Helping Stroke Patients With Movement Using Photos, Videos, and Pictograms

A Comparison of Visual Aids for Stroke Rehabilitation: Photos, Videos, Pictograms

The goal of this interventional study is to learn how different types of visual aids-photos, videos, and pictograms-help people with stroke understand and perform simple physical movements. The researcher wants to find out which type of visual aid is most helpful and easiest to understand for stroke rehabilitation.

To take part, participants must be able to stand for at least one minute without help and understand simple instructions.

The main questions this study aims to answer are:

• Which type of visual aid (photo, video, or pictogram) helps participants perform movements more accurately?
• Which visual aid do participants find the easiest to understand and prefer?
• How much mental effort (cognitive load) do participants feel when using each type of visual aid?
• Do the effects of visual aids vary depending on stroke type, brain lesion location, or time since stroke?

The researcher will compare how each type of visual aid affects movement performance and participants' responses.

Participants will:

• View three types of visual aids (photo, video, pictogram) and perform specific physical tasks based on each.
• Have their movement performance recorded using a video camera.
• Complete a short survey after the tasks to rate their understanding, preferences, and cognitive effort.
• Take part in a single session that lasts about 20 minutes in a quiet room within the hospital.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Behavioral: Visual Aids(Photos, Videos, and Pictograms)

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• South Korea
  • Goyang-si, South Korea
    • Ilsan Central Rehabilitation Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed with stroke.
• Have sufficient vision and cognitive ability to perceive the provided visual materials (pictures or text).
• Able to stand independently without assistive devices for at least 1 minute.
• Have minimum cognitive ability necessary to understand tasks and follow instructions, with a score of 18 or higher on the Korean version of the Mini-Mental State Examination (K-MMSE).

Exclusion Criteria:

• ndividuals with other central nervous system disorders besides stroke that may affect motor performance or assessment.
• Individuals with musculoskeletal disorders, such as arthritis or fractures, that may affect motor performance or assessment.
• Individuals with severe visual impairments, such as visual field defects, unilateral neglect, or color blindness.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Visual Aids Intervention

Behavioral: Visual Aids(Photos, Videos, and Pictograms); Participants will be presented with three types of visual instructional aids: photographs, videos, and pictograms, via a laptop or tablet. Each participant will perform three motor tasks, each paired with a different visual aid, assigned in random order using a Latin Square design. Each task takes approximately 3 minutes, followed by 1 minute of rest. After completing all tasks, participants will complete a 5-minute survey about their understanding, preference, and perceived cognitive load. The total session lasts about 20 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motor Task Performance Accuracy	Motor task performance accuracy will be assessed using a checklist developed by the researchers, considering task characteristics and learning effects. Each movement consists of 6 key performance elements, scored as 0 (not performed) or 1 (performed accurately), with a maximum of 6 points per task. All performances will be video recorded, and three trained raters will independently score the recordings. Inter-rater reliability will be evaluated using the Intraclass Correlation Coefficient (ICC) based on total scores.	Immediately after the experimental session

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Hesitations	The number of hesitations will be counted during motor task performance. A hesitation is defined as a pause lasting more than 1 second, re-checking the visual aid, or modifying the movement. This measure indirectly reflects the participant's movement fluency and level of cognitive certainty. All performances will be video recorded and independently reviewed by three trained raters. Inter-rater reliability will be assessed using the Intraclass Correlation Coefficient (ICC 3,k).	Immediately after the experimental session (video review)
Understanding of Visual Aids	Participants will rate how helpful each type of visual aid (photo, video, pictogram) was for understanding the motor task. A 5-point Likert scale will be used, where 1 indicates "Not helpful at all" and 5 indicates "Very helpful." Participants will complete this rating immediately after completing each task.	Immediately after the experimental session
Preference for Visual Aids	Participants will indicate which of the three visual instructional aids (photos, videos, pictograms) they found easiest to understand. This measure captures participants' relative preference for the visual materials after performing the motor tasks.	Immediately after the experimental session
Number of Replays	The number of times the participant presses the replay button to review the visual instructional material before performing the task will be automatically recorded. This measure will be stored using PsychoPy 2025.1.1 (Open Science Tools Ltd., Nottingham, UK).	During each task trial (approximately 3 minutes per task)
Perceived Cognitive Load	The degree of mental effort experienced by participants while performing the motor tasks with each type of visual instructional material will be assessed. A pictorial 9-point Likert scale will be used, where a score of 1 indicates "not difficult at all" and a score of 9 indicates "very difficult"	Immediately after the experimental session

Collaborators and Investigators

• Sponsor: Jaegyeong Lee

Study record dates

Study Major Dates

• Study Start (Actual): September 6, 2025
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): November 9, 2025

Study Registration Dates

• First Submitted: July 24, 2025
• First Submitted That Met QC Criteria: July 24, 2025
• First Posted (Actual): July 31, 2025

Study Record Updates

• Last Update Posted (Actual): November 25, 2025
• Last Update Submitted That Met QC Criteria: November 22, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Keywords: Motor performance; Videos; Photos; Cognitive load; Pictograms; Visual aids; Visual instruction; Movement accuracy
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke; Technology, Industry, and Agriculture; Technology; Tape Recording; Audiovisual Aids; Educational Technology; Television; Videotape Recording
• Other Study ID Numbers: SYU 2025-06-028-003

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No