Effects of the Application of a Reflex Locomotion Program in the Neurological Hand

Study Overview
=================
Brief Summary
-----------------
The recovery of the function of the hand is one of the most important aspects for patients who have suffered the consequences of neurological damage. Currently there are numerous therapeutic procedures aimed at rehabilitation that have scientific evidence such as restrictive therapy. However, dysfunction of the upper limb has an impact on the whole body that is not always taken into consideration.

Detailed Description
-----------------
The intervention of the stimulation of the reflex locomotion is carried out in this study in a sitting position in a conventional chair, an unorthodox posture in the usual treatment of Vojta therapy. Description of the sitting posture: the back in axial extension with the shoulders located in front of the hips. The elbows must be supported with the medial epicondyl in contact on a table, whose height is at the level of the end of the patient's sternum. The forearms are placed prone with the palms facing the surface. In this position we place a rubber sphere 3 centimeters in diameter under the pisiform of one of the patient's wrists. The reflex stimulation is performed by the passive pressure exerted by the weight of the wrist (pisiform) on the rubber sphere. Simultaneously the patient has to exert a slight pressure with the heel towards the ground with his foot. This foot will be the opposite of the wrist that has the sphere under the pisiform. It is a cross-stimulation, that is, pisiform in one hand together with the load in the heel of the opposite side. Alternating each diagonal 4 times, 5 minutes each. Total session 20 minutes, 2 times per day, every day according to degree of affectation The duration of the study will depend on the degree of involvement: mild 2 weeks, moderate 3 months.

Official Title
-----------------
Effects of the Application of a Reflex Locomotion Program on Sitting in the Neurological Hand of the Chronic Adult Patient

Conditions
-----------------
Neurological Disorder

Intervention / Treatment
-----------------
* Other: Reflex locomoction therapy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Sequelae in the upper limb after neurological damage. Understanding and oral expression preserved. More than a year after the episode. Possibility of walking Exclusion Criteria: Aphasia. Concomitant diseases: Diabetes and arthritis of the hand.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: Pretest-posttest trial
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental<br>Adult patients with chronic sequelae in the upper limb after neurological damage | Other: Reflex locomoction therapy<br>* The intervention of the stimulation of the reflex locomotion is carried out in this study in a sitting position in a conventional chair, an unorthodox posture in the usual treatment of Vojta therapy. The reflex stimulation is performed by the passive pressure exerted by the weight of the wrist (pisiform) on the rubber sphere. Simultaneously the patient has to exert a slight pressure with the heel towards the ground with his foot. This foot will be the opposite of the wrist that has the sphere under the pisiform. Alternating each diagonal 4 times, 5 minutes each. Total session 20 minutes, 2 times x day, every day according to degree of affectation.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| kinesiological test of the upper limb | Shoulder: flexion and maximum abduction. Forearm: Supination / pronation. Wrist: maximum dorsal flexion. Hand: finger extension | 2 weeks for mild grade and 3 months for moderate degree | 
| The Box and Block Test | The Box and Block Test is a functional outcome measure that is commonly used across multiple clinical populations due to its benefits of ease and speed of implementation; reliable, objective measurement; and repetition of motion. | 2 weeks for mild grade and 3 months for moderate degree. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
stroke, Physical therapy, neurological hand, Vojta therapy