Hand Grasping Techniques on Eliciting the Grasp Reflex in Patients With Dementia (GRASP)

The Effect of Hand Grasping Techniques on Eliciting the Grasp Reflex in Patients With Dementia or Suspected Frontal Lobe Dysfunction

In this study, the investigators will determine the difference between the two techniques used to elicit the grasp response in patients with frontal lobe dysfunction, primarily in dementia patients versus control patients.

Study Overview

• Status: Completed
• Conditions: Dementia
• Intervention / Treatment: Other: palmar grasp without dorsal stimulation; Other: standard palmar grasp test with dorsal stimulation

Detailed Description

The goal of this project is to determine the optimal technique to elicit the grasping response in patients with dementia or suspected frontal lobe dysfunction. The proposed study is to perform two techniques to elicit grasp response in patients with dementia or suspected frontal lobe dysfunction and observe the presence or absence of the response and prominence of the response on a proposed rating scale. Future goals will be aimed at aiding clinicians in refining their clinical techniques to be more sensitive for diagnosing frontal lobe dysfunctions.

• Study Type: Interventional
• Enrollment (Actual): 1
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New Jersey
    • Stratford, New Jersey, United States, 08084
      • Rowan University School of Osteopathic Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Ability to sign informed consent or have a surrogate present to sign the consent
2. Age 18 or above
3. Patients are diagnosed with dementia, Alzheimer's disease, or frontal lobe dysfunction
4. Medications are to remain stable during the course of the study except for emergency modifications.

Exclusion Criteria:

1. Inability to obtain informed consent from patient or surrogate
2. Unable to follow commands.
3. Physical restrictions (i.e. spasticity of hands/arms, upper extremity amputation)
4. Other comorbidities such as muscular diseases, hepatic encephalopathy, renal failure, down syndrome, NPH, depression, and cerebral palsy.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: HEALTH_SERVICES_RESEARCH
• Allocation: NA
• Interventional Model: SINGLE_GROUP
• Masking: NONE

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

OTHER: Standard; Prospective, grasp techniques will be compared in each patient from the experimental group using a palmar grasp without dorsal stimulation and a standard palmar grasp test with dorsal stimulation on the same patient as the control group

Other: palmar grasp without dorsal stimulation; The patient will then be asked to keep the arms at 90 degrees and the researcher will slightly stroke palm and fingers of both hands of the patient simultaneously. After completion of each technique, the presence or absence of the response will be noted. In addition, the prominence of the response on the rating scale will be obtained as explained below. The scaling of the grasp response is as followed: Flexion at the distal interphalangeal joint of the hand; Flexion at the proximal interphalangeal joint of the hand; Flexion at the metacarpal-phalangeal joint of the hand; Other: standard palmar grasp test with dorsal stimulation; The patient will be asked to put their arms at 90 degrees and the researcher will hold one hand at the wrist and dorsum of the palm and lightly stroke the palm and fingers. The patient will be instructed to relax hands and not hold on while doing the grasp and see if the response persists. The same technique will be repeated for the patient's other hand.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Grasp response	The primary objective of the study will be to determine if a change in the performance of the grasp response will lead to a change in the way the response is elicited. The prominence of the grasp response will be scored on a rating scale	six months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frontal Lobe release- Glabellar Response	The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The glabellar response will be tested.	six months
Frontal lobe release- Palmomental Response	The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The palmomental response will be tested.	six months
Frontal lobe release- Snout Response	The secondary objective during this study will be to determine if other frontal release signs are present in study participants. The snout response will be tested.	six months

Collaborators and Investigators

• Sponsor: Rowan University

Study record dates

Study Major Dates

• Study Start: July 1, 2016
• Primary Completion (ACTUAL): May 23, 2018
• Study Completion (ACTUAL): May 23, 2018

Study Registration Dates

• First Submitted: August 5, 2016
• First Submitted That Met QC Criteria: October 4, 2016
• First Posted (ESTIMATE): October 5, 2016

Study Record Updates

• Last Update Posted (ACTUAL): October 28, 2019
• Last Update Submitted That Met QC Criteria: October 24, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Keywords: dementia
• Additional Relevant MeSH Terms: Mental Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Dementia
• Other Study ID Numbers: GRASP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO