Constraint-Induced Movement Therapy in Chronic Stroke Patients

NCT ID: NCT02345525

Last Updated: 2017-12-20

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

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-31

Study Completion Date

2017-08-31

Brief Summary

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The aim of this study is to evaluate the feasibility of a Home-based Constraint-Induced Movement Therapy (hCIMT) compared to a Modified Constraint-Induced Movement Therapy (mCIMT) delivered in a outpatient setting on upper limb motor recovery in stroke survivors.

Detailed Description

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Home-based Constraint Induced Modified Therapy (hCIMT) consist of 2 hours intensive upper limb practice with shaping techniques + 2 hours ADLs supervised by a caregiver. Patients are supposed to wear a mitt on the unaffected hand for 4 hours daily.

Modified Constraint Induced Modified Therapy (mCIMT) consist of 2 hours intensive upper limb practice with shaping techniques supervised by an experienced physiotherapist + 2 hours ADLs at home (supervised by a caregiver) Patients are supposed to wear a mitt on the unaffected hand for 4 hours daily.

Conditions

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Stroke

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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mCIMT

2 hours intensive upper limb practice with shaping techniques supervised by an experienced physiotherapist + 2 hours ADLs at home (supervised by a caregiver) Patients are supposed to wear a mitt on the unaffected hand for 4 hours daily.

Group Type ACTIVE_COMPARATOR

mCIMT

Intervention Type BEHAVIORAL

This intervention is based on 3 main aspects:

1. intensive training of functional tasks with the affected arm (massed practice)
2. constraint of the un-affected hand through a mitt
3. shaping techniques designed to transfer gains to the real world activities

The 2 hours massed practice will be performed in a outpatient clinic with a supervision of PT.

hCIMT

2 hours intensive upper limb practice with shaping techniques + 2 hours ADLs supervised by a caregiver.

Patients are supposed to wear a mitt on the unaffected hand for 4 hours daily.

Group Type EXPERIMENTAL

hCIMT

Intervention Type BEHAVIORAL

This intervention is based on 3 main aspects:

1. intensive training of functional tasks with the affected arm (massed practice)
2. constraint of the un-affected hand through a mitt
3. shaping techniques designed to transfer gains to the real world activities

In this group, a comprehensive set of the material necessary to perform the training at home and a booklet containing an explanation of the exercises that can be done will be provided to subjects.

In addition, 2 hospital visits will be scheduled to instruct subjects and caregivers on the training and to update activities (1 visit at the beginning + 1 visit after 1 week).

Interventions

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mCIMT

This intervention is based on 3 main aspects:

1. intensive training of functional tasks with the affected arm (massed practice)
2. constraint of the un-affected hand through a mitt
3. shaping techniques designed to transfer gains to the real world activities

The 2 hours massed practice will be performed in a outpatient clinic with a supervision of PT.

Intervention Type BEHAVIORAL

hCIMT

This intervention is based on 3 main aspects:

1. intensive training of functional tasks with the affected arm (massed practice)
2. constraint of the un-affected hand through a mitt
3. shaping techniques designed to transfer gains to the real world activities

In this group, a comprehensive set of the material necessary to perform the training at home and a booklet containing an explanation of the exercises that can be done will be provided to subjects.

In addition, 2 hospital visits will be scheduled to instruct subjects and caregivers on the training and to update activities (1 visit at the beginning + 1 visit after 1 week).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* age \> 18 years and \< 80 years
* diagnosis of first ischemic stroke
* stroke onset \> 6 months prior to study enrollment
* upper extremity hemiparesis with impairment of hand and/or arm:
* active wrist extension ≥20º
* active metacarpophalangeal- and interphalangeal-joints extension ≥ 10°
* muscle tone assessed by the Modified Ashworth Scale (MAS) ≤ 2
* pain assessed by the Visual Analogue Scale (VAS) \<4

Exclusion Criteria

* anyone who does not have adequate understanding of verbal or written information in Italian sufficient to complete any test
* impaired cognitive functioning: score less than 24 on the Mini Mental Status Examination (MMSE)
* contraindications to single-pulse transcranial magnetic stimulation (TMS)(TMS will be used to measure cortical excitability): presence of a history of epilepsy, frequent headaches or neck pain, implantable devices (ventriculoperitoneal shunts, pacemakers, intrathecal pumps, intracranial metal implants)
* neurological or psychiatric pathology
* severe cardio-pulmonary, renal, hepatic diseases
* pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of Ferrara

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sofia Straudi, MD

Role: PRINCIPAL_INVESTIGATOR

Ospedale San Giorgio

Locations

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Ferrara University Hospital

Ferrara, , Italy

Site Status

Countries

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Italy

Other Identifiers

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Studio CIMT

Identifier Type: -

Identifier Source: org_study_id