Motor Control Physical Therapist Support Stroke
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|ClinicalTrials.gov Identifier: NCT04856527|
Recruitment Status : Recruiting
First Posted : April 23, 2021
Last Update Posted : June 3, 2021
|Condition or disease||Intervention/treatment||Phase|
|Stroke||Behavioral: Physical therapist support||Not Applicable|
Independent motor task performance is the most highly prioritized outcome of physical therapy for individuals with motor disability. Accordingly, a key priority for physical therapists in multiple practice settings is the advancement of functional motor independence. Therapists must determine when a patient requires assistance (e.g., verbal cues, physical support) to complete a motor task and when a patient is able to execute a motor skill with less assistance. If a therapist does not provide enough support, the patient is at risk for unsuccessful task performance. As such, therapists often default to providing a higher level of assistance.
An individual following stroke, for instance, may demonstrate an increased magnitude of postural sway while completing self-care activities at the sink. A therapist may decide to provide physical support for the patient to decrease sway variability, whether or not the patient requires this support to maintain performance. The motor control consequences of providing this assistance (thus constraining movement variability and providing fewer options for adapting movement) when assistance is actually not needed is unknown. The purpose of this study is to systematically determine the effect of unnecessary assistance during the practice of an upper limb task on functional performance and underlying motor control patterns when learning (or re-learning) motor skills in individuals with stroke. The insights gained from the current project will have the potential to improve the currently available physical therapy interventions for individuals with stroke.
The effects of unnecessary physical therapist support will be examined in terms of upper limb task performance, retention, and transfer, and in terms of the postural control supporting task performance. The study is currently planned for individuals with stroke. Participants will be required to maintain the position of a virtual laser within a target while standing. An experimental group will receive postural support (physical assistance to maintain upright posture) during a practice period in order to specifically determine the effect of postural support on upper limb task performance and postural sway patterns. Participants will also engage in a light finger force production transfer task to ascertain the influence of postural support on a different supra-postural task.
It is hypothesized that providing unnecessary assistance (and thus limiting independence) during practice of a novel motor task will result in (a) faster improvements in task performance but reduced retention and more limited transfer to another, similar task; and (b) reduced task- sensitive postural sway adjustments (measured in terms of both the quantity and temporal structure) during practice, at transfer, and at retention, reflecting reduced adaptability of postural patterns to task demands.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||30 participants|
|Intervention Model:||Parallel Assignment|
|Primary Purpose:||Basic Science|
|Official Title:||The Motor Control Consequences of Excessive Physical Therapist Support in Individuals With Stroke|
|Actual Study Start Date :||June 2, 2021|
|Estimated Primary Completion Date :||July 1, 2022|
|Estimated Study Completion Date :||July 1, 2022|
Experimental: Experimental Group
Participants will receive physical therapist support to reduce postural sway while completing a precision aiming task in virtual reality, whether or not they require the support.
Behavioral: Physical therapist support
Participants will receive physical therapist support to reduce postural sway variability while completing an upper limb precision aiming task in virtual reality.
No Intervention: Control Group
Participants will receive no physical therapist support while completing the task.
- Center of pressure path length [ Time Frame: Change from initial assessment to after 10 minutes of practice; during practice (10 minutes total) ]The amount of displacement of the location of the (resultant) vertical ground reaction force vector.
- Standard deviation of center of pressure [ Time Frame: Change from initial assessment to after 10 minutes of practice; during practice (10 minutes total) ]Variability of center of pressure trajectory for each plane.
- Recurrence quantification analysis [ Time Frame: Change from initial assessment to after 10 minutes of practice; during practice (10 minutes total) ]Quantifies the patterning, non-stationarity, and complexity of biological time series through the analysis of local recurrences in a reconstructed phase space.
- Entropy (Sample entropy or multiscale entropy) [ Time Frame: Change from initial assessment to after 10 minutes of practice; during practice (10 minutes total) ]Evaluates the predictability of the next state of a system, given what is known about the current state of a system.
- Error (root mean square error) [ Time Frame: Change from initial assessment to after 10 minutes of practice; during practice (10 minutes total) ]Deviation of laser from target; deviation of force production from target force.
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): NCT04856527
|Contact: Sarah M Schwabfirstname.lastname@example.org|
|United States, Ohio|
|University of Cincinnati Center for Cognition, Action, and Perception||Recruiting|
|Cincinnati, Ohio, United States, 45221|
|Contact: Sarah M Schwab, PT, DPT, MA email@example.com|
|Principal Investigator: Sarah M Schwab, PT, DPT, MA|