Can we Train Patients With Chronic Stroke Out of Abnormal Hand Synergy?

NCT ID: NCT03255590

Last Updated: 2021-11-08

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

2017-03-03

Study Completion Date

2020-12-30

Brief Summary

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This study plans to determine whether training can change abnormal flexion synergy in chronic stroke patients.

Detailed Description

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The aim of the current study is to investigate whether motor training in chronic stroke patients can change their abnormal flexion synergy. The investigators will study chronic stroke patients , who are defined as patients that sustained a stroke at least 6 months prior to our testing date.

Three functional aspects of each finger will be tested: maximal voluntary contraction (MVC), finger dexterity, and hand posture.

Prior to intervention, participants will have a baseline assessment including clinical tests, MVC, the individuation task, and the configuration task. Following the baseline assessment patients will receive intervention, training on the configuration task for 5 consecutive days. On the sixth day and as a one week follow-up after, subjects will have a post-intervention assessment containing the same tests performed in baseline.

This design will allow us to determine speed and accuracy during the configuration task, the individuation index, and possible changes in abnormal flexion synergy.

We initially registered the study as two arms (anodal tDCS and sham tDCS groups) but decided to make it one arm due to the number of participants we were able to recruit.

Conditions

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Cerebral Stroke

Keywords

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motor recovery motor learning ischemic Stroke

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Finger Dexterity Training

Chronic stroke patients (i.e. great than 6 months) with ischemic stroke confirmed by CT or MRI, residual unilateral upper extremity weakness, able to give informed consent, and able to understand the tasks involved.

Participants trained for 5 consecutive days, 3 to 4 h/d, on a multi-finger piano-chord-like task that cannot be performed by compensatory actions of other body parts (e.g., arm). Participants had to learn to simultaneously coordinate and synchronize multiple fingers to break unwanted flexor synergies.

Group Type EXPERIMENTAL

Configuration task

Intervention Type BEHAVIORAL

Training the impaired hand on a configuration task

Interventions

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Configuration task

Training the impaired hand on a configuration task

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age 21 and older
* Ischemic stroke greater than six months ago, confirmed by CT or MRI
* Residuals unilateral upper extremity weakness
* Ability to give informed consent and understand the tasks involved.
* Appearance of Flexion synergy in hand.
* Ability to extent finger at least for 5 degrees.

Exclusion Criteria

* Cognitive impairment, with score on Montreal Cognitive assessment (MoCA) ≤ 20
* History of physical or neurological condition that interferes with study procedures or assessment of motor function (e.g. severe arthritis, severe neuropathy, Parkinson's disease)
* Contraindication to tDCS (deep brain stimulators or other metal in the head, skull defect, pacemaker)
* Inability to sit in a chair and perform upper limb exercises for one hour at a time
* Participation in another upper extremity rehabilitative therapy study or tDCS study during the study period
* Terminal illness
* Social and/or personal circumstances that interfere with ability to return for therapy sessions and follow up assessments
* Pregnancy
* Severe Neglect
Minimum Eligible Age

21 Years

Maximum Eligible Age

99 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

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pablo Celnik

Role: PRINCIPAL_INVESTIGATOR

Department of Physical Medicine and Rehabilitation Johns Hopkins University

Locations

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Kennedy Krieger Institute

Baltimore, Maryland, United States

Site Status

Countries

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United States

Other Identifiers

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2R01HD053793-09A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NA_00082367

Identifier Type: -

Identifier Source: org_study_id