Comparing Constraint-Induced Therapy and Occupation-Based Intervention for Optimal Stroke Recovery

April 18, 2017 updated by: Lumy Sawaki
This pilot study was designed to compare the effects of modified constraint-Induced therapy and occupation-based intervention to increase functional motor recovery in stroke

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The purpose of this study is to investigate change in motor performance and the extent of neuroplastic change associated with both occupation-based intervention and modified constraint-Induced therapy (m-CIT) in the recovery of upper extremity motor function following a stroke. Transcranial Magnetic Imaging (TMS) will be used to compare the difference in the brain reorganization of each client before and after the intervention to identify which technique is more effective in changing brain function. Central Hypothesis: Stroke subjects with motor deficit receiving occupation-based interventions will demonstrate improved motor function greater to that of the subjects receiving m-CIT interventions. Sixteen participants with chronic stroke will be recruited for the study over the age 21. Participants will be randomly assigned to one of the two therapy groups and will receive 55 minutes of therapy 2 times per week for 4 weeks for a total of 8 sessions.

Study Type

Interventional

Enrollment (Actual)

16

Phase

  • Phase 2

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

21 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • 21 years of age and older
  • at least 12 months from stroke
  • mild-to-severe upper extremity motor deficit
  • single ischemic or hemorrhagic stroke

Exclusion Criteria:

  • history of head injury with loss of consciousness
  • seizures
  • severe alcohol or drug abuse
  • psychiatric illness interfering with participation in the study including uncontrolled depression
  • cognitive deficits severe enough to preclude informed consent
  • ferromagnetic material near the brain
  • individuals that could be pregnant
  • cardiac or neural pacemakers
  • if currently receiving occupational therapy services

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Occupation-based practice
Occupation-based intervention (OBP) is a form of activity-based therapy consisting of client-directed occupations that match client-identified goals. OBP group will participate in activities such as wood working, scrap booking, higher level dressing (don/doffing a bra, zipping coat), hair care, opening doors, using bathroom stalls, typing, cooking, tying shoes, washing dishes, carrying dirty dish carts, clearing dirty dishes and raking. Repetition of the tasks are not the focus in the OBP group. Each session lasted 55-minute and it was delivered twice a week for 4 weeks (8 sessions).
Behavioral: Occupation-based practice (OBP)
Active Comparator: Modified-constraint induced therapy
Modified-constraint induced therapy (m-CIT) group will target functional goals (eg, activities of daily living) or goal subcomponents (eg, pinching, grasp/release, or functional reach patterns). Tasks were repeated at rate of approximately 10 to 50 repetitions each session according to the demands of the task. No physical constraint of the less-affected UE will be applied, but training compelled highly repetitive use of the more-affected upper extremity. Subjects will attempt tasks with progressive difficulty. Each session lasted 55-minute and it was delivered twice a week for 4 weeks (8 sessions).
Behavioral: Modified-constraint induced therapy (m-CIT)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Fugl Meyer Assessment (FMA
Time Frame: Score change after 8 days of intervention compared to baseline
Score change after 8 days of intervention compared to baseline

Secondary Outcome Measures

Outcome Measure
Time Frame
Stroke Impact Scale (SIS)
Time Frame: Score change after 8 days of intervention compared to baseline
Score change after 8 days of intervention compared to baseline
Canadian Occupational Performance Measure (COPM)
Time Frame: Score change after 8 days of intervention compared to baseline
Score change after 8 days of intervention compared to baseline
Goal Attainment Scale (GAS).
Time Frame: Score change after 8 days of intervention compared to baseline
Score change after 8 days of intervention compared to baseline
Transcranial Magnetic Stimulation (map volume)
Time Frame: Score change after 8 days of intervention compared to baseline
Score change after 8 days of intervention compared to baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Lumy Sawaki

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2013

Primary Completion (Actual)

May 1, 2016

Study Completion (Actual)

May 1, 2016

Study Registration Dates

First Submitted

July 27, 2016

First Submitted That Met QC Criteria

July 28, 2016

First Posted (Estimate)

July 29, 2016

Study Record Updates

Last Update Posted (Actual)

April 20, 2017

Last Update Submitted That Met QC Criteria

April 18, 2017

Last Verified

April 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 13-0509

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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