Visual Feedback Therapy for Treating Individuals With Hemiparesis Following Stroke

Study Overview
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Brief Summary
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The purpose of the study is to determine whether an existing treatment for problems that participants have with making movements after a stroke can be performed at home.

Detailed Description
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This study will compare two forms of home-based treatment for post-stroke problems making movements with the arms and hands. After initial pre-treatment assessments, participants will complete 4 weeks of treatment, with assessments after each week of treatment and 3 months after the completion of treatment.

Official Title
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Visual Feedback Therapy for Treating Individuals With Hemiparesis Following Stroke

Conditions
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Hemiparesis, Stroke

Intervention / Treatment
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* Behavioral: Mirror therapy
* Behavioral: Divider therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 6 months or more post-stroke upper extremity Fugl-Meyer score between 10 and 50 no longer participating in upper-extremity physical or occupational therapy sufficient comprehension ability to understand instructions Exclusion Criteria: previous head trauma, psychiatric illness or chronic exposure to medications that might be expected to have lasting consequences for the central nervous system (e.g., haloperidol, dopaminergics) dementia

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 85 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: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mirror therapy<br>4 weeks of home-based mirror therapy. Participants practiced making movements with mirrored visual feedback of the low-functioning arm. | Behavioral: Mirror therapy<br>* A home-based therapy involving mirrored visual feedback<br>|
| Active Comparator: Divider therapy<br>4 weeks of home-based divider therapy (control therapy to mirror therapy; mirror replaced by a divider). Participants practiced making movements with no visual feedback of the low-functioning arm. | Behavioral: Divider therapy<br>* A home-based therapy involving removed visual feedback.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Upper Extremity Fugl-Meyer | This test measures impairment-level ability to move the arm and hand. Scores range from 0 to 66, with higher scores indicating greater ability to move the arm and hand. | Immediately after 1 month of treatment | 
| Action Research Arm Test | The test measures the ability to complete simulated everyday tasks with the arm. Scores range from 0 to 54, with higher scores indicating better performance. | 1 month | 
| Rivermead Assessment of Somatosensory Performance | This test measures the integrity of sensory perception of the arm. The score is the proportion of items answered correctly, and ranges from 0 to 1 with higher scores indicating better performance. | 1 month | 
| Virtual-reality Assessment of Navigation | This test measures the ability to detect lateralized attention problems in a simulated navigation test. Evidence for lateralized attentional problems was defined as a 20% difference in item detection between the left and right side. | 1 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke Impact Scale | This test measures the self-reported ability to complete everyday tasks with the arm. Total scores for all items are reported. The scale ranged from 0 to 300, with higher scores indicating higher self-reported ability. | 1 month | 
| Wolf Motor Function Test | The test measures the ability to completed simulated everyday tasks with the arm. The scale ranged from 0 to 75, with higher scores indicating better performance. | 1 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, hemiparesis, arm movement, sensory functioning