The Application of Thermal Stimulation on Functional Recovery of Stroke Patients
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      In literature review, thermal stimulation (TS) intervention is effective in facilitating
      upper extremity functional recovery in stroke patients. In addition, several functional MRI
      studies have indicated that thermal stimuli promoted activation in the premotor and motor
      cortices of healthy participants. These imply the possibility of TS in cortical
      reorganization. However, there were no studies exploring the relationship of the TS
      intervention and cortical reorganization. By the functional recovery of stroke patients,
      findings of brain image and brain mapping, it could enhance the understanding the TS
      influences on brain reorganization. Regarding with clinical application of the TS
      intervention for improving functional performance of upper extremity in participants with
      stroke, the best parameters of TS intervention in clinical practice have not been decided.
      Therefore, this five-year study recruited three groups of stroke patients (acute, sub-acute,
      chronic) undergoing TS intervention with different parameters. Functional scales, kinematic
      data, brain image were taken in several timelines as outcome measures.
    

Detailed description: 
      The thermal stimulation (TS) intervention uses the heat and cold apply alternately
      (~30minutes), and this kind temperature application is common in clinical neuromuscular or
      sports rehabilitation. Moreover, some studies have proved efficacy of the TS on stroke.
      However, the best parameters and application on different-stage stroke groups have not been
      clearly explored. Moreover, in order to discover the TS intervention influences on
      neuroplasticity, the brain images and the brain mapping are taken in the group A (explained
      in the below). In addition, the kinematic data was also collected in group A. However, the
      above-mentioned three examination are optional. Finally, functional recovery measurements
      (clinical scales) are measured in the three groups.

      There are three groups (90 participants in each group) and their respective TS intervention
      design. In other word, three sub-studies (A, B, C) are under this project. Group A recruited
      90 acute stroke (~ 30 days) and the independent variable is temperature of TS intervention.
      Group B is with sub-acute stroke (3-12 months), undergoing different frequency of TS
      intervention. Group C targets on participants with chronic stroke (> 1 y/o) and this
      variation in TS is intensity of TS application (30 mins vs 60 mins/each session).
    

Intervention name(s): Noxious TS; Innocuous TS; High Frequency of Noxious TS; Low Frequency of Noxious TS; High Intensity of Noxious TS; Low Intensity of Noxious TS
Intervention type(s): Other; Other; Other; Other; Other; Other
Intervention description(s): hot, cold alternately, noxious TS in study A; warm, cool alternately, Innocuious TS in study A; High Frequency of Noxious TS in study B; Low Frequency of Noxious TS in study B; High Intensity of Noxious TS in study C; Low Intensity of Noxious TS in study C
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stroke; Effects of TS in U/E motor recovery; Brain mapping; Kinematics analysis