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Task-Related Training of Arm Use After Stroke

This study has been completed.

Sponsored by: University of Melbourne
Information provided by: University of Melbourne
ClinicalTrials.gov Identifier: NCT00222339
  Purpose

Stroke is the leading cause of long-term physical disability in Australia. Currently around 25% of hemiplegic stroke patients discharged from rehabilitation have significantly impaired use of the affected hand with consequent dependence in dressing, grooming and feeding themselves. The poor outcome can be attributed in part to a lack of focus by therapists on the negative signs of stroke (weakness and lack of dexterity) as well as too little time (around 10 minutes per day) being devoted to retraining of the arm. Presently there is a very limited evidence base to guide the content of clinical practice. Results from both animal and human studies suggest that specific post-lesion training can result in substantial improvement in function. The hypothesis is that task-specific training of the affected upper limb to subjects in the early period following stroke will result in significantly better functional outcome than standard intervention.


Condition Intervention
Stroke
Behavioral: task-specific training

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Randomized, Single Blind, Active Control, Parallel Assignment, Efficacy Study
Official Title:   Task-Related Training of Arm Use After Stroke: a Randomised Controlled Trial

Further study details as provided by University of Melbourne:

Primary Outcome Measures:
  • Arm and hand function measured using the Motor Assessment Scale and the Chedoke-McMaster Impairment Inventory.
  • Grip and pinch strength measured using dynamometers.

Secondary Outcome Measures:
  • Dexterity measured using the NK Dexterity Board
  • Quality of Life measured using the Stroke-adapted Sickness Impact Profile.
  • Sensation using a validated assessment of tactile spatial resolution.

Estimated Enrollment:   30
Study Start Date:   February 2002
Estimated Study Completion Date:   June 2004

Detailed Description:

Stroke is the leading cause of long-term physical disability in Australia. Currently around 25% of hemiplegic stroke patients discharged from rehabilitation have significantly impaired use of the affected hand with consequent dependence in dressing, grooming and feeding themselves. The poor outcome can be attributed in part to a lack of focus by therapists on the negative signs of stroke (weakness and lack of dexterity) as well as too little time (around 10 minutes per day) being devoted to retraining of the arm. Presently there is a very limited evidence base to guide the content of clinical practice. Results from both animal and human studies suggest that specific post-lesion training modulates physiological changes that take place in undamaged tissue. It is probable that this training induces use-dependent patterns of neural activity that can selectively drive the reorganization of the undamaged cortical areas and thereby improve the functional outcome for the arm and hand. We have developed a task-specific training program for the upper limb that is unique in a) the focus on performance of functional tasks, and b) the intensity of practice, with patients practising the tasks both during and outside of therapy sessions.

Comparisons: A 3-week daily task-specific training of the affected upper limb compared to a control intervention that does not involve upper limb training. Both interventions are additional to the standard rehabilitation program.

Outcomes measured pre- and post-intervention and 3 months follow-up. Outcome measures include: variables grip and pinch force, dexterity, arm use and quality of life. Severity of stroke, classified according to the upper arm sub-test of the Motor Assessment Scale, will be used as a covariate.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  • within 6 weeks of first stroke
  • unilateral stroke
  • impaired arm function
  • able to cope with intensive training program
  • medically stable
  • able to understand instructions

Exclusion Criteria:

  • uncontrolled systemic disease
  • significant musculotendinous or bony restrictions of the affected upper limb
  • any serious chronic disease independently causing significant disability of the affected limb
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00222339

Locations
Australia, Victoria
Austin Health    
      Melbourne, Victoria, Australia, 3084

Sponsors and Collaborators
University of Melbourne

Investigators
Principal Investigator:     Mary P Galea, PhD     University of Melbourne    
  More Information


Publications of Results:
Miller K, Galea M, Kilbreath S, Phillips B (2002) Early intensive task-specific sensory and motor training of the upper limb following acute stroke: a pilot study. In Battistin L, Dam M, Tonin P(eds) Neurological Rehabilitation. Bologna:Mondizzi Editore.
 

Study ID Numbers:   H2001/01313
First Received:   September 13, 2005
Last Updated:   September 13, 2005
ClinicalTrials.gov Identifier:   NCT00222339
Health Authority:   Australia: National Health and Medical Research Council

Keywords provided by University of Melbourne:
Stroke  
Hand function  
Task-specific training  

Study placed in the following topic categories:
Cerebral Infarction
Stroke
Vascular Diseases
Brain Ischemia
Central Nervous System Diseases
Ischemia
Brain Infarction
Brain Diseases
Infarction
Cerebrovascular Disorders

Additional relevant MeSH terms:
Nervous System Diseases
Cardiovascular Diseases

ClinicalTrials.gov processed this record on October 03, 2008




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