Objective Assessment of Upper Extremity Functioning of Stroke Patients Before and After Rehabilitation

NCT ID: NCT02092662

Last Updated: 2015-08-06

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

57 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-01-31

Study Completion Date

2015-05-31

Brief Summary

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The purpose of this study is to evaluate by objective measures the improvement in upper extremity functioning, as reflection of motor learning, in stroke patients in the sub acute phase. The investigators hypothesize that the improvements in daily functioning are partially due to compensation strategies and partially due to motor learning.

Detailed Description

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Background: Most stroke patients continue to suffer from upper extremity motor deficiencies even after prolonged and intense rehabilitation in hospital. Even though guidelines and other studies recommend to apply a rehabilitation programs as patient reception. As opposed to that there is a scarce evidence for the efficacy of the rehabilitation.

Objectives: To evaluate by objective measures the improvement in motor performance of the upper extremity of stroke patients in the sub acute period. Secondary objective is to describe the correlation between proximal and distal motor deficiencies of the upper extremity.

Hypothesis: Patients will show better hand performance at the end of hospitalization. Part of it can be attributed to the rehabilitation and part to a spontaneous recovery. Correlation will be found for proximal and distal upper extremity motor deficiencies.

Methods:

Trial began only after the IRB research approval. All treatment sessions will implemented by the physical and occupational staff of the hospital. Assessments for the measures will be carry out by a certified physical therapist which is coinvestigator. The coinvestigator collect the raw data for analysis in Excel and than in SPSS.

20 stroke patients who meet the inclusion criteria will participate in the study, after signing an informed consent.Patients will undergo the first assessment of all measures, e.g: motor abilities by Fugl-Meyer test, handwriting kinematic and kinetic measures and surface electromyography for measurement of muscle synergy.Patients will be treated by standard rehabilitation of physical and occupational therapy for a period of 3-4 weeks. Before discharge from hospital patients will undergo another assessment of all measures, in order to evaluate the progression in their upper limb motor abilities from reception. Part of the patients will be assessed again two to three weeks after discharge as follow up.

Outcome Measures: upper limb Fugl-Meyer assessment, handwriting Air-time, pressure and velocity, EMG (i.e., muscle onset, muscle amplitude, muscle co-activation ratio).

Statistical analysis: ANOVA analysis will be used to measure time effect. Correlation between measures will be measured by Pearson's correlation. Sample size (n=20) was calculated based on 5 points improvement in Fugl-Meyer test as minimal significant change with power of 0.8 and p-level under 0.05 for significance.

Key words: Stroke, Muscle synergy, Handwriting, Fugl-Meyer

Conditions

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Stroke

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Stroke

Stroke patients at the subacute phase

stroke

Intervention Type OTHER

task-oriented therapy: physical and occupational therapy emphasizing integration of the patients needs, environment and context

Healthy controls

healthy age-matched voluntiers

Healthy controls

Intervention Type OTHER

no treatment

Interventions

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stroke

task-oriented therapy: physical and occupational therapy emphasizing integration of the patients needs, environment and context

Intervention Type OTHER

Healthy controls

no treatment

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* diagnosis of cerebral stroke with upper extremity hemiparesis
* Ability to understand simple orders

Exclusion Criteria

* Other orthopedic pathology
* Apraxia
* Bilateral Paresis
* Other neurologic pathology
* sensory aphasia
Minimum Eligible Age

30 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Carmeli Eli

OTHER

Sponsor Role lead

Responsible Party

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Carmeli Eli

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Emanuel Markovich, MD

Role: PRINCIPAL_INVESTIGATOR

Fliman Geriatric Rehabilitation Center

Sharon Israely, MSc.

Role: STUDY_DIRECTOR

University of Haifa

Eli Carmeli, PhD.

Role: STUDY_CHAIR

University of Hifa

Locations

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Fliman Geriatric Rehabilitation Center

Haifa, Israel, Israel

Site Status

Countries

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Israel

Other Identifiers

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UHai920130001

Identifier Type: -

Identifier Source: org_study_id

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