此页面是自动翻译的,不保证翻译的准确性。请参阅 英文版 对于源文本。

基于PETTLEP的AOMI对中风幸存者上肢运动学的即时影响

2026年11月5日 更新者:Abdelrahman Sabee、Istinye University

基于PETTLEP的AOMI对脑卒中幸存者上肢运动学的即时影响:一项随机对照试验

This study investigates the immediate effects of a single session of Physical, Environment, Task, Timing, Learning, Emotion, Perspective (PETTLEP)-based Action Observation and Motor Imagery (AOMI) on upper-limb movement quality in chronic stroke survivors. Stroke frequently causes reduced movement smoothness and prompts compensatory strategies such as trunk displacement and shoulder elevation. Participants received a single session of either PETTLEP-based AOMI (watching mirror-reversed self-observation and performing real-time kinesthetic imagery of a functional Reach-Drink-Return task) or a duration- and structure-matched active sham (non-motor nature videos and resonant breathing). A single smartphone camera and MediaPipe Pose Landmarker were utilized to evaluate immediate changes in movement smoothness (NVP and SPARC), path straightness, shoulder elevation, trunk displacement, movement time, and functional performance (WMFT-4).

研究概览

详细说明

This study employs a single-blind, pretest-posttest, prospective randomized controlled trial design to evaluate the acute effects of a single session of Physical, Environment, Task, Timing, Learning, Emotion, Perspective (PETTLEP)-based Action Observation and Motor Imagery (AOMI) in stroke patients. Following a stroke, patients often develop pathological movement patterns and maladaptive compensatory strategies, such as trunk displacement or shoulder girdle elevation, due to impaired motor commands. Traditional task practice requires voluntary motor output that many severely impaired patients lack. Motor imagery combined with action observation offers a cognitive simulation alternative that activates neural motor planning circuits.A total of 28 eligible stroke survivors will be randomized in a 1:1 ratio into an experimental (AOMI) group or a control group. Baseline kinematics of a standardized Reach-to-Drink task will be recorded using MediaPipe, a markerless motion capture system utilizing smartphone cameras.The intervention lasts approximately 13 minutes in total. The experimental group will engage in a scaffolded AOMI protocol. This includes action observation (watching a 1st-person video of the task) and selective motor imagery with specific constraints targeting movement smoothness and the inhibition of compensatory trunk and shoulder movements. The control group will perform matched-duration non-motor mental tasks, focusing on forming mental images that contain no movement, such as calm natural scenes, colors, or light. They will be explicitly instructed to avoid imagining any upper-extremity movements. Immediately following the intervention, the reach-to-drink task will be re-assessed using the MediaPipe system to quantify short-term changes in movement smoothness (Number of Velocity Peaks and Spectral Arc Length - SPARC), trunk displacement, and shoulder girdle elevation.

研究类型

介入性

注册 (实际的)

24

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Istanbul、土耳其(türkiye)
        • Neurorehabilitation Clinic, Istinye University Liv Bahçeşehir Hospital
      • Istanbul、土耳其(türkiye)
        • Physical Medicine and Rehabilitation Outpatient Clinic, Biruni University Hospital

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

40年 至 80年 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  • Female and male adults aged 40 to 80 years with a diagnosis of unilateral ischemic or hemorrhagic stroke.
  • A first-ever unilateral ischemic or hemorrhagic stroke confirmed by computed tomography (CT) or magnetic resonance imaging (MRI), or recurrent stroke that left no residual motor deficit from the earlier strokes.
  • Mild to moderate spasticity (Modified Ashworth Scale ≤ 2).
  • Medically stable patients, with no active or uncontrolled systemic illness.
  • Ability to sit unsupported for at least 30 minutes and be able to perform brief cognitive-motor exercises.
  • Able to perform the brief cognitive-motor exercises included in the protocol.
  • Medical Research Council (MRC) muscle strength grade of 3 or higher.

Exclusion Criteria:

  • Other central nervous system disorders (e.g., Parkinson's disease, multiple sclerosis, traumatic brain injury).
  • Musculoskeletal or orthopedic conditions causing restriction of movement in the upper-limb (such as fixed contractures, severe joint deformities, shoulder subluxation).
  • Moderate or severe sensory loss (NIHSS sensory score ≥ 2), or moderate or severe neglect (NIHSS extinction/inattention score ≥ 2).
  • Uncontrolled seizures, severe cardiovascular instability, or any other contraindication to imagery.

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:单身的

武器和干预

参与者组/臂
干预/治疗
实验性的:Experimental Group: PETTLEP-based AOMI

Participants will receive a single 13-minute session of a scaffolded AOMI protocol. The session includes a preparation phase involving sensory transfer using the unaffected arm, action observation of a 1st-person video, and selective motor imagery with smoothness and trunk control constraints. No physical execution of the task is performed during the intervention.

A mental practice protocol involving sensory preparation (using the unaffected arm to transfer sensation), action observation, and motor imagery of a reach-to-drink task with selective functional constraints targeting movement smoothness, trunk stability, and shoulder control.

假比较器:Control Group: Cognitive and Somatic Control

A duration-matched 13-minute session comprising non-motor nature footage (beach, forest, waterfall) paired with scene imagery, followed by paced resonant slow breathing (6 breaths/min) using an expanding/contracting visual circle, containing no upper-limb motor content.

Structured non-motor mental tasks, including attention to breathing and calm mental imagery (e.g., natural scenes or colors), timed to match the experimental intervention and explicitly designed to engage attention without any motor system participation.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Change in Movement Smoothness (Number of Velocity Peaks)
大体时间:Immediately before and after the 13-minute intervention session.

Movement smoothness of the affected upper extremity will be quantified as the total Number of Velocity Peaks (NVP) by MediaPipe. Lower NVP values indicate a more continuous movement.

Immediately before and after the 13-minute intervention session.

次要结果测量

结果测量
措施说明
大体时间
Movement Smoothness (Spectral Arc Length - SPARC)
大体时间:Immediately before and after the 13-minute intervention session.

A secondary measure of smoothness calculated using Spectral Arc Length (SPARC) across different phases of the task by MediaPipe. Higher SPARC values indicate smoother movement.

Immediately before and after the 13-minute intervention session.
Path Straightness
大体时间:Immediately before and after the 13-minute intervention session.

Evaluated as a ratio (0-1) during the reach and reach-to-drink phases. It is calculated by dividing the straight-line distance between the start and end of the wrist path by the total path length travelled. Values closer to 1.0 indicate a straighter, more efficient goal-directed movement path.

Immediately before and after the 13-minute intervention session.
Trunk Displacement (Compensatory Strategy)
大体时间:Immediately before and after the 13-minute intervention session.

Measured in centimeters (cm) as the maximum anterior horizontal shift of the midpoint between the shoulders in the direction of hand travel from lift onset to the highest wrist point, converted using a participant-specific body-based scale factor. Larger values indicate greater compensatory trunk movement.

Immediately before and after the 13-minute intervention session.
Shoulder Girdle Elevation (Compensatory Strategy)
大体时间:Immediately before and after the 13-minute intervention session.

Measured in centimeters (cm) as the maximum upward vertical displacement of the affected shoulder in the image plane after lift onset (following median smoothing over a 9-frame window). Larger values reflect greater compensatory shoulder hitching during upper-limb movement.

Immediately before and after the 13-minute intervention session.
Upper-Extremity Function (Wolf Motor Function Test, Short Form - WMFT-4)
大体时间:Immediately before and after the 13-minute intervention session.

Upper-extremity functional performance will be assessed using the four-item short form of the Wolf Motor Function Test (WMFT-4). Completion time and functional performance scores will be recorded for each item.

Immediately before and after the 13-minute intervention session.
Movement Imagery Ability (Kinesthetic and Visual Imagery Questionnaire-10 - KVIQ-10)
大体时间:Immediately before and after the 13-minute intervention session.

Evaluates visual and kinesthetic movement-imagery capacity. The visual and kinesthetic subscale scores are summed separately; each ranges from 5 to 25, and the total score ranges from 10 to 50. Higher scores signify greater vividness of imagery.

Immediately before and after the 13-minute intervention session.
Pain - Visual Analog Scale (VAS)
大体时间:Immediately before and immediately after the 25-minute intervention session.

Participants indicate their pain intensity by placing a mark on a 10-cm horizontal line. The left side is labeled "no pain" (0) and the right side is labeled "worst pain imaginable".

Immediately before and immediately after the 25-minute intervention session.
Visual Analog Mood Scale - 4 dimensions (VAMS-4)
大体时间:Immediately before and after the 13-minute intervention session.

Evaluates immediate changes in mood state across four dimensions (happy, sad, calm, and tense). Participants rate how they feel at the moment on a 0-10 scale (0 = not at all, 10 = extremely) to control for non-specific emotional responses to the intervention.

Immediately before and after the 13-minute intervention session.
Motor Difference Rating Scale (MDRS)
大体时间:Immediately before and after the 13-minute intervention session.

A two-item 0-10 self-report scale assessing perceived motor control. Before the intervention, participants rate how well they can control the muscles of the affected arm (0 = no control, 10 = full normal control); immediately after, they rate how much difference they feel in muscle control resulting from the session.

Immediately before and after the 13-minute intervention session.

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 研究主任:Begüm Kara Kaya, Asst. Prof、Istinye University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2026年4月10日

初级完成 (实际的)

2026年10月5日

研究完成 (实际的)

2026年10月5日

研究注册日期

首次提交

2026年3月27日

首先提交符合 QC 标准的

2026年3月27日

首次发布 (实际的)

2026年4月2日

研究记录更新

最后更新发布 (实际的)

2026年11月9日

上次提交的符合 QC 标准的更新

2026年11月5日

最后验证

2026年10月1日

更多信息

与本研究相关的术语

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

不

IPD 计划说明

Individual participant data (IPD) will not be shared to ensure the strict privacy and confidentiality of the stroke survivors participating in this study. The data collected involves specific clinical and kinematic assessments conducted for an academic Master's thesis. The informed consent obtained from participants covers the use of their data for this specific research project and allows for publication in aggregate form only. It does not explicitly grant permission for open public data sharing. Therefore, only summary and aggregate data will be reported in the final thesis and any resulting peer-reviewed publications.

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

订阅