Modulation of Upper Limb Spasticity Post-Stroke
Condition: Spasticity as Sequela of Stroke; Spastic Hemiplegia; Upper Extremity Dysfunction
MeSH terms: Muscle Spasticity; Stroke; Hemiplegia
Study type: Interventional

Summary: 
      Stroke is one of the commonest causes of severe disability in adults. Stroke often results in
      spasticity and motor impairments in the upper limb. Permanent upper extremity impairments can
      lead to limitations in activities of daily living, social participation, and quality of life.
      Spasticity may obscure motor learning ability after stroke. Spasticity control is one of the
      main aims of most therapists in the rehabilitation process for patients with chronic stroke.
      Traditional approaches for managing spasticity may not be enough for gaining satisfactory
      results. Virtual reality-based therapy is one of the most innovative and developments in
      rehabilitation technology. It could be effective in accelerating motor recovery and
      modulating spasticity for the involved upper limbs. The purpose of this study was to examine
      the impact of virtual reality-based therapy on upper limb spasticity and motor functions in
      patients post-stroke.
    

Detailed description: 
      Stroke is an acute, medical event, which mainly results in neurological damage leading to
      disability and mortality. Stroke is a common, serious, and disabling problem. The most widely
      recognized impairment caused by stroke is motor impairment of one side of the body called
      hemiplegia, which restricts function in muscle movement or mobility. Following a stroke, many
      upper limb impairments may influence the patient's ability to perform functional activities.
      These include spasticity, muscle weakness, restricted and in-coordinated movement. The impact
      of upper limb dysfunctions on participation in home, work, community life, and daily living
      activities is great. Upper limb recovery after stroke is unacceptably poor; with only 50% of
      stroke survivors likely to regain some functional use. In many neurological disabilities
      associated with spasticity such as hemiplegia post-stroke, the rehabilitation process is of
      long duration and clinicians face the challenge of identifying a variety of meaningful and
      motivating intervention tasks that could be effective in controlling spasticity and
      preventing its negative hazards. Current rehabilitation techniques have focused on teaching
      and reinforcing different strategies that encourage the use of the non-involved upper
      extremity to decrease functional limitations. Treatment options for controlling spasticity
      and enhancing upper limb functions include physical therapy, occupational therapy,
      neurodevelopmental therapy, peripheral splinting and casting, constrained induced movement
      therapy, pharmacotherapy (e.g., botulinum toxin type A), and surgery. Till now, there is a
      lack of strong evidence of successful treatment with any of these approaches. Virtual reality
      is a relatively recent approach to stroke rehabilitation. It has been shown to be an
      interactive and enjoyable medium that, with sufficient use, may improve upper limb motor
      function in adults with stroke. Enhanced feedback provided by a virtual reality system has
      been shown to promote motor learning in normal subjects. The main advantage of virtual
      game-based rehabilitation over conventional approaches is the inclusion of an interactive and
      motivating exercise environment. Until now, there have been limited researches involving the
      inclusion of virtual reality-based therapy systems in neuro-rehabilitation and spasticity
      management of the involved upper limb for hemiplegic patients post-stroke. Therefore, the
      purpose of this study was to evaluate the efficacy of virtual reality technology on
      modulating spasticity and improving the function of the involved upper extremity in patients
      having a chronic stroke.
    

Intervention name(s): Virtual reality-based training equipment.; Traditional physical therapy program
Intervention type(s): Device; Other
Intervention description(s): It is a functional upper extremity rehabilitation device to provide specific therapy with augmented feedback. The equipment facilitates intensive task-oriented upper extremity therapy after stroke, traumatic brain injury, or other neurological diseases and injuries. It combines adjustable arm support, with augmented feedback and a large 3D workspace that allows functional therapy exercises in a virtual reality environment.; The traditional physical therapy program aimed for inhibition of spasticity, facilitation of muscle action, and improving the motor functions of the involved upper limbs.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Spasticity , Stroke ,Upper Extremity,Rehabilitation.