Proprioceptive Stimulation With Manual Bilateral Rhythmic Exercise in Post-stroke Patients (BAT)
Proprioceptive Stimulation With Manual Bilateral Rhythmic Exercise in Post-stroke Patients (Stimolazione Propriocettiva Manuale Con Esercizio Ritmico Bilaterale in Pazienti Post Ictus - BAT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Venezia, Italy, 30126
- Fondazione Ospedale San Camillo IRCCS
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- time since stroke up to 6 months,
- presence of the upper limb plegia (0 point according to the Medical Research Council scale),
- passive range of motion (ROM) completely free,
- absence of primary joint trauma of the wrist, elbow and shoulder,
Exclusion Criteria:
- increased muscle tone (score higher than 1 point in modified Ashworth scale),
- apraxia (De Renzi test < 62 points),
- global sensory aphasia (clinical notes),
- neglect (clinical notes),
- cognitive impairments (Mini Mental State Examination test < 24 points) ,
- severe sensitivity disorders ( < 1 point in items shoulder, elbow, wrist and thumb at the proprioceptive sensitivity section of the Fugl-Meyer scale),
- stroke lesion located in the cerebellum (clinical notes).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Proprioceptive based training (PBT)
The treatment will last one hour and will be divided as follows: 2 proprioceptive based stimulation sessions per 3 minutes for each movement, with a rest of 2 minutes between each session.
Every patient will receive 15 treatments, 5 days a week, for 3 weeks.
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During the PBT patient will stay in supine position with the upper limbs positioned in symmetric posture.
He/She will be asked to move both limbs with the same frequency performing bilateral flexion-extension of one of the upper limb districts according to the available free ROM of the target joint.
The movement execution of the affected arm will be supported by the physiotherapist performing passive movement at the same rhythm, as the one executed with the unaffected side.
Patient will be asked to focus the attention on the movement performed against gravity, which will be reinforced by a verbal command.
Afterwards, the physiotherapist will fully support movement execution coherently with the patient's movement initialization.
The active movement performed voluntarily by the patient with unaffected limb will be considered as the reference movement, that the physiotherapist has to emulate passively, by synchronization of passive movement executed in phase with the affected side.
|
|
Other: Conventional neuromotor treatment (CNT)
The CNT group will be treated for one hour daily by means of a CNT programme.
The treatment will last 3 weeks.
|
The patients randomized to the CNT group will be asked to perform exercises for postural control, exercises for hand pre-configuration, exercises for the stimulation of manipulation and functional skills, exercises for proximal-distal coordination.
All the exercises will be performed with or without the assistance of a physiotherapist.
The upper limb motricity will be trained with progressive complexity.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Medical Research Council scale (MRC)
Time Frame: Change from baseline of the MRC scale at the end of PBT (three weeks thereafter)
|
Applied at the beginning and at the end of treatment (after 15 sessions).
The following muscles will be considered: deltoid, biceps brachii, triceps brachii, flexor carpi radialis, flexor carpi ulnaris, extensor carpi radialis, extensor carpi ulnaris, flexor digitorum and extensor digitorum.
|
Change from baseline of the MRC scale at the end of PBT (three weeks thereafter)
|
|
Dynamometer
Time Frame: Change from baseline of dynamometer at the end of PBT (three weeks thereafter)
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Applied at the beginning and at the end of treatment (after 15 sessions)
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Change from baseline of dynamometer at the end of PBT (three weeks thereafter)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Fugl-Meyer Upper Extremity scale (FM UE)
Time Frame: Change from baseline of the FM UE scale at the end of PBT (three weeks thereafter)
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Applied at the beginning and at the end of treatment (after 15 sessions).
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Change from baseline of the FM UE scale at the end of PBT (three weeks thereafter)
|
|
Functional Independence Measure scale (FIM)
Time Frame: Change from baseline of the FIM scale at the end of PBT (three weeks thereafter)
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Applied at the beginning and at the end of treatment (after 15 sessions)
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Change from baseline of the FIM scale at the end of PBT (three weeks thereafter)
|
|
Modified Ashworth Scale
Time Frame: Change from baseline of the Ashworth scale at the end of PBT (three weeks thereafter)
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Applied at the beginning and at the end of treatment (after 15 sessions).
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Change from baseline of the Ashworth scale at the end of PBT (three weeks thereafter)
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surface Electromyography (sEMG)
Time Frame: Change from baseline of the MVC at the end of PBT (three weeks thereafter)
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Applied at the beginning and at the end of treatment (after 15 sessions) and aiming to record the maximal voluntary contraction (MVC).
sEMG signal will be recorded online during the tasks in each modality with bipolar electrodes from the following muscles; long head of biceps brachii, short head of biceps brachii, long head of triceps brachii and lateral head of triceps brachii.
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Change from baseline of the MVC at the end of PBT (three weeks thereafter)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Pawel Kiper, PhD, Fondazione Ospedale San Camillo IRCCS
- Study Director: Andrea Turolla, PhD, Fondazione Ospedale San Camillo IRCCS
- Study Chair: Michela Agostini, MSc, Fondazione Ospedale San Camillo IRCCS
- Study Chair: Alfonc Baba, MSc, Fondazione Ospedale San Camillo IRCCS
Publications and helpful links
General Publications
- Kiper P, Szczudlik A, Venneri A, Stozek J, Luque-Moreno C, Opara J, Baba A, Agostini M, Turolla A. Computational models and motor learning paradigms: Could they provide insights for neuroplasticity after stroke? An overview. J Neurol Sci. 2016 Oct 15;369:141-148. doi: 10.1016/j.jns.2016.08.019. Epub 2016 Aug 11.
- Kiper P, Baba A, Agostini M, Turolla A. Proprioceptive Based Training for stroke recovery. Proposal of new treatment modality for rehabilitation of upper limb in neurological diseases. Arch Physiother. 2015 Aug 3;5:6. doi: 10.1186/s40945-015-0007-8. eCollection 2015.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Protocollo 2012.07 BAT v.1.2
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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