Study Results
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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NOT_YET_RECRUITING
NA
40 participants
INTERVENTIONAL
2024-12-31
2027-12-31
Brief Summary
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1. Teaching people to reach their movement goals using any strategies they like.
2. Teaching people to improve their movement technique and avoid compensatory strategies.
There is no one-size-fits-all approach. The second goal is to find out who might benefit more from each method. Some people with stroke may rely on compensatory strategies due to severe impairment, while others with milder strokes might benefit more from techniques that enhance movement quality.
The third goal is to take pictures of the brain to see how it changes with each method. This will help researchers understand how the brain adapts after a stroke and could lead to treatments that target the brain directly.
Participants will:
1. Visit the lab for clinical and research assessments on weeks 1, 4, 5, and 15.
2. Complete 10 days of piano training.
3. Undergo magnetic resonance imaging (MRI) scans twice, once in week 1 and once in week 4.
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Detailed Description
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1. One group will focus on improving the quality of their movements while playing music on a digital piano.
2. The other group will focus on achieving their movement goals while playing playing music on a digital piano.
Participation in this study will involve 14 visits, each taking place on a separate day.
Piano training consists of 20 hours total, spread over 2 hours per day for 5 days across 2 weeks. Each participant will receive one-on-one and/or group instruction from a Music Therapist with expertise in Neurologic Music Therapy and piano instruction. Exercises will include pressing single keys and multiple keys with different fingers, holding down certain keys while pressing others, and playing melodies and chords with all five fingers, involving various coordination patterns, rhythms, and speeds.
Assessments will be conducted at four timepoints: Baseline, Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months). Participants will undergo validated clinical assessments to evaluate their ability to move and feel their arm, hand, and fingers, as well as for assessor to understand how the stroke has affected them overall. Some of these tests are routinely used by physical therapists and other rehabilitation professionals who work with people living with stroke. For other types of tests, sensors will be placed on their arm, hand, and fingers. These sensors do not emit anything; they will simply record their movements.
Kinetic and kinematic measures will assess finger forces, grip strength, and pinch strength. Magnetic resonance imaging (MRI) scans at Baseline and Post-training-1 will be taken to quantify structure and function of the brain.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
BASIC_SCIENCE
TRIPLE
However, the therapist delivering the piano training will know which method is being used. To reduce bias, this therapist won't be involved in analyzing the data or know the research goals.
Study Groups
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Quality Training Group
Quality Training
Participants will engage in piano playing tasks using their affected hand and fingers. The training focuses on specific aspects of finger movement, and participants will receive feedback related to their playing. They will wear a wrist brace for support, and their hand and arm positions will be monitored to ensure proper technique.
Goal Training Group
Goal Training
Participants will engage in piano playing tasks using their affected hand and fingers. The training emphasizes learning to play and producing music. Feedback will be provided on various aspects of performance such as speed and accuracy, but specific details about finger movement or technique will not be given. The use of a wrist brace and monitoring of hand and arm positions will be consistent with standard practice.
Interventions
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Quality Training
Participants will engage in piano playing tasks using their affected hand and fingers. The training focuses on specific aspects of finger movement, and participants will receive feedback related to their playing. They will wear a wrist brace for support, and their hand and arm positions will be monitored to ensure proper technique.
Goal Training
Participants will engage in piano playing tasks using their affected hand and fingers. The training emphasizes learning to play and producing music. Feedback will be provided on various aspects of performance such as speed and accuracy, but specific details about finger movement or technique will not be given. The use of a wrist brace and monitoring of hand and arm positions will be consistent with standard practice.
Eligibility Criteria
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Inclusion Criteria
* Diagnosis of first time unilateral ischemic or hemorrhagic
* Stroke occurrence: \> 6 months and \< 2 years
* Able to perform active finger movements (Chedoke-McMaster (CM) Impairment Inventory of the Hand, Stage ≥ 3)
Exclusion Criteria
* Cognitive deficits (\< 23/30 Montreal Cognitive Assessment)
* Apraxia (\<2SD mean Waterloo Apraxia test)
* Neglect (\> 40/100, Sunnybrook Neglect Assessment Procedure)
* Cerebellar stroke
* Musculoskeletal injury affecting motor performance
* Inability to sit in a chair and perform exercises for sustained periods
* Contraindications to MRI
19 Years
80 Years
ALL
No
Sponsors
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Heart and Stroke Foundation of Canada
OTHER
McGill University
OTHER
University of Toronto
OTHER
Responsible Party
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Joyce Chen
Associate Professor
Principal Investigators
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Joyce L Chen, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Toronto: Faculty of Kinesiology & Physical Education
Locations
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University of Toronto
Toronto, Ontario, Canada
Jewish Rehabilitation Hospital
Laval, Quebec, Canada
University Institute for Physical Impairment Rehabilitation of Montreal (IURDPM)
Montreal, Quebec, Canada
Lethbridge-Layton-Mackay Rehabilitation Center
Montreal, Quebec, Canada
Jewish General Hopsital
Montreal, Quebec, Canada
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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G-23-0034937
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
46065
Identifier Type: -
Identifier Source: org_study_id
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