Comparing Perceptual Motor Training and Repetitive Facilitation Exercises on UE in Stroke

NCT ID: NCT06688812

Last Updated: 2024-11-14

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-11-25
• Study Completion Date: 2025-07-30

Brief Summary

The aim of the study is to determine the comparative effects of perceptual motor training and repetitive facilitation exercises on upper limb quality of movement and motor function in Stroke patients.

Detailed Description

Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation.

This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks.

Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.

Conditions

Stroke

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Group A Perceptual Motor Training with Routine Physical Therapy

Group A will receive treatment session of 60 minutes including Perceptual motor training for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention.

Group Type: EXPERIMENTAL

Perceptual Motor Training

Intervention Type: OTHER

8 set of exercises

1. Balance training and related exercises

2. Tones of awareness training, body parts' role and related exercises

3. Space awareness training and related exercises

4. Perception of shape training and related exercises

5. Visual perception training and related exercise.

6. Kinesthetic-tactile perception training and related exercises

7. Auditory perception training and related exercises

8. Eye and hand coordination, fine motor movements and related Exercises

Group B Repetitive Facilitation Exercises with Routine Physical Therapy

Group B will receive treatment session of 60 minutes including Repetitive facilitation exercises for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention.

Group Type: EXPERIMENTAL

Repetitive Facilitation Exercises

Intervention Type: OTHER

Eight set of exercises:

1. Shoulder Flexion with 90° Elbow Flexion (Supine).

2. Shoulder Horizontal Extension/Flexion with Elbow flexion (supine).

3. Complex Shoulder and Upper Limb Movements (Supine)

4. Shoulder Flexion/Abduction/External Rotation with Elbow and Forearm Supination (Supine)

5. Forearm Supination/Pronation with 90° Elbow Flexion (Sitting)

6. Wrist Extension and Forearm Pronation with Finger Extension (Supine)

7. Finger Extension with Wrist Flexion (Supine)

8. Finger Extension/Flexion with Wrist Flexion (Sitting) • Therapist facilitate the movement by rubbing, tapping and gentle stretching.

Interventions

Perceptual Motor Training

8 set of exercises

1. Balance training and related exercises

2. Tones of awareness training, body parts' role and related exercises

3. Space awareness training and related exercises

4. Perception of shape training and related exercises

5. Visual perception training and related exercise.

6. Kinesthetic-tactile perception training and related exercises

7. Auditory perception training and related exercises

8. Eye and hand coordination, fine motor movements and related Exercises

Intervention Type: OTHER

Repetitive Facilitation Exercises

Eight set of exercises:

1. Shoulder Flexion with 90° Elbow Flexion (Supine).

2. Shoulder Horizontal Extension/Flexion with Elbow flexion (supine).

3. Complex Shoulder and Upper Limb Movements (Supine)

4. Shoulder Flexion/Abduction/External Rotation with Elbow and Forearm Supination (Supine)

5. Forearm Supination/Pronation with 90° Elbow Flexion (Sitting)

6. Wrist Extension and Forearm Pronation with Finger Extension (Supine)

7. Finger Extension with Wrist Flexion (Supine)

8. Finger Extension/Flexion with Wrist Flexion (Sitting) • Therapist facilitate the movement by rubbing, tapping and gentle stretching.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Both male and female patients.
• Age 40-65 years
• 1st ever stroke confirmed by MRI
• mild-to-moderate upper-limb motor paralysis
• sub-acute and chronic stroke patients
• ability to understand tasks such as evaluations in the intervention
• Modified Ashworth scale score < 3
• Mini Mental State Examination Score should be>24 out of 30

Exclusion Criteria

• Participants who have a history of significant neurological or psychiatric disorders, other than stroke, that could interfere with upper limb motor recovery
• Patients with pain, contracture and profound atrophy in arm and fingers.
• Participants with severe cognitive dysfunction that would interfere with understanding instructions from the physician or therapist.
• Presence of any other musculoskeletal condition. e.g. (Frozen shoulder, any recent fractures of upper limb.
• Any accompanying diseases or disorders, other than stroke, that could interfere with upper extremity training.
• Uncontrolled health conditions for which exercise was contraindicated.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Hira Jabeen, MS-NMPT

Role: STUDY_CHAIR

Riphah International University

Locations

Dr. Faisal Masood Teaching Hospital

Sargodha, Punjab Province, Pakistan

Countries

Pakistan

Central Contacts

Hira Jabeen, MS-NMPT

Role: CONTACT

hira.jabeen@riphah.edu.pk

03234116506

Facility Contacts

Hira Jabeen, MS-NMPT

Role: primary

hira.jabeen@riphah.edu.pk

03234116506

References

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Reference Type: BACKGROUND

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Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M. Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. J Hand Ther. 2022 Oct-Dec;35(4):507-515. doi: 10.1016/j.jht.2021.01.005. Epub 2021 Jan 26.

Reference Type: BACKGROUND

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Other Identifiers

REC/RCR & AHS/24/0253

Identifier Type: -

Identifier Source: org_study_id