Comparing Perceptual Motor Training and Repetitive Facilitation Exercises on UE in Stroke

November 12, 2024 updated by: Riphah International University

Comparative Effects of Perceptual Motor Training and Repetitive Facilitation Exercises on Upper Limb Quality of Movement and Motor Function in Stroke Patients

The aim of the study is to determine the comparative effects of perceptual motor training and repetitive facilitation exercises on upper limb quality of movement and motor function in Stroke patients.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation.

This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks.

Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab
      • Sargodha, Punjab, Pakistan, 40100
        • Dr. Faisal Masood Teaching Hospital
        • Contact:
        • Principal Investigator:
          • Hafiza Ayema Mufti, DPT

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria;

  • Both male and female patients.
  • Age 40-65 years
  • 1st ever stroke confirmed by MRI
  • mild-to-moderate upper-limb motor paralysis
  • sub-acute and chronic stroke patients
  • ability to understand tasks such as evaluations in the intervention
  • Modified Ashworth scale score < 3
  • Mini Mental State Examination Score should be>24 out of 30

Exclusion Criteria:

  • Participants who have a history of significant neurological or psychiatric disorders, other than stroke, that could interfere with upper limb motor recovery
  • Patients with pain, contracture and profound atrophy in arm and fingers.
  • Participants with severe cognitive dysfunction that would interfere with understanding instructions from the physician or therapist.
  • Presence of any other musculoskeletal condition. e.g. (Frozen shoulder, any recent fractures of upper limb.
  • Any accompanying diseases or disorders, other than stroke, that could interfere with upper extremity training.
  • Uncontrolled health conditions for which exercise was contraindicated.

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group A Perceptual Motor Training with Routine Physical Therapy
Group A will receive treatment session of 60 minutes including Perceptual motor training for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention.
Other: Perceptual Motor Training

8 set of exercises

  1. Balance training and related exercises
  2. Tones of awareness training, body parts' role and related exercises
  3. Space awareness training and related exercises
  4. Perception of shape training and related exercises
  5. Visual perception training and related exercise.
  6. Kinesthetic-tactile perception training and related exercises
  7. Auditory perception training and related exercises
  8. Eye and hand coordination, fine motor movements and related Exercises
Experimental: Group B Repetitive Facilitation Exercises with Routine Physical Therapy
Group B will receive treatment session of 60 minutes including Repetitive facilitation exercises for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention.
Other: Repetitive Facilitation Exercises

Eight set of exercises:

  1. Shoulder Flexion with 90° Elbow Flexion (Supine).
  2. Shoulder Horizontal Extension/Flexion with Elbow flexion (supine).
  3. Complex Shoulder and Upper Limb Movements (Supine)
  4. Shoulder Flexion/Abduction/External Rotation with Elbow and Forearm Supination (Supine)
  5. Forearm Supination/Pronation with 90° Elbow Flexion (Sitting)
  6. Wrist Extension and Forearm Pronation with Finger Extension (Supine)
  7. Finger Extension with Wrist Flexion (Supine)
  8. Finger Extension/Flexion with Wrist Flexion (Sitting) • Therapist facilitate the movement by rubbing, tapping and gentle stretching.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
1. Motor Evaluation Scale For Upper Extremity In Stroke Patients (MESUPES)
Time Frame: 8 week
A 17-items into two sub scales ; MESUPES Arm function; 8 items(score 0-5) MESUPES-Hand function; 9 items (score0-2) objective evaluation scale designed to assess quality of movement of arm and hand function after stroke. MESUPES takes 5-15 min to complete. Total score 58. A higher score indicates the greater the quality of movement
8 week
2. Fugl-Meyer Assessment (FMA):
Time Frame: 8 weeks
The Fugl-Meyer Assessment is used to assess motor function. It is a well-designed, feasible and efficient clinical examination method that has been tested widely in the stroke population. A three-level ordinal scale (0, can perform no part of the test; 1, performs test partially; 2, performs test normally) is applied to each item. A total possible score for the upper extremity is 66. The higher the score, the better the performance.
8 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Study Chair: Hira Jabeen, MS-NMPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Estimated)

November 25, 2024

Primary Completion (Estimated)

July 30, 2025

Study Completion (Estimated)

July 30, 2025

Study Registration Dates

First Submitted

November 12, 2024

First Submitted That Met QC Criteria

November 12, 2024

First Posted (Estimated)

November 14, 2024

Study Record Updates

Last Update Posted (Estimated)

November 14, 2024

Last Update Submitted That Met QC Criteria

November 12, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0253

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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