Comparing Different Rehabilitation Exercise Strategies for Improving Arm Recovery After Stroke (Boost)
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 Contact
Study Contact
- Name: Vicky Chan, PT, DPT
- Phone Number: (949) 447 - 8339
- Email: vchan2@hs.uci.edu
Study Contact Backup
- Name: Christine Kim, OTR/L
- Phone Number: (562) 385 - 8116
- Email: chrissyk@ranchoresearch.org
Study Locations
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California
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Downey, California, United States, 90242
- Rancho Research Institute
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Orange, California, United States, 92868
- University of California Irvine
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Pomona, California, United States, 91767
- Casa Colina Hospital and Centers for Healthcare
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 18 to 84 years of age
- Experienced a single stroke or multiple strokes >3 days and < 4 weeks prior to study enrollment, and currently admitted or accepted into Acute Rehabilitation program for stroke.
- UE Fugl-Meyer Motor Score <42/66
- Absence of moderate to severe shoulder pain while using the movable wheelchair arm rest device (<6 on the 10-point visual analog pain scale)
- Absence of severe tone at the affected UE (score <4 on the Modified Ashworth Spasticity Scale)
- Deem to be an appropriate candidate for manual wheelchair by ARU clinicians. A patient who has been able to transfer into a wheelchair while at ARU (with or without assistance) and has tolerated sitting in the wheelchair for at least 30 minutes.
Exclusion Criteria:
- Subarachnoid hemorrhage
- Presence of other neurological or psychological disorders affecting motor functions
- Moderate to severe pain in the stroke-affected upper extremity (score > 6 on 10-point visual analog pain scale), while using the movable wheelchair arm rest device
- Severe tone at the affected upper extremity (score > 4 on the Modified Ashworth Spasticity scale)
- Severe aphasia (score of 2 or higher on the NIH stroke scale - question 9). PI may dismiss this criterion if the participant is deemed able to follow all study instructions.
- Deficits in vision, language, attention, neglect, or other cognitive functions severe enough to interfere with safe operation of wheelchair or the movable wheelchair arm rest device.
- Currently pregnant
- Difficulty in understanding or complying with instructions given by the experimenter.
- Inability to perform the experimental task that will be studied.
- Not part of another upper extremity motor-related interventional study
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: Boost - Moveable wheelchair Arm rest
Movable wheelchair arm rest device group: participants in this group will be provided with a wheelchair equipped with movable wheelchair arm rest device and will be trained by training therapists on how to use the device.
Therapists will determine if the participant is capable of using the device in either a stationary mode or overground mode.
Afterwards, participants will be allowed to utilize the device within the inpatient facility on their own.
The investigators encourage at least 30 minutes per day of device use, although this is not required or limited to 30 minutes.
Therapists may adjust the difficulty of the device utilize to provide additional challenge as they deem suitable for the participant.
Once participants are discharged from the unit, they will be allowed to keep the movable wheelchair arm rest devices until their 3-month post stroke follow up visit, the last visit of the study.
|
The movable wheelchair arm rest device is a novel wheelchair armrest that quickly clicks into a manual wheelchair frame just like a conventional armrest.
However, unlike a conventional armrest, the movable wheelchair arm rest device allows users to activate arm muscles in a way that is appropriate for the early stages of stroke recovery and consistent with the Feys et al. rocking chair approach: with biomechanical support of the shoulder, without high cognitive demand, and focusing on the "out-of-synergy" movement pattern that requires elbow extension.
For the study, the investigators ask participants to exercise using Boost for a 30-minute period per day for 5 times a week in addition to their regular therapy until their discharge from the unit.
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Active Comparator: Electronic Arm Exercises
Electronic exercise program designed by training therapists.
These exercises will be assigned to the participants electronically using a commercial home exercise program platform commonly used by hospital systems (i.e.: Medbridge).
They will be encouraged to exercise for 30 min/day in addition to the regular rehabilitation therapy at Acute Rehab Unit (ARU), although this is not required or limited to 30 minutes.
Therapists may adjust the difficulty of exercise program to provide additional challenge as they deem suitable for the participant.
Once participants are discharged from the unit, they will be allowed to keep the electronic exercise program until their 3-month post stroke follow up visit, the last visit of the study.
|
These exercises will be assigned to the participants electronically using a commercial home exercise program platform commonly used by hospital systems (i.e.: Medbridge).
They will be encouraged to exercise for 30 min/day in addition to the regular rehabilitation therapy at ARU.
These exercises will be monitored and supervised by therapists who have been trained in the study protocol.
Once participants are discharged from the unit, they will be allowed to keep the electronic exercise program until their 3-month post stroke follow up visit, the last visit of the study.
For this study, the investigators ask participants to exercise following this customized arm and hand exercise program for a 30-minute period per day for 5 times a week in addition to their regular therapy until their discharge from the unit.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Fugl-Meyer Arm Motor Assessment Score (FMAMA)
Time Frame: Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
|
The investigators measure the change of the Fugl-Meyer Arm Motor Assessment scores from the baseline evaluation to the 3-month post stroke follow up evaluation.
Fugl-Meyer Arm Motor Assessment is a 66-point scale measuring the movement pattern of the upper extremities.
The minimum score is zero and the maximum score is 66.
The higher scores indicate a better outcome.
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Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Modified Ashworth Spasticity Scale (MASS)
Time Frame: Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
|
The investigators measure the spasticity of the upper extremity at baseline, post-intervention, and at the 3-month post stroke follow up evaluation.
Spasticity is described as the resistance to passive movement.
Participants are asked to relax and evaluators assess muscle resistance to passive movement at one joint at a time: Shoulder, elbow, wrist, and fingers.
The evaluator will then grade the resistance on a 6-point scale for each joint.
Higher scores indicate more rigid movement or more muscle tone resistance.
The minimum score is zero and the maximum score is 4.
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Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
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Box and Blocks Test
Time Frame: Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
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The investigators measure the Box and Blocks Test scores at baseline, post-intervention, and at 3-month post stroke follow up evaluation.
Participants are instructed to move as many blocks as possible, one at a time, from one compartment in a box to a second compartment over a divider for a period of 60 seconds; each block that is moved is counted, and multiple blocks moved at the same time are counted as a single block.
The higher scores indicate a better outcome.
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Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
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Shoulder Subluxation Distance
Time Frame: Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
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The investigators measure the shoulder subluxation distance at baseline, post-intervention, and at 3-month post stroke follow up evaluation.
Participants are asked to be seated in a upright chair and relax their affected upper extremity.
The evaluator measures the distance, in centimeter, between the inferior aspect of the acromion and the superior aspect of the humeral head.
The lower scores indicate a better outcome.
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Baseline upon admission (assessed within 3 days upon admission), Post-intervention evaluation at discharge (At discharge: assessed up to 3 weeks post baseline), and 3-month post-stroke evaluation (Follow up occurred at Month 3 after Baseline)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: An Do, MD, University of California, Irvine
- Principal Investigator: Charles Liu, MD, Rancho Research Institute
- Principal Investigator: Emily Rosario, PhD, Casa Colina Research Institute
Publications and helpful links
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
- 2508
- 5R44HD106850-02 (U.S. NIH Grant/Contract)
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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