Study of the Recovery of Muscle Function in the Arm/Hand After a Stroke
Condition: Stroke; Hemiparesis
MeSH terms: Stroke; Paresis
Study type: Interventional

Summary: 
      The purpose of this study is to examine if practicing joint movements using specially
      designed devices can help in the recovery of muscle function in the arm/hand after a stroke.
      Subjects may qualify for participation in this study because they had a stroke and have had
      difficulty using their affected arm/hand ever since.
    

Detailed description: 
      Stroke is a leading cause of long-term adult disability in the United States, and hemiparesis
      is the most common motor impairment that frequently leads to persistent deficits in hand
      function. The mechanisms of recovery of hand motor function after stroke are poorly
      understood, and the protocols used in clinical practice lack a solid scientific rationale.
      The long-term objective of this research is to understand the neural mechanisms underlying
      the recovery of voluntary motor functions in brain-injured patients in order to provide a
      more objective and scientific basis to rehabilitation protocols used in clinical practice.

      These devices will be used to facilitate the training of either unimanual or bimanual
      movements that can be used both in the acute and chronic post-stroke period, even when there
      is little active movement in the affected upper extremity. The specially designed mechanical
      devices (BAT, PST and WIFIT), Psychophysical methods using an instrumented glove, and
      electromyographic recordings from upper extremity muscles to investigate the following
      specific aims in patients with post-stroke hemiparesis will lead to:

        -  greater extensor muscle activation and out of synergy movement compared with unimanual
           training facilitated by an external agent (e.g. another person).

        -  Bimanual training with the specially designed mechanical devices (BAT, PST and WIFIT)
           over 6 weeks will produce greater functional recovery in the affected upper extremity in
           patients with post-stroke hemiparesis, compared with conventional therapy.

        -  The gains in motor control and function will be greater in patients who begin bimanual
           training in the acute post-stroke phase (0-6) months, compared with those that begin in
           the chronic post-stroke phase (> 6 months).
    

Intervention name(s): Simultaneous Bimanual training; Conventional Occupational Therapy
Intervention type(s): Other; Other
Intervention description(s): Patients who have had a stroke and are in the Device group will undergo 12 weeks of training using the devices.
Patients who have had a stroke and are in the Control group, will undergo 12 weeks of conventional therapy.; Conventional Occupational Therapy will be given to patients in the control group.
Other intervention name(s): Device group; Control group; Control Group
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Rehabilitation; Fingers; Grasp; Hand; Strength; Brain Infraction; Hand Function; Post Stroke; Neural mechanisms; Motor Control; Motor Function