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Effects of Training in a Virtual Environment in Chronic Stroke Patients

1. november 2018 oppdatert av: 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.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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).

Studietype

Intervensjonell

Registrering (Faktiske)

40

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 65 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Virtual Reality Training
The virtual reality training will be done by experimental group with ten games of Nintendo Wii Fit.
Annen: Virtual Reality Training
The participants of the study will be trained 8 balance games during 14 sessions
Aktiv komparator: Control group: Physical Therapy
The Control Group will be trained by conventional Physical Therapy exercises.
Annen: Physical Therapy
Patients of the control group will be trained with balance exercises.
Andre navn:
  • Kontrollgruppe

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The lower limb subscale of the Fugl-Meyer Assessment (FMA-LE)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Balance Evaluation Systems Test (BESTest)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

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Sponsor

University of Sao Paulo General Hospital

Etterforskere

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

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. februar 2014

Primær fullføring (Faktiske)

1. juni 2017

Studiet fullført (Faktiske)

1. februar 2018

Datoer for studieregistrering

Først innsendt

20. juni 2013

Først innsendt som oppfylte QC-kriteriene

20. juni 2013

Først lagt ut (Anslag)

25. juni 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. november 2018

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. november 2018

Sist bekreftet

1. juli 2018

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • USPNEC005

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