Dose Optimization for Stroke Evaluation

NCT ID: NCT01749358

Last Updated: 2017-04-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-03-31

Study Completion Date

2016-08-31

Brief Summary

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This study is about rehabilitation of arm function after a stroke. The investigators are testing the dosage of therapy that is needed for meaningful recovery of arm and hand function. Dosage of therapy refers to the amount of time (in this case, the total number of hours) that a person participates in treatment. The investigators hope to learn how much therapy time is needed in order for change to occur in arm and hand function after a person has had a stroke. Eligible candidates must have had a stroke affecting the use of an arm or hand at least 6 months ago.

Detailed Description

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Conditions

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Stroke Cerebrovascular Disorders Brain Ischemia Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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High Therapy Dose

Sixty total hours of ASAP therapy--challenging, intensive and meaningful practice of tasks of your choice in a collaborative partnership with your personal trainer (therapist).

Group Type EXPERIMENTAL

Accelerated Skill Acquisition Program (ASAP)

Intervention Type BEHAVIORAL

A focused, intense, evidence-based, upper extremity rehabilitation program. The training intervention is based on the fundamental elements of skill acquisition through task-specific practice, impairment mitigation to increase capacity, and motivational enhancements to build self-confidence Dosage of therapy (number of hours of therapy) will vary based on group assignment. Frequency is 4x/week, 1 week per month for 3 months in a train-wait-train paradigm. A 2-hour orientation session precedes the first visit.

Moderate Therapy Dose

Thirty total hours of ASAP therapy--challenging, intensive and meaningful practice of tasks of your choice in a collaborative partnership with your personal trainer (therapist).

Group Type EXPERIMENTAL

Accelerated Skill Acquisition Program (ASAP)

Intervention Type BEHAVIORAL

A focused, intense, evidence-based, upper extremity rehabilitation program. The training intervention is based on the fundamental elements of skill acquisition through task-specific practice, impairment mitigation to increase capacity, and motivational enhancements to build self-confidence Dosage of therapy (number of hours of therapy) will vary based on group assignment. Frequency is 4x/week, 1 week per month for 3 months in a train-wait-train paradigm. A 2-hour orientation session precedes the first visit.

Low Therapy Dose

Fifteen total hours of ASAP therapy--challenging, intensive and meaningful practice of tasks of your choice in a collaborative partnership with your personal trainer (therapist).

Group Type EXPERIMENTAL

Accelerated Skill Acquisition Program (ASAP)

Intervention Type BEHAVIORAL

A focused, intense, evidence-based, upper extremity rehabilitation program. The training intervention is based on the fundamental elements of skill acquisition through task-specific practice, impairment mitigation to increase capacity, and motivational enhancements to build self-confidence Dosage of therapy (number of hours of therapy) will vary based on group assignment. Frequency is 4x/week, 1 week per month for 3 months in a train-wait-train paradigm. A 2-hour orientation session precedes the first visit.

Active Monitoring

This is an observation only group.

Group Type OTHER

Active Monitoring

Intervention Type BEHAVIORAL

This is an observation-only group. Any therapy received while in this group will be dosed according to usual and customary practice.

Interventions

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Accelerated Skill Acquisition Program (ASAP)

A focused, intense, evidence-based, upper extremity rehabilitation program. The training intervention is based on the fundamental elements of skill acquisition through task-specific practice, impairment mitigation to increase capacity, and motivational enhancements to build self-confidence Dosage of therapy (number of hours of therapy) will vary based on group assignment. Frequency is 4x/week, 1 week per month for 3 months in a train-wait-train paradigm. A 2-hour orientation session precedes the first visit.

Intervention Type BEHAVIORAL

Active Monitoring

This is an observation-only group. Any therapy received while in this group will be dosed according to usual and customary practice.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Ischemic or hemorrhagic stroke that occured at least 6 months ago.
* At least 21 years of age
* Persistent arm and hand weakness, with some ability to release a grasp
* Able to provide consent to participate
* No history of a medical condition that limited arm or hand use prior to the stroke
* Medically stable
* Able to participate for 10 months and attend evaluations at the University of Southern California (USC) Health Sciences Campus.
* Able to communicate in English or Spanish.

Exclusion Criteria

* Severe upper extremity sensory impairment
* Neglect
* Current major depressive disorder
* Severe arthritis or orthopedic problems that limit arm or hand movement
* Pain that interferes with daily activities
* Currently enrolled in other rehabilitation or drug intervention studies
* Living too far from the training site to participate reliably
* Receiving oral or injected anti-spasticity medications during study treatment.
* Pregnancy.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Carolee Winstein

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carolee Winstein, PhD, PT, FAPTA

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Nicolas Schweighofer, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Clarisa Martinez, PT, DPT

Role: STUDY_DIRECTOR

University of Southern California

Locations

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University of Southern California-Health Sciences Campus

Los Angeles, California, United States

Site Status

Countries

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United States

References

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Schweighofer N, Ye D, Luo H, D'Argenio DZ, Winstein C. Long-term forecasting of a motor outcome following rehabilitation in chronic stroke via a hierarchical bayesian dynamic model. J Neuroeng Rehabil. 2023 Jun 29;20(1):83. doi: 10.1186/s12984-023-01202-y.

Reference Type DERIVED
PMID: 37386512 (View on PubMed)

Winstein C, Kim B, Kim S, Martinez C, Schweighofer N. Dosage Matters. Stroke. 2019 Jul;50(7):1831-1837. doi: 10.1161/STROKEAHA.118.023603. Epub 2019 Jun 5.

Reference Type DERIVED
PMID: 31164067 (View on PubMed)

Other Identifiers

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R01HD065438

Identifier Type: NIH

Identifier Source: secondary_id

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R01HD065438

Identifier Type: NIH

Identifier Source: org_study_id

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