Effect of Adding Augmented Cues /Hand Stroke Patient (AUGMENTED CUES)

Effect of Adding Augmented Cues to Physical Therapy Intervention on Hand Function Post Stroke Patients

This study aims to investigate the effect of adding augmented cues to conventional physical therapy intervention on hand function in patients with post-stroke hemiparesis. Fifty patients with subacute ischemic stroke will be randomly assigned to either a study group receiving augmented cue-based training in addition to conventional physical therapy or a control group receiving conventional physical therapy alone. Hand function will be assessed before and after the intervention period using the Nine-Hole Peg Test (NHPT), hand grip strength measured by a dynamometer, and pressure pain threshold measured by a pressure algometer. The findings of this study may provide evidence regarding the effectiveness of augmented cue-based rehabilitation strategies in improving hand function after stroke.

Study Overview

• Status: Not yet recruiting
• Conditions: Ischemic Stroke
• Intervention / Treatment: Other: Conventional physical therapy; Device: musicgloves training

Detailed Description

Stroke is one of the leading causes of long-term disability worldwide and frequently results in impaired hand function, reduced dexterity, decreased grip strength, and limitations in activities of daily living. Conventional physical therapy is commonly used to improve upper extremity function; however, recovery of hand performance remains challenging for many stroke survivors.

Augmented cues provide additional sensory information through visual, auditory, or sensorimotor feedback that may enhance motor learning and neuroplasticity. Incorporating augmented cues into rehabilitation programs may improve patient engagement, increase repetition of task-specific movements, and facilitate functional recovery.

The purpose of this randomized controlled trial is to examine the effectiveness of adding augmented cue-based training to conventional physical therapy intervention in improving hand function among patients with subacute ischemic stroke.

A total of 50 participants meeting the eligibility criteria will be recruited and randomly assigned into two equal groups:

Study Group: Participants will receive augmented cue-based training combined with conventional physical therapy.

Control Group: Participants will receive conventional physical therapy only.

The intervention will be conducted over an eight-week treatment period. Outcome measures will be collected before and after treatment and will include:

1. Nine-Hole Peg Test (NHPT) to assess manual dexterity.
2. Hand grip strength measured using a hand dynamometer.
3. Pressure pain threshold measured using a pressure algometer.

The primary objective is to determine whether the addition of augmented cues results in greater improvement in hand function compared with conventional physical therapy alone. The results may contribute to the development of more effective rehabilitation strategies for individuals recovering from stroke.

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

Contacts and Locations

• Study Contact: Name: Mostafa abdullah ahmed, MD; Phone Number: 00201095052373; Email: dr.mostafa.abdullah.abdelaziem@gmail.com
• Study Contact Backup: Name: mariam mohamed elsayed, phd; Phone Number: 002010950505529; Email: mariamelanany5@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• - Male and female patients.
• Age between 40 and 60 years.
• First-ever subacute ischemic stroke.
• Time since stroke between 6 weeks and 6 months.
• Unilateral upper limb involvement.
• Able to understand and follow verbal instructions.
• Medically stable and able to participate in the rehabilitation program.
• Willing to provide informed consent.

Exclusion Criteria:

• - Hemorrhagic stroke.
• Bilateral stroke involvement.
• Severe cognitive impairment or severe aphasia interfering with participation.
• Severe visual or auditory deficits affecting training.
• Severe upper limb spasticity that prevents hand training.
• Other neurological disorders affecting upper limb function.
• Severe musculoskeletal disorders of the upper limb.
• Participation in another rehabilitation trial during the study period.
• Unstable cardiovascular or medical conditions.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: control group; Participants will receive a conventional physical therapy program for hand rehabilitation after stroke. Treatment will be administered three times per week for eight weeks (24 sessions), with each session lasting 60 minutes and including range of motion exercises, strengthening exercises, stretching, and task-oriented hand training.	Other: Conventional physical therapy; Participants will receive a conventional physical therapy program for upper limb and hand rehabilitation after stroke. The program includes stretching exercises, range of motion exercises, strengthening exercises, and task-oriented hand training. Treatment will be provided three times per week for eight weeks (24 sessions).
Experimental: musical gloves; articipants will receive the same conventional physical therapy program provided to the control group in addition to MusicGlove training. Treatment will be administered three times per week for eight weeks (24 sessions). MusicGlove will provide augmented visual, auditory, and performance feedback during task-specific hand training.	Other: Conventional physical therapy; Participants will receive a conventional physical therapy program for upper limb and hand rehabilitation after stroke. The program includes stretching exercises, range of motion exercises, strengthening exercises, and task-oriented hand training. Treatment will be provided three times per week for eight weeks (24 sessions).; Device: musicgloves training; MusicGlove is a sensor-based rehabilitation device that provides augmented visual, auditory, and performance feedback during task-specific hand exercises. Participants perform repetitive thumb-to-finger opposition and grasping movements synchronized with computer-based musical activities. Training will be provided in addition to conventional physical therapy three times per week for eight weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nine-Hole peg Test (NHPT)	Manual dexterity assessed using the Nine-Hole Peg Test. The time required to place and remove nine pegs will be recorded in seconds. Lower scores indicate better hand dexterity.	Baseline and after 8 weeks of treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
hand grip strength	Hand grip strength will be assessed using a calibrated hand dynamometer. Participants will perform maximal voluntary grip contractions, and the average value of three trials will be recorded in kilograms. Higher values indicate greater hand strength.	Baseline and after 8 weeks of treatment
pressure pain threshold	Pressure pain threshold of the Extensor Carpi Radialis Brevis muscle will be measured using a digital pressure algometer. Pressure will be applied at a standardized rate until the participant first perceives pain. Higher values indicate lower pain sensitivity.	Baseline and after 8 weeks of treatment

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Moshera H Darwish, PHD, Professor of Physical Therapy for Neurology and Neurosurgery Faculty of Physical Therapy Cairo University; Study Director: mariam m elsayed, phd, Lecturer in department of physical Therapy for Neurology and Neurosurgery Faculty of physical therapy Cairo University; Study Director: Essam M Abdulwahab, PHD, Professor of Neurology Faculty of Medicine Al-Azhar university

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): August 1, 2027
• Study Completion (Estimated): August 1, 2027

Study Registration Dates

• First Submitted: June 13, 2026
• First Submitted That Met QC Criteria: June 13, 2026
• First Posted (Actual): June 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 17, 2026
• Last Update Submitted That Met QC Criteria: June 13, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: hand function; grip strenght; augmented cues; stroke rehab; musical gloves; upper extremity rehabilition
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke; Ischemic Stroke
• Other Study ID Numbers: P.T.REC/012/006310

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will be available from the corresponding author upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No