Improving Arm and Hand Functions in Chronic Stroke (CIHR 2012-2015)

Completed

Phase N/A Results N/A

Trial Description

Improving arm and hand function after stroke has been difficult to achieve within the rehabilitation service provided in the acute stage often due to the limited resource in health care. While spontaneous recovery plateaus after 6 months, the prolonged disability affects quality of life and social participation in stroke survivors. This study is aimed at improving chronic motor impairment arm and hand impairment by providing the intervention with intensive training schedule. This study will compare two types of rehabilitation intervention using a randomized controlled trial. Measurements also will be taken on various brain functions non-invasively to help discover how each of the intervention strategies works differently to repair the brain.

Detailed Description

After unilateral stroke, incomplete recovery of arm and hand movement is common and its long-lasting negative effects include increased care giving costs and overall reduced quality of life. Recent evidence suggests that a novel behavioral intervention could improve motor functions in sub-acute patients with added benefits in cognitive and brain functions. However few studies have addressed whether chronic stage patients can also benefit from the intervention and how brain plasticity works over the course of rehabilitation. This study will investigate the benefits of two types of intervention methods that are extendable for community-based intervention services in the future. It also will examine changes in integrity of motions before and after the intervention. Further comparisons between brain functions and structure will be made using magnetoencephalography (MEG) and magnetic resonance imaging (MRI), non-invasively. These behavioural and physiological measures will inform the mechanisms of stroke recovery and training.

Conditions

Interventions

  • Music Supported Rehabilitation Behavioral
    Intervention Desc: Music Supported Rehabilitation -using musical exercises to improve hand and arm motor functioning.
    ARM 1: Kind: Experimental
    Label: MSR (Music Supported Rehabilitation)
    Description: Behavioral: Music Supported Rehabilitation Using musical exercises to improve hand and arm motor functioning.
    ARM 2: Kind: Experimental
    Label: MSR - Music Supported Rehabilitation
    Description: Behavioral: Music Supported Rehabilitation
  • Conventional Physical Therapy Device
    ARM 1: Kind: Experimental
    Label: CPT (Conventional Physical Therapy)
    Description: Experimental: CPT (Conventional Physical Therapy) -GRASP (Graded Repetitive Arm Supplementary Program-developed Janice Eng, PhD, PT/OT Jocelyn Harris, PhD, OT, Andrew Dawson, MD, FRCP, Bill Miller, PhD, OT) protocol will be used to improve arm and hand function in people living with stroke.
  • Conventional Upper Extremity Therapy Behavioral
    Intervention Desc: -GRASP (Graded Repetitive Arm Supplementary Program-developed Janice Eng, PhD, PT/OT Jocelyn Harris, PhD, OT, Andrew Dawson, MD, FRCP, Bill Miller, PhD, OT) protocol will be used to improve arm and hand function in people living with stroke.
    ARM 1: Kind: Experimental
    Label: CPT (Conventional Upper Extremity Therapy)
    Description: Experimental: CPT (Conventional Upper Extremity Therapy) -GRASP (Graded Repetitive Arm Supplementary Program-developed Janice Eng, PhD, PT/OT Jocelyn Harris, PhD, OT, Andrew Dawson, MD, FRCP, Bill Miller, PhD, OT) protocol will be used to improve arm and hand function in people living with stroke.
    ARM 2: Kind: Experimental
    Label: CU/ET
    Description: Experimental: CU/ET (Conventional Upper Extremity Therapy)

Trial Design

  • Allocation: Randomized
  • Masking: Double Blind (Subject, Investigator, Outcomes Assessor)
  • Purpose: Treatment
  • Endpoint: Efficacy Study
  • Intervention: Parallel Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Change in performance on Action Research Arm Test Baseline, post-5-weeks, post-10-weeks, and 4-month-follow-up No
Primary Change in performance on Chedoke Arm and Hand Inventory Baseline, post-5-weeks, post-10-weeks, and 4-month-follow-up No
Primary Change in status on Stroke Impact Scale Baseline, post-5-weeks, post-10-weeks, and 4-month-follow-up No
Secondary Brain structure Pre, post-5-weeks, post-10-weeks, and 4-month-follow-up No
Secondary Brain Function Baseline, post-5-weeks, post-10-weeks, and 4-month-follow-up No

Sponsors