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Transfer of Grasp Control Across Hands After Stroke

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ClinicalTrials.gov Identifier: NCT00589368
Recruitment Status : Completed
First Posted : January 9, 2008
Last Update Posted : October 8, 2012
Information provided by (Responsible Party):

Study Description
Brief Summary:
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.

Condition or disease Intervention/treatment
Stroke With Hemiparesis Behavioral: Transfer of grasp control across hands

Detailed Description:
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.

Study Design

Study Type : Observational
Actual Enrollment : 58 participants
Observational Model: Case Control
Time Perspective: Cross-Sectional
Official Title: Interhemispheric Transfer of Grasp Control After Stroke
Study Start Date : May 2006
Primary Completion Date : May 2012
Study Completion Date : May 2012
Groups and Cohorts

Group/Cohort Intervention/treatment
stroke group
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
control group
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

Outcome Measures

Primary Outcome Measures :
  1. 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 ]

Secondary Outcome Measures :
  1. Timing and magnitude of motor unit recruitment as measured by quantitative EMG of the grasping and lifting muscles. [ Time Frame: immediately post-intervention ]

Eligibility Criteria

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Ages Eligible for Study:   21 Years to 90 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
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.

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.
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00589368

United States, New York
Rusk Institute of Rehabilitation Medicine
New York, New York, United States, 10016
Sponsors and Collaborators
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
More Information

Responsible Party: Preeti Raghavan, Assistant Professor of Rehabilitation Medicine, New York University School of Medicine
ClinicalTrials.gov Identifier: NCT00589368     History of Changes
Other Study ID Numbers: 04-0585
K23HD049472 ( U.S. NIH Grant/Contract )
First Posted: January 9, 2008    Key Record Dates
Last Update Posted: October 8, 2012
Last Verified: October 2012

Keywords provided by Preeti Raghavan, New York University School of Medicine:
Brain Infarction
Functional Laterality
Neuronal Plasticity
Psychomotor Performance

Additional relevant MeSH terms:
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Neurologic Manifestations
Signs and Symptoms