Mechanism and Efficacy of Rehabilitation Approaches

Study Overview
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Brief Summary
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Identify the possible mechanisms and the relative effectiveness of existing rehabilitation approaches that target upper extremity deficits of stroke patients on the ground that these approaches are based on neuroplasticity principles and sound motor control theories.

Detailed Description
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Comparisons of constraint-induced therapy (CIT) vs. bilateral arm training (BIT)vs. combined therapy were made. Stroke patients will receive one of these three approaches and be evaluated pre- and post-treatment. the treatment will last 3 weeks and 5 days per week. The evaluation will include clinical measures of motor function, ADL, and quality of life, kinematic performance, and activation patterns of cortex.

Official Title
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Mechanisms and Long-term Effects of Separate vs. Coupled Rehabilitation Approaches After Stroke

Conditions
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Cerebrovascular Accidents

Intervention / Treatment
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* Other: Constraint-induced therapy (CIT)
* Other: Bilateral arm training (BAT)
* Other: Combined therapy (CT)
* Behavioral: Control intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a first-ever clinical cerebrovascular accident patients at least 6 months post-stroke onset premorbid right-hand dominance demonstration of Brunnstrom stage III of the affected upper extremity no excessive spasticity in the joints of the affected upper extremity Exclusion Criteria: a score of less than 24 on the Mini Mental State Exam poor physical conditions that would interfere with participation excessive pain in any joint that might limit participation

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 75 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>constraint-induced therapy | Other: Constraint-induced therapy (CIT)<br>* restraint of the unaffected arm and practice of the affected arm<br>|
| Experimental: 2<br>bilateral arm training | Other: Bilateral arm training (BAT)<br>* bilateral symmetric, repetitive arm training<br>|
| Experimental: 3<br>combined therapy | Other: Combined therapy (CT)<br>* combined different treatment approaches<br>|
| Active Comparator: Control intervention<br> | Behavioral: Control intervention<br>* Conventional treatment program<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cortical reorganization and kinematic analysis |  | 2008-2010 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| clinical measures at the impairment, activity, participation levels |  | 2008-2010 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke rehabilitation, cortical reorganization, kinematic analysis