Unilateral Versus Bilateral Task-specific Training on Motor Impairment, Upper Extremity Function, and Hand Dexterity in Post-Stroke Rehabilitation

This randomized clinical trial will examine upper limb rehabilitation in individuals recovering from stroke. The study will compare unilateral and bilateral task-oriented training approaches to determine their relative effectiveness. Thirty-two medically stable participants with active shoulder movement and adequate cognition will be enrolled into two groups. Both groups will receive structured training for four weeks. Outcomes related to motor function and dexterity will be measured using standardized assessment tools. The aim is to identify the more effective strategy for improving upper extremity function after stroke.

Study Overview

• Status: Recruiting
• Conditions: Stroke
• Intervention / Treatment: Procedure: Unilateral task oriented training (UTOT) with baseline EMS; Procedure: Bilateral task oriented training (BTOT) with baseline EMS

• Study Type: Interventional
• Enrollment (Estimated): 32
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Dr Izza Ayub Principal Investigator; Phone Number: (041) 8868326; Email: drizzaayub@gmail.com
• Study Contact Backup: Name: Dr Ayesha Principal Investigator; Email: Ayeshaanwarulhaq12@gmail.com

Study Locations

• Pakistan
  • Kot Addu, Pakistan
    • Recruiting
    • Hospitals

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• • Age between 40 and 75 years

  • Clinically diagnosed stroke (no more than three lifetime episodes)
  • Stroke duration between 6 to 24 months
  • Ability to perform antigravity shoulder movement with the paretic limb
  • Abbreviated Mental Test score ≥ 7
  • Medically stable and capable of giving consent

Exclusion Criteria:

• • Uncontrolled systemic conditions (e.g. Unstable cardiac conditions)

  • Major orthopedic issues affecting the involved upper limb
  • Hearing deficits
  • Allergy to electrodes
  • Receptive aphasia or severe language impairment
  • Severe joint contracture limiting required upper limb movements

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Unilateral task oriented training with Electrical Muscle Stimulation	Procedure: Unilateral task oriented training (UTOT) with baseline EMS; Baseline: EMS applied to target muscles (depending on requirement of patient like wrist and finger extensors) with 15-20 minutes duration Treatment: Task oriented functional exercises performed only with affected arm. Task progress from simple to complex e.g. drinking form a cup, lifting a glass to 90° flexion of shoulder, polishing a table, and hair combing. Visual, verbal, or proprioceptive feedback provided to support motor learning. Sessions conducted 4 times/week for 4 weeks.
Active Comparator: Bilateral task oriented training with Electrical Muscle Stimulation	Procedure: Bilateral task oriented training (BTOT) with baseline EMS; Baseline: EMS applied to target muscles (depending on requirement of patient like wrist and finger extensors) with 15-20 minutes duration Treatment: Same tasks previous group, but performed by both upper limbs, simultaneously in a coordinated manner. Intensity, duration and task complexity matched with UTOT group to ensure comparability. Therapist provides cueing and feedback to maintain proper movement and progression. Sessions conducted 4 times/week for 4 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motor recovery and upper extremity function	Motor recovery and upper extremity performance will be assessed using Fugl-Meyer Assessment for Upper Extremity (FMA-UE). This scale assesses upper limb motor function by examining reflex activity, voluntary movements and movement synergy patterns. It allows systemic tracking of recovery over time.	Four weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hand dexterity	Modified Box and Block test, a customized adaptation of the original test, will assess hand dexterity. It has been validated for use in individuals with stroke and demonstrates high reliability. It supports excellent test-retest reliability meaning strong consistency.	Four weeks

Collaborators and Investigators

• Sponsor: University of Faisalabad

Study record dates

Study Major Dates

• Study Start (Estimated): April 5, 2026
• Primary Completion (Estimated): May 5, 2026
• Study Completion (Estimated): May 15, 2026

Study Registration Dates

• First Submitted: April 5, 2026
• First Submitted That Met QC Criteria: April 5, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 5, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: TUF/EIRB/165/26

Drug and device information, study documents

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