Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improvement of Postural Control and Motor Function by Vojta Therapy in Early Stroke Rehabilitation of Stroke Patients - a Pilot Study and New Approach in Stroke Rehabilitation
Brief Summary: Stroke is the major cause for permanent disability in adults. It is still unclear, which physiotherapeutic approaches are most effective. The Bobath-concept is one of the most widely used approaches in stroke rehabilitation within the western world, although several studies have failed to demonstrate superiority and showed partially even inferiority compared to other physiotherapy approaches. The Vojta therapy is based on a completely different approach - the reflex locomotion. However to date no study has been performed for stroke. We designed a randomized clinical trial (RCT) to compare Vojta and conventional physiotherapy in patients with acute ischemic (AIS) or hemorrhagic stroke (ICH). This RCT will be the first trial to investigate improvement of postural control due to Vojta therapy in early rehabilitation of stroke patients, which is a very new approach in stroke-rehabilitation.


Options:
A: Inclusion Criteria:

* Diagnosis of stroke according to WHO's definition of stroke
* Living in the city of Trondheim or the municipalities of Asker or Bærum
* Included 2.5 - 4 months after stroke
* Modified Rankin Scale 0 - 4
* Living at home
* Mini Mental State Examination \> 20 or \> 16 if aphasia
* Provide informed consent

Exclusion Criteria:

* Are already included in the study
* Are included in other experimental studies
* Unstable coronary function
* Uncompensated heartfailure
* Other diseases that make it difficult to complete the intervention
B: Inclusion Criteria:

* stroke onset \>3 months prior to study enrollment
* subject has at least 10 degrees mobility over wrist, thumb and fingers on the affected side
* subject can move, stand up and stand firmly with constrained healthy hand
* subject can perform training 6 hours daily in 2 weeks
* subject is able to understand instructions and be able to cooperate

Exclusion Criteria:

* pregnancy
* contraindications to MRI of brain
* epilepsy, major psychiatric disease
* excessive pain that prevents training
* history of other diseases resulting decreased mobility of affected upper limb
C: Inclusion Criteria:

* Ischemic stroke confirmed by computed tomography or magnetic resonance imaging, with onset between 72 hours and 6 weeks before enrollment.
* Unilateral paresis of upper limb
* National Institute of Health Stroke Scale ( NIHSS) score of at least 1 point in items 5a or 5b .
* Ability to provide written informed consent (patient ou legal representative).

Exclusion Criteria:

* Lesions affecting the corticomotor pathway in the hemisphere contralateral to the stroke.
* Neurologic diseases except migraine.
* Modified Rankin Scale \> 2 prior to stroke.
* Advanced systemic disease such as cancer or advanced chronic renal disease.
* Clinical instability such as uncontrolled cardiac arrhythmia or heart failure.
* Contraindication for physical therapy.
* Pregnancy.
* Absolute or relative contraindications to tDCS: metallic prosthesis in the head or neck; lesions on the scalp, history of neurosurgery, pacemaker.
* Comprehension aphasia
* Dementia
* Cerebellar stroke or ataxia caused by involvement of cerebellar pathways in the brainstem
D: Inclusion Criteria:

* Adult patients (\> 18 years)
* CT or MRI proven acute ischemic (AIS) or hemorrhagic stroke (ICH) within 72h after onset of symptoms
* Severe hemiparesis (medical research council scale for muscle strength ≤2)
* premorbid modified Rankin Scale (mRS) ≤3
* maximal National Institute of Health Stroke Scale Score (NIHSS) 25
* Voluntary written consent by the patient

Exclusion Criteria:

* Severe cognitive impairment due to aphasia or dementia, prohibiting that physiotherapeutic challenges can be understood.
* Participation on another clinical trial
* Pregnancy

Answer: D