The Effect of Different Schedules of Functional Task Practice for Improving Hand and Arm Function After Stroke
|Cerebrovascular Accident Hemiplegia||Behavioral: functional task practice - distributed Behavioral: functional task practice - condensed|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind
Primary Purpose: Treatment
|Official Title:||The Impact of Functional Task Practice Dosing on Motor Control in Hemiplegia From Chronic Stroke|
- Upper extremity subscale of the Fugl-Meyer Motor Assessment [ Time Frame: immediately after therapy ends ]
- Wolf Motor Function Test [ Time Frame: Immediately after therapy ends ]
|Study Start Date:||August 2006|
|Estimated Study Completion Date:||December 2007|
|Primary Completion Date:||August 2007 (Final data collection date for primary outcome measure)|
Therapy is provided every other day 3 days per week (Monday, Wednesday, Friday).
Behavioral: functional task practice - distributed
This functional task practice is modeled after Constraint-Induced Movement Therapy in which participants wear a mitt on the non-paretic arm for up to 90% of waking hours and then attend therapy for 3 hours a session Monday, Wednesday, and Friday in which they practice various functional tasks, such as tracing a stencil, placing toothbrushes in toothbrush holders, etc.
Other Name: constraint-Induced Movement Therapy
Active Comparator: 2
The same therapy is provided daily Monday through Friday
Behavioral: functional task practice - condensed
This functional task practice is modeled after Constraint-Induced Movement Therapy in which participants wear a mitt on the non-paretic arm for up to 90% of waking hours and then attend therapy for 3 hours a session Monday through Friday in which they practice various functional tasks, such as tracing a stencil, placing toothbrushes in toothbrush holders, etc.
Other Name: Constraint-Induced Movement Therapy
Intense skill practice with the affected arm after stroke has the potential to improve upper extremity (UE) function resulting from neuroplastic changes in the motor cortex. However, the necessary and sufficient parameters of this therapy in humans have not been fully investigated. Delineation of the most efficacious and efficient therapy for promoting UE recovery post-stroke is necessary before effective clinical implementation of this therapy. In this study, using parallel group design methodology, we will test the effect of 2 practice parameter (i.e. spacing of practice and number of repetitions per task practiced per session) modifications on UE function following skill practice.
Forty subjects will complete multiple baseline testing and then be randomized, using random number table, to one of 4 groups: condensed functional task practice modeled after Constraint-Induced Movement Therapy (6 hours of practice/day, 5 days/week, 2 weeks), condensed functional task practice with a restricted number of tasks practiced, distributed, distributed functional task practice (Monday, Wednesday, Friday, 6 hours/session, 10 sessions), distributed functional task practice with a restricted number of tasks practiced. During therapy sessions, subjects will practice performing common activities with their paretic upper extremity. They will wear a mitt on their non-paretic upper extremity for up to 90% of their waking hours. Post-testing sessions will follow within one week of completing therapy with an additional follow-up testing session 3 months later.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00361660
|Principal Investigator:||Lorie G Richards, PhD||North Florida/South Georgia Veterans Health System|