Effects of Modified Constraint-Induced on Chronic Stroke Patients

Study Overview
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Brief Summary
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In the present study, it was aimed to compare the proprioception training applied in addition to conventional treatment and Modified Constraint-Induced Movement Therapy treatment in patients with chronic strokes and to investigate the effects on proprioception, spasticity, functional motor skills and daily living activities in the upper extremity.

Official Title
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Comparison of the Effect of Proprioceptive Training Therapy or Modified Constraint-Induced Movement Therapy on Upper Extremity Physical Functions in Chronic Stroke Patients - A Randomized Controlled Study

Conditions
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Stroke, Rehabilitation

Intervention / Treatment
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* Other: modified constraint-induced therapy
* Other: Proprioceptive Training
* Other: conventional rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Post stroke hemiparetic patients of six months spasticity ≤ Grade -3 on modified Ashworth scale those patients capable of extension of at least 10º each at Metacarpophalangeal (MCP), Proximal Interphalangeal (PIP) and Distal Interphalangeal (DIP) joints and 20º at wrist joint a score of 24 or higher on the Modified Mini-Mental State Examination no excessive pain in the affected upper limb, as measured by a score of 4 or higher on a 10-point visual analog scale Exclusion Criteria: Patients with history of previous stroke, angina, uncontrolled hypertension, on medication that could impair neuromuscular performance, wrist or finger pathologies, significant visual or hearing impairment, balance problems which may compromise safety during sound upper limb constraint, unwilling to participate

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: conventional rehabilitation<br> | Other: conventional rehabilitation<br>* Patients received conventional rehabilitation schedule<br>|
| Experimental: Modified constraint-induced therapy<br> | Other: modified constraint-induced therapy<br>* Patients received conventional rehabilitation and modified constraint-induced therapy schedule<br>|
| Experimental: Proprioceptive Training<br> | Other: Proprioceptive Training<br>* Patients received conventional rehabilitation and Proprioceptive Training schedule<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fugl-Meyer assessment test | The Fugl-Meyer Assessment (FMA) is a stroke-specific, performance-based upper extremity function. The maximum available score is 66 and The minimum available score is zero.The higher total score means better motor function in the arm | Score change after 6 weeks of intervention compared to baseline | 
| Action Research arm test | The Action Research Arm Test (ARAT) is a 19 item observational measure used by physical therapists and other health care professionals to assess upper extremity performance. The maximum available score from the 19 items was 57. The higher total score means better motor function in the arm | Score change after 6 weeks of intervention compared to baseline | 
| Motor Activity Log | Daily use of the affected upper extremity was assessed using Motor Activity Log. It is a self-statement questionnaire to determine the frequency and quality of movement in the upper extremity. Score range is 0-5, The higher total score means better motor function in the arm | Score change after 6 weeks of intervention compared to baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Ashworth Scale | Modified Ashworth Scale was measure muscle spasticity. It is among the most commonly used scales for clinical and research purposes. The resistance against passive movement is evaluated on a scale of 0-4 points.The lower total score means better spasticity in the arm | Score change after 6 weeks of intervention compared to baseline | 
| thumb localizing test | A proprioception examination, called the 'thumb localizing test' (TLT), is described as a technique for testing 'limb localization'. With the patient's eyes closed, the examiner positions one of the patient's upper limbs (fixed limb) and asks him to pinch the thumb of that limb with the opposite thumb and index finger (reaching limb).It is evaluated on a 0-3 point scale. The lower the total score, the better the proprioceptive in the arm. | Score change after 6 weeks of intervention compared to baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Modified constraint-induced therapy, Proprioceptive Training, conventional rehabilitation