Effects of Mirror Therapy Versus Fine Motor Activities on Hand Function in Chronic Stroke Patients.

Study Overview
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Brief Summary
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to compare the effects of the Mirror therapy and fine motor activities on hand function in chronic stroke patients

Detailed Description
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This study will be conducted to compare the effects of mirror therapy and fine motor activities in chronic stroke patients. Total Twenty eight hemiplegic patients will be recruited according to inclusion criteria and data will be collected from Riphah rehabilitation centre Lahore and Mian Munshi Hospital Lahore (DHQ). The patients will randomly assigned to a mirror therapy group (n=14) and Fine motor activities group (n=14). The patients in both groups will undergo conventional therapy for 4 weeks (60minutes/day, 5 days/week). The patients will be evaluated at the beginning and end of the treatment by Fugl- Meyer Aassessment (FMA) wolf motor assessment scale and the Functional Independence Measure (FIM). After approval from ethical committee, data collection will be started and informed consent will be taken from all patients.

Official Title
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Effects of Mirror Therapy Versus Fine Motor Activities on Hand Function in Chronic Stroke Patients.

Conditions
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Stroke, Ischemic, Acute Pain, Weakness, Muscle

Intervention / Treatment
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* Other: fine motor activities
* Other: conventional therapy and mirror therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A score greater than 24 on the Mini-Mental State examination test Chronic stroke patients whose episode of stroke onset was 6 months to 2 years. Patients who are able to communicate well and grasp the therapist's spoken instructions Exclusion Criteria: Patients who have restricted joint movement in their healthy upper extremities. Neglect syndrome or a visual field deficiency Patients with recurrent stroke. Spine surgery.

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 65 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
Interventional Model Description: Study participants will be divided in two groups. Patients in group A will receive conventional therapy for four weeks sixty minutes per day, five days per week. In Group B patients will perform fine motor exercises like therapy ball exercises, therapy putty exercises, table top exercises, moving beans, stacking pennies and rubber band resistances exercises etc. for 30 minutes along with conventional therapy
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: fine motor activities group<br>Patients in this group will receive conventional therapy for 1 month sixty minutes/day, 5 days/week in addition to performing fine motor exercises like therapy ball exercises, therapy putty exercises, table top exercises, moving beans, stacking pennies and rubber band resistances exercises etc. for 30 minutes | Other: fine motor activities<br>* patient will perform fine motor exercises like therapy ball exercises, therapy putty exercises, table top exercises, moving beans, stacking pennies and rubber band resistances exercises etc. for 30 minutes along with conventional therapy<br>|
| Active Comparator: control group<br>Patients in this group will receive conventional therapy for four weeks sixty minutes per day, five days per week. In addition, receive thirty minutes of mirror therapy, which included periodic wrist flexion-extension, flexion and extension exercises of fingers on non paralyzed limb | Other: conventional therapy and mirror therapy<br>* Patients in this group will receive conventional therapy for four weeks sixty minutes per day, five days per week. In addition, receive thirty minutes of mirror therapy, which included periodic wrist flexion-extension, flexion and extension exercises of fingers on non paralyzed limb<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| fugl mayer assessment FMA upper limb | For stroke patients, the Fugal-Meyer Assessment (FMA) is a performance-based impairment measure. It is used to assess balance, motor function, sensation, and joint function in persons who suffer hemiplegia after a stroke. In both clinical and research settings, it is used to identify sickness severity, define motor recovery, and plan and assess treatment | 9 months | 
| The Functional Independence Measure (FIM) | The Functional Independence Measure (FIM) is a non-diagnostic disability assessment instrument that was developed for a wide range of groups | 9 months | 
| The Wolf Motor Function Test (WMFT) | The Wolf Motor Function Test (WMFT) uses timed and functional tasks to assess upper limb motor skills | 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Ischemic, Acute Pain, Weakness, Muscle