Effects of Home-based Mirror Therapy Combined With Task-oriented Training for Patients With Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The specific aims of this study will be:

        1. To compare the immediate and retention treatment effects of the patients receiving
           home-based mirror therapy combined with task-oriented training (MTOT) with a
           hospital-based MTOT group and a hospital conventional rehabilitation group on different
           aspects of outcomes.

        2. To examine the feasibility, satisfaction, and safety of this novel home-based MTOT
           program.

        3. To investigate the factors that may affect the efficacy of home-based stroke
           rehabilitation.
    

Detailed description: 
      In this 3-year study project, we will design a single-blind randomized controlled trial (1)
      to compare the treatment effects of home-based MTOT with a hospital-based MTOT group and a
      hospital conventional rehabilitation group, (2) to investigate the feasibility, satisfaction,
      and safety of this home-based program, and (3) to identify the factors that might influence
      treatment outcomes. An estimated total of 90 patients with stroke will be recruited in this
      study. All participants will be randomly assigned to receive home-based MTOT or
      hospital-based rehabilitation for a 4-week training period (a total of 12 sessions). Before
      the first treatment session, a client-centered questionnaire will be administered to each
      patient for identifying individual needs and goals. Feasibility evaluation and caregiver's
      wellbeing will be also assessed. Outcome measures will be conducted at baseline, immediately
      after treatment, and 3 months follow-up.
    

Intervention name(s): home-based MTOT; hospital-based therapy; hospital-based MTOT
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The home-based MTOT group will receive 30 minutes of MT followed by 30 minutes of TOT per session. The intervention will take place in the participant's home environment. During the mirror practices, the patient will seat close to a table which the mirror box will be placed at the mid-sagittal plane. During MT, the participant will be encouraged to actively move their paretic arm and hand concurrently with the mirror reflection of the movement of the nonparetic arm and hand as possible as they can. If necessary, the therapist will assist the participant in moving the paretic hand to synchronize the movement with the nonparetic hand.; The control group will receive a dose-matched, individualized occupational therapy at a hospital. The participants will receive customary rehabilitation programs as usual performed at hospitals for 1 hour per session. The treatment protocol will include: (a) passive range of motion exercises, stretching of the affected limb, or facilitatory and inhibitory techniques, (b) fine motor or dexterity training, (c) arm exercises or gross motor training, (d) muscle strengthening of the affected upper limb, and (e) activities of daily living training or functional task practice.; The hospital-based MTOT group will also receive 30 minutes of MT followed by 30 minutes of TOT per session at a hospital. The intervention will take place in the occupational therapy clinic. The treatment modalities in the hospital will be selected and provided for this group. Most of the treatment principles and components are the same as aforementioned in the home-based MTOT. However, the major differences between home-based and hospital-based MTOT are the treatment contexts, environments and functional modalities used.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: home-based rehabilitation; stroke; combination therapy; client-centered approach; post-acute