 99 Years |
Eligibility | Inclusion Criteria: - Age 21 and older - Ischemic stroke greater than six months ago, confirmed by CT or MRI - Residuals unilateral upper extremity weakness - Ability to give informed consent and understand the tasks involved. - Appearance of Flexion synergy in hand. - Ability to extent finger at least for 5 degrees. Exclusion Criteria: - Cognitive impairment, with score on Montreal Cognitive assessment (MoCA) = 20 - History of physical or neurological condition that interferes with study procedures or assessment of motor function (e.g. severe arthritis, severe neuropathy, Parkinson's disease) - Contraindication to tDCS (deep brain stimulators or other metal in the head, skull defect, pacemaker) - Inability to sit in a chair and perform upper limb exercises for one hour at a time - Participation in another upper extremity rehabilitative therapy study or tDCS study during the study period - Terminal illness - Social and/or personal circumstances that interfere with ability to return for therapy sessions and follow up assessments - Pregnancy - Severe Neglect |
Country | Name | City | State |
---|---|---|---|
United States | Kennedy Krieger Institute | Baltimore | Maryland |
Lead Sponsor | Collaborator |
---|---|
Johns Hopkins University | Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Individuation Index | The relationship between forces (in Newton) in active vs passive fingers during a set of isolated finger movements. It is a measure of finger independence. | Change from Baseline Individuation Index at 2 weeks | |
Primary | Action Research Arm Test (ARAT) | Assesses upper limb functioning in activities of daily living using observational methods. It is a 19 item measure divided into a 4-point ordinal scale ranging from: 3: Performs test normally 2: Completes test, but takes abnormally long or has great difficulty 1: Performs test partially 0: Can perform no part of test. Possible score range of 0 to 57; higher scores equal less impairment. |
Change from Baseline ARAT at 2 weeks | |
Primary | Fugl-Meyer (Motor Function - Upper Extremity Subscale) | Assesses functional mobility using observational methods. It is a 66 item measure. Its items are scored on a 3-point ordinal scale. 0: Cannot perform performs partially performs fully Possible score range from 0 - 66 |
Change from Baseline Impairment Index at 2 weeks | |
Primary | Accuracy (Euclidian norm) | The deviation of each finger from a target amount of force generation during a set of finger movements. | Change from Baseline Accuracy at 2 weeks | |
Secondary | Execution Time | The time period from cue appearance to the first moment when finger forces reach the required target. Lower values equal faster execution time. | Change from Baseline Execution Time at 2 weeks | |
Secondary | Semmes Weinstein Monofilament Examination (SWME) | A quantitative method to systematically assess the threshold stimulus necessary for perception of light touch to deep pressure by using monofilaments of different sizes. Interpretation scale for monofilaments: 2.83 Normal 3.61 Diminished light touch 4.31 Diminished protective sensation 4.56 Loss of protective sensation 6.65 Deep pressure sensation only |
Change from Baseline SWME at 2 weeks | |
Secondary | Modified Ashworth scale | Tests resistance to passive movement about a joint with varying degrees of velocity in order to assess muscle spasticity. Scoring: 0 No increase in muscle tone 1 Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension. 1+ Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the Range of motion (ROM). 2 More marked increase in muscle tone through most of the ROM, but affected part(s) easily moved. 3 Considerable increase in muscle tone, passive movement difficult. 4 Affected part(s) rigid in flexion or extension |
Change from Baseline Modified Ashworth Scale at 2 weeks |
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