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Effects of Training in a Virtual Environment in Chronic Stroke Patients

1 novembre 2018 mis à jour par: University of Sao Paulo General Hospital

Effects of Training in a Virtual Environment on the Motor Function,Postural Control and Quality of Life in Chronic Stroke Patients: A Randomized Controlled Trial

The objective of this work will be compare the effects of two balance training programs, one Nintendo Wii Fit-based and the other traditionally-based without the use of a gaming system, on the (1) motor function, (2) cognition, (3) balance and (4) gait in chronic stroke patients. It is a prospective, single blinded, randomized clinical trial performed at Center of Research of the courses of Speech Therapy, Physical Therapy and Occupational Therapy of São Paulo University. Forty patients will be randomly assigned in control and experimental group, 20 each one.

Aperçu de l'étude

Statut

Complété

Description détaillée

The objective of this work is to compare the effects of two balance training programs, one Nintendo Wii Fit-based and the other traditionally-based without the use of a gaming system, motor function, balance and quality of life in chronic stroke patients. It is a prospective, single-blinded, randomized clinical trial performed at Center of Research of the courses of Speech Therapy, Physical Therapy and Occupational Therapy of São Paulo University. Forty chronic stroke patients are randomly in control and experimental group, 20 each one. Both groups conduct 14 training sessions, twice a week, for seven weeks. Each session will consist a 30 minute-global-exercise series including stretching, muscle strength and axial mobility exercises. After this, both groups will performed more 30 minutes of balance training: the control group will performed balance exercises without external cues, visual or auditory feedbacks or cognitive stimulations; the experimental group will performed the balance training with 8 Wii Fit games which stimulate motor and cognitive functions. The main outcome measures will be: (1) the lower limb subscale of the Fugl-Meyer Assessment (FMA-LE); (2); Balance Evaluation Systems Test (BESTest);(3) the Stroke-Specific Quality of Life (SS-QOL); (4) 6- minute walk test (6MWT) and (5) The limits of stability (LOS).

Type d'étude

Interventionnel

Inscription (Réel)

40

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

      • São Paulo, Brésil, 05360-160
        • Department of Physiotherapy, Communication Science & Disorders, Occupational Therapy, School of Medicine, University of São Paulo

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 65 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • hemiparetic status resulting from a single stroke at least 6 months earlier;
  • the ability to walk 10 m independently with or without an assistive device;
  • the absence of a musculoskeletal condition that could potentially affect the ability to walk safely;
  • the absence of serious visual impairment or a hearing disorder;
  • power of at least grade 3 in the hemiplegic lower extremity;
  • able to understand and follow simple instructions.

Exclusion Criteria:

  • a Montreal Cognitive Assessment (MoCA) score of < 20;
  • severe dementia or aphasia;
  • hemispatial neglect, ataxia or any other cerebellar symptom;
  • inability to stand without minimal assist;
  • Impaired vision
  • Uncontrollable medical complications
  • participation in other studies or rehabilitation programs

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Virtual Reality Training
The virtual reality training will be done by experimental group with ten games of Nintendo Wii Fit.
The participants of the study will be trained 8 balance games during 14 sessions
Comparateur actif: Control group: Physical Therapy
The Control Group will be trained by conventional Physical Therapy exercises.
Patients of the control group will be trained with balance exercises.
Autres noms:
  • Groupe de contrôle

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
The lower limb subscale of the Fugl-Meyer Assessment (FMA-LE)
Délai: up to 2 months
FMA-LE is a subscale measuring lower limb motor recovery. It examines movement and coordination of the hip, knee, and ankle in the supine, sitting, and standing positions. Each item is scored on a 3-point scale (0, cannot perform; 1, partially performs; 2, performs fully). The score range is 0 to 34, with higher scores indicating better lower limb motor performance
up to 2 months

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Balance Evaluation Systems Test (BESTest)
Délai: Up 2 months
Balance Evaluation Systems Test (BESTest) measures balance. It includes 36 items that evaluate performance of 6 balance systems: biomechanical constraints, stability limits/verticality, anticipatory postural adjustments, postural responses, sensory orientation, and stability in gait.
Up 2 months
6-minute walk test
Délai: Up to 2 months
The 6MWT is a practical simple test. This test measures the distance that a patient can quickly walk on a flat, hard surface in a period of 6 minutes (the 6MWD). The 6MWT has been used as a measure of functional status of patients.
Up to 2 months
Stroke specific quality of life scale
Délai: Up to 2 months
Stroke Specific Quality of Life Scale is a self-report assessment that includes 12 stroke specific subscales with 49 items. The Stroke Specific Quality of Life Scale attempts to capture the domains of stroke specific QOL that are insufficiently assessed with generic QOL measures. The 12 subscales, which are unidimensional, are Energy, Family Role, Language, Mobility, Mood, Personality, Self-Care, Social Roles, Thinking, Upper Extremity Function, Vision, and Work-Productivity. Participants responded to each item on a 5-point scale. Domain scores are the averages of the item scores, and the total score is the average of the domain scores. All summary scores therefore range from 1 to 5. Higher scores indicate better function.
Up to 2 months
Limits of Stability
Délai: Up to 2 months
The Limits of Stability subtest quantifies the maximum distance a person can intentionally displace their center of pressure (COP) from start position of midline COP centered over the base of support to eight targets. Location and movement of the COP was indicated by a cursor display projected on a screen in front of the subject. As targets were highlighted, the subject was to move the COP cursor quickly and accurately as possible towards a target located on the Limits of Stability perimeter and hold position as close to the target as possible. The parameters include COP movement velocity and directional control (% to target).
Up to 2 months

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: Tatiana P Oliveira, PhD student, University of Sao Paulo
  • Chercheur principal: Camila S Miranda, Ms Student, University of Sao Paulo

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 février 2014

Achèvement primaire (Réel)

1 juin 2017

Achèvement de l'étude (Réel)

1 février 2018

Dates d'inscription aux études

Première soumission

20 juin 2013

Première soumission répondant aux critères de contrôle qualité

20 juin 2013

Première publication (Estimation)

25 juin 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

2 novembre 2018

Dernière mise à jour soumise répondant aux critères de contrôle qualité

1 novembre 2018

Dernière vérification

1 juillet 2018

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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