Non-use After Stroke: Influence of Applied Force and Precision When Reaching With the Paretic Upper Limb

NCT ID: NCT04747587

Last Updated: 2025-12-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 53 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-05-11
• Study Completion Date: 2023-04-25

Brief Summary

After a stroke, 80% of patients have an upper limb deficit, limiting activity. Some develop a non-use: they can, but do not, use their paretic limb. Non-use is a general phenomenon applied to all situations where the patient applies unnecessary compensation. Several rehabilitation techniques are effective to counter non-use, but there is insufficient knowledge to choose the most suitable technique. Optimal control theory could help guide these choices. It assumes that the chosen coordination satisfies the constraints of the task (force, amplitude, tolerance) while reducing the cost of the movement. This study will assess non-use by anticipating the sensitivity to the constraints of force and precision deduced from the logic of optimal control. The study authors expect to observe a weakness effect: in a reaching task (i.e. when the person has to touch an object placed in front of them), lightening the paretic arm makes it possible to reduce non-use, and a precision effect: in a reaching task, non-use increases with the required spatial precision.

Conditions

Stroke

Keywords

Non-use; Compensation; Weakness; Optimal control

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Patients with stroke

Group Type: EXPERIMENTAL

Reaching Session

Intervention Type: OTHER

Two x 45 minutes sessions of reaching tasks. Patients in the stroke group will perform the task with the paretic arm using a weight reduction system, allowing movement in the horizontal plane.

Subjects in the control group will perform the task with the randomly selected arm weighted at 80% of their maximum voluntary shoulder torque

Controls

Group Type: EXPERIMENTAL

Reaching Session

Intervention Type: OTHER

Two x 45 minutes sessions of reaching tasks. Patients in the stroke group will perform the task with the paretic arm using a weight reduction system, allowing movement in the horizontal plane.

Subjects in the control group will perform the task with the randomly selected arm weighted at 80% of their maximum voluntary shoulder torque

Interventions

Reaching Session

Two x 45 minutes sessions of reaching tasks. Patients in the stroke group will perform the task with the paretic arm using a weight reduction system, allowing movement in the horizontal plane.

Subjects in the control group will perform the task with the randomly selected arm weighted at 80% of their maximum voluntary shoulder torque

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patient having had a 1st stroke
• Patient whose stroke occurred more than a month ago.
• Patient having had a supratentorial stroke
• Patient able to touch the opposite knee with the paretic arm

• Subject who has never had a stroke
• Subject without motor or orthopedic impairment of the upper limbs and in particular of the shoulder

• Subject who has given free and informed consent.
• Subject who signed the consent form.
• Subject affiliated or beneficiary of a health insurance plan.

Exclusion Criteria

• Pregnant, parturient or breastfeeding subject.
• The subject is participating in a category 1 interventional study, or is in a period of exclusion determined by a previous study
• The subject refuses to sign the consent
• It is impossible to give the subject informed information
• The patient is under safeguard of justice or state guardianship
• Patient with cognitive disorders incompatible with a good understanding of the use of the device
• Patient with other neurological or osteoarticular history that may limit the performance of the task - criterion left to the deiscretion of the investigator

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Centre Hospitalier Universitaire de Nīmes

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jérôme Froger

Role: PRINCIPAL_INVESTIGATOR

Centre Hospitalier Universitaire de Nīmes

Locations

CHU de Montpellier

Montpellier, , France

CHU de Nîmes

Nîmes, , France

Countries

France

Other Identifiers

NCT04747587

Identifier Type: OTHER

Identifier Source: secondary_id

NIMAO/2020-1/JF-01

Identifier Type: -

Identifier Source: org_study_id