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Sponsored by: |
National Institute of Neurological Disorders and Stroke (NINDS) |
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Information provided by: | National Institutes of Health Clinical Center (CC) |
ClinicalTrials.gov Identifier: | NCT00108680 |
This study will compare the effectiveness of unilateral versus bilateral exercise training for recovering movement abilities in chronic stroke patients. After a stroke, some people have improved their movement ability by exercising the arm affected by the stroke. Others have improved by exercising both arms together. This study will compare these two kinds of exercise to see which might work best.
Healthy volunteers and people who have had a stroke more than 6 months ago may be eligible for this study. Stroke patients must have some weakness in their stroke-affected arm. All participants must be 18 years of age or older. Candidates are screened with a clinical and neurological examination. Women who can become pregnant have a pregnancy test. Stroke patients have a magnetic resonance imaging (MRI) study of the brain if they have not had one in the last year.
Participants undergo the following tests and procedures:
MRI: This procedure uses a magnetic field and radio waves to produce images of body tissues and organs. The subject lies on a table that slides into the scanner (a narrow cylinder), wearing earplugs to muffle loud knocking sounds that occur during the scanning process. The procedure lasts about 45 minutes, during which time the subject must lie still for up to 30 minutes.
Testing sessions: There are six test sessions - two to familiarize the subject with the reaching test, two to do the reaching test plus transcranial magnetic stimulation (TMS) before and after an exercise session, and two to do the reaching test plus TMS one day after the exercise session. The sessions are on consecutive days, with a 1-week break after session 3. The procedures involved are:
Condition |
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Cerebrovacular Accident Paresis |
Study Type: | Observational |
Official Title: | Effects of Unilateral and Bilateral Training on Motor Function in Chronic Stroke |
Estimated Enrollment: | 60 |
Study Start Date: | April 2005 |
Objective: It has been proposed that individuals with stroke may benefit to a greater degree by training with both arms simultaneously than by training with the paretic arm alone. The purpose of this protocol is to identify the extent and the mechanisms of paretic arm performance improvement after a single session of bilateral arm training compared to a single session of unilateral paretic arm training in individuals with moderate-severity chronic stroke.
Study population: The study population will consist of individuals with chronic stroke.
Design: A single-blinded, counterbalanced, crossover design will be used.
Outcome measures: Endpoint measures will include paretic arm peak acceleration and disinhibition of the stroke-affected cortical hemisphere as measured by transcranial magnetic stimulation (TMS) in the context of a reaching task. These measures will be compared after a unilateral vs. a bilateral arm training session in individuals with chronic stroke.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Individuals with Chronic Stroke (n=40):
We will include individuals at least 6 months post thromboembolic non-hemorrhagic hemispheric or hemorrhagic hemispheric lesion. We will select individuals who initially had severe hemiparesis but who recovered to the point of having moderate motor impairment. Individuals with moderate motor impairment will be defined by a Fugl-Meyer score of at least 30, and the inability to actively extend the paretic wrist and fingers at least 20 degrees. Assessment of severity of initial hemiparesis will be taken either from patient report or medical records.
We would also like to study a smaller group (n=10) of individuals with mild motor impairment due to stroke. Individuals with mild motor impairment will be defined by an Upper Extremity Fugl-Meyer score of 50 or greater (maximum score = 66), and the ability to actively extend the paretic wrist and fingers 20 degrees or more. We will also enroll 10 healthy volunteers.
EXCLUSION CRITERIA:
Healthy Volunteers:
Individuals with Chronic Stroke (Moderate and Mild Impairment Groups):
Contact: Patient Recruitment and Public Liaison Office | (800) 411-1222 | prpl@mail.cc.nih.gov |
Contact: TTY | 1-866-411-1010 |
United States, Maryland | |
National Institutes of Health Clinical Center, 9000 Rockville Pike | Recruiting |
Bethesda, Maryland, United States, 20892 |
Study ID Numbers: | 050142, 05-N-0142 |
Study First Received: | April 16, 2005 |
Last Updated: | July 18, 2008 |
ClinicalTrials.gov Identifier: | NCT00108680 |
Health Authority: | United States: Federal Government |
Hemiparesis Rehabilitation Reaching |
Interlimb Coupling Cortical Excitability Stroke |
Paresis Cerebral Infarction Stroke |