Mirror Therapy Education for Acute Stroke Patients

Study Overview
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Brief Summary
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In Canada, the number of stroke survivors is equivalent to the size of one of the four Atlantic Provinces. The incident rate of stroke has been increasing steadily since 1995. The majority of the stroke survivors lose upper extremity function, resulting in diminished activities of daily living (ADL). Many therapeutic interventions are recommended to improve upper extremity function or ADLs of stroke survivors, however, Mirror Therapy (MT), inexpensive intervention, can be self-administered by stroke survivors with intact cognition. Thus, the research question is whether a self-administered MT technique improves acute stroke patients' upper extremity motor function and recovery?

Official Title
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Effectiveness of Patient Education on Mirror Therapy to Improve Upper Extremity Function in Acute Stroke Patients

Conditions
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Stroke, Acute

Intervention / Treatment
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* Other: Mirror Therapy
* Other: Regular Rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admitted with diagnosis of stroke with onset within two weeks Medically stable Able to follow directions No severe cognitive impairments that could interfere with patient participation Consent to treatment by patient Alpha-Functional Independence Measure (Alpha-FIM) score of > 40 Exclusion Criteria: Medical instability Lack of motivation Recurrent/ chronic stroke Recent upper extremity musculoskeletal injuries with movement restrictions Receptive or global aphasia Delirium Unilateral neglect Visual field deficiency.

Ages Eligible for Study
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Minimum Age: 18 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: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mirror Therapy + Standard of Care<br>Participants in this group will receive standard of care based on their needs along with mirror therapy education. | Other: Mirror Therapy<br>* Participants will receive the standard-of-care; multidisciplinary rehabilitation intervention based on their needs and tolerance, and will receive an additional 30 min of Mirror Therapy education. During Mirror Therapy education, the patients will be educated or shown how to perform MT and the patients will complete the recommended exercises on their own for 30 minutes/day for 5 days a week/ for 4 weeks. Standard Mirror Therapy Protocol will be followed.<br>Other: Regular Rehabilitation<br>* Participants will receive the standard-of-care, multidisciplinary rehabilitation intervention based on their needs and tolerance.<br>|
| Active Comparator: Standard of Care<br>Participants in this group will receive only standard of care based on their needs. | Other: Regular Rehabilitation<br>* Participants will receive the standard-of-care, multidisciplinary rehabilitation intervention based on their needs and tolerance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fugl-Meyer Assessment scale | Scores of < 31 corresponded with 'no to poor' upper extremity capacity, 32 to 47 represented 'limited capacity', 48 to 52 represented 'notable capacity' and 53 to 66 represented 'full' upper extremity capacity. | Assessment will be completed at 2 points: Pre-test assessment will be done within 48 hours of stroke admission and post-test assessment will be done at 4 weeks. | 
| Wolf Motor Function Test | Assess upper extremity function; maximum Score is 75; lower scores are indicative of lower functional levels. | : Assessment will be completed at 2 points: Pre-test assessment will be done within 48 hours of stroke admission and post-test assessment will be done at 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Barthel Index | Assess Activity of Daily Living, Scores of <15 usually represents moderate disability and <10 usually represents severe disability. | : Assessment will be completed at 2 points: Pre-test assessment will be done within 48 hours of stroke admission and post-test assessment will be done at 4 weeks |