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Transfer of Grasp Control Across Hands After Stroke

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Preeti Raghavan, New York University School of Medicine
ClinicalTrials.gov Identifier:
NCT00589368
First received: December 24, 2007
Last updated: October 5, 2012
Last verified: October 2012

December 24, 2007
October 5, 2012
May 2006
May 2012   (final data collection date for primary outcome measure)
Difference in peak load force rates for grasping a light and a heavy weight object as measured using a custom made object with 6 dof force sensors. [ Time Frame: immediately post-intervention ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00589368 on ClinicalTrials.gov Archive Site
Timing and magnitude of motor unit recruitment as measured by quantitative EMG of the grasping and lifting muscles. [ Time Frame: immediately post-intervention ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Transfer of Grasp Control Across Hands After Stroke
Interhemispheric Transfer of Grasp Control After Stroke

The purpose of this study is to examine if the strong hand can assist in the recovery of muscle function in the weak hand after a stroke.

Hemiparesis is the most common motor impairment after stroke. Persistent deficits in the distal upper extremity lead to impaired hand function and disability in Activities of Daily Living, accruing enormous costs in terms of health care services and lost productivity. The mechanisms of recovery of hand motor function after stroke are poorly understood, and the protocols used in clinical practice lack a solid scientific rationale. Prior work has shown that grasping with the non-involved hand may assist in planning of grasp with the involved hand after stroke. The goal of the proposed project is to investigate the type and nature of information relayed across the hemispheres by prior manipulation with the non-involved hand to improve planning and control of grasp with the involved hand. Psychophysical methods using a grip instrument will be used to examine the type of information necessary for planning of grasp, and quantitative surface electromyography will be used to investigate the contribution of improved planning to neuromuscular control of grasp. Integration of these methods in the study of grasp control will clarify the neural mechanisms underlying hand dysfunction, and facilitate the development of rational therapeutic protocols for upper extremity rehabilitation after stroke.

Observational
Observational Model: Case Control
Time Perspective: Cross-Sectional
Not Provided
Not Provided
Non-Probability Sample

Subjects with stroke will be recruited from the inpatient and outpatient Rehabilitation units at the Mount Sinai Medical Center and from referrals by community rehabilitation physicians and neurologists. Control subjects will be recruited by public advertisement in the New York City area. There are no exclusions based on gender or ethnic groups.

Stroke With Hemiparesis
Behavioral: Transfer of grasp control across hands
transfer of planning and execution of grasp across hands in terms of its effect on fingertip forces, and the timing and magnitude of muscle contraction in patients with hemiparesis and healthy controls
  • 1
    stroke group
    Intervention: Behavioral: Transfer of grasp control across hands
  • 2
    control group
    Intervention: Behavioral: Transfer of grasp control across hands
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
58
May 2012
May 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  1. Previously right-handed subjects with hemiparesis and complaints of unilateral hand dysfunction during grasping resulting from a single unilateral cerebral infarct in the MCA territory affecting either the right or the left side of the brain at least 3 months prior to data collection
  2. Previously right-handed healthy control subjects age-matched to the stroke patients
  3. All subjects must have the ability to reach, grasp and lift the test object with both extremities (stroke patients with the impaired extremity as well) and complete the experimental protocol as assessed by the PI.
  4. All subjects must score > 24 on the Folstein's mini-mental exam to screen out significant cognitive dysfunction
  5. Subjects must obtain MRI or CT scan images of their brain taken since their stroke, or be willing to have a structural MRI or CT scan taken as part of this research study.

Exclusion Criteria:

  1. Presence of clinically significant visual deficits, aphasia, neglect, or apraxia as determined by clinical neurologic examination that may interfere with the research protocol
  2. Presence of sensory deficits in control subjects and in the non-involved hand of stroke subjects on testing of two-point discrimination
  3. History of surgery or other significant injury to the upper extremities
  4. Botulinum toxin injections in the upper extremity musculature in the three months prior to enrollment in the study.
  5. Current treatment with intrathecal baclofen
  6. Previous neurological illness such as head trauma, prior stroke, epilepsy, demyelinating disease
  7. Complicating medical problems such as uncontrolled, diabetes with polyneuropathy, severe renal, cardiac or pulmonary disease, or any other severe concurrent medical problem that will interfere with obtaining reliable results.
Both
21 Years to 90 Years
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00589368
04-0585, K23HD049472
No
Preeti Raghavan, New York University School of Medicine
New York University School of Medicine
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Principal Investigator: Preeti Raghavan, MD NYU School of Medicine
New York University School of Medicine
October 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP