Cerebrovascular Accident Clinical Trial
Official title:
The Impact of Functional Task Practice Dosing on Motor Control in Hemiplegia From Chronic Stroke
The first purpose of this study is to determine how often people should practice motor skills to best improve the ability to use the affected arm and hand after stroke. The second purpose is to determine whether it is better to practice a lot of repetitions of a few tasks or a few repetitions of many tasks during motor rehabilitation for the arm and hand after stroke.
Intense skill practice with the affected arm after stroke has the potential to improve upper
extremity (UE) function resulting from neuroplastic changes in the motor cortex. However,
the necessary and sufficient parameters of this therapy in humans have not been fully
investigated. Delineation of the most efficacious and efficient therapy for promoting UE
recovery post-stroke is necessary before effective clinical implementation of this therapy.
In this study, using parallel group design methodology, we will test the effect of 2
practice parameter (i.e. spacing of practice and number of repetitions per task practiced
per session) modifications on UE function following skill practice.
Forty subjects will complete multiple baseline testing and then be randomized, using random
number table, to one of 4 groups: condensed functional task practice modeled after
Constraint-Induced Movement Therapy (6 hours of practice/day, 5 days/week, 2 weeks),
condensed functional task practice with a restricted number of tasks practiced, distributed,
distributed functional task practice (Monday, Wednesday, Friday, 6 hours/session, 10
sessions), distributed functional task practice with a restricted number of tasks practiced.
During therapy sessions, subjects will practice performing common activities with their
paretic upper extremity. They will wear a mitt on their non-paretic upper extremity for up
to 90% of their waking hours. Post-testing sessions will follow within one week of
completing therapy with an additional follow-up testing session 3 months later.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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