Action Selection and Arm Rehabilitation After Stroke
16 juillet 2021 mis à jour par: Jill Stewart, PT, PhD, University of South Carolina
Targeted Engagement of the Motor Action Selection Network During Arm Rehabilitation After Stroke
After stroke, individuals often have persistent difficulty using the arm and hand in everyday functional tasks that reduces quality of life.
Currently available rehabilitation techniques are not adequate and new protocols are needed that are based on an understanding of how brain regions work together to produce skilled movement.
This research project aims to improve our understanding of how the brain controls movement after stroke and determine whether a period of motor practice that targets specific brain regions through the addition of action selection demands leads to improved arm function.
We hypothesize that arm motor function and the ability to efficiently activate the action selection motor circuit during movement will improve after training.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
Rehabilitation of arm impairment after stroke includes the repetitive practice of functional tasks.
In healthy adults, planning plays a vital role in the control of skilled movement, however, the behavioral and neural correlates of planning have largely been unexplored in individuals recovering from stroke.
Action selection is an important motor planning process that engages dorsal premotor cortex (PMd) in controls.
While PMd activation is a commonly reported neural correlate of motor recovery after stroke, the role of PMd in action selection and motor training are not known.
Therefore, the purpose of this study is to determine the effect of training that includes action selection demands on the behavioral and neural correlates of movement after stroke.
Thirty-eight individuals in the chronic phase of stroke will be recruited.
After completion of clinical measures of impairment and function, all participants with stroke will complete a motor action selection task and functional MRI followed by arm training.
Arm training will consist of three weeks (15 sessions) of arm motor training (1.5 hours per session) that includes action selection demands on movement.
Follow-up clinical testing will occur at the end of treatment and three weeks later.
Type d'étude
Interventionnel
Inscription (Réel)
32
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
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South Carolina
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Columbia, South Carolina, États-Unis, 29208
- University of South Carolina
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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 et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- At least 18 years old
- Had stroke at least 6 months ago
- Right-hand dominant prior to stroke
- Some continued arm and hand weakness
- Some ability to move the arm and hand that is weaker from the stroke
Exclusion Criteria:
- Acute medical issues that would interfere with participation
- Another neurologic diagnosis that may impact movement (e.g. Parkinson's Disease)
- Cannot undergo MRI scanning
- Severe apraxia or hemispatial neglect
- Pain in the arm that interferes with movement
- Difficulty maintaining attention or following directions
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: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Arm Training with Action Selection
Task-oriented, functional arm training with the addition of action selection cues to practice.
All participants receive the same arm training intervention.
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Treatment occurs in 1.5 hour sessions, 5 times a week for 3 weeks.
In each treatment session, you will practice functional tasks with your weaker arm and hand.
Additionally, you will be given cues on a computer screen that dictate your movement response (action selection).
Practice will be scaled to match your current level of function and progressed over time as able.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Action Research Arm Test
Délai: Change from baseline to end of treatment (3 weeks)
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Behavioral assessment of arm function.
Scores range from 0 to 57 with a higher score equating to better function.
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Change from baseline to end of treatment (3 weeks)
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Brain activation during functional MRI
Délai: Change from baseline to end of treatment (3 weeks)
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Brain activation during movement will be captured with functional MRI.
Analyses will investigate changes in magnitude of activation.
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Change from baseline to end of treatment (3 weeks)
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Brain connectivity during functional MRI
Délai: Change from baseline to end of treatment (3 weeks)
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Brain activation during movement will be captured with functional MRI.
Analyses will investigate changes in connectivity between brain regions.
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Change from baseline to end of treatment (3 weeks)
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Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
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Upper Extremity Fugl-Meyer Motor Assessment
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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Stroke Impact Scale Hand Domain
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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Box & Blocks Test
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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9-Hole Peg Test
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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Grip Strength
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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Confidence in Arm and Hand Movements Questionnaire
Délai: Change from baseline to end of treatment (3 weeks)
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Change from baseline to end of treatment (3 weeks)
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
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)
8 décembre 2015
Achèvement primaire (Réel)
1 décembre 2020
Achèvement de l'étude (Réel)
1 décembre 2020
Dates d'inscription aux études
Première soumission
9 mai 2016
Première soumission répondant aux critères de contrôle qualité
24 mai 2016
Première publication (Estimation)
27 mai 2016
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
23 juillet 2021
Dernière mise à jour soumise répondant aux critères de contrôle qualité
16 juillet 2021
Dernière vérification
1 juillet 2021
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- Pro00032516
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 .