Effect of Body Representation in Movement

Study Overview
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Brief Summary
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This study explores the possible implications of the increase in perceived body size for rehabilitation of motor functions. In a recent study we have tested if motor abilities of patients with stroke improve wearing magnifying lenses, showing that a beneficial effect of magnifying lenses can be observed in some patients. In the present study, we will identify 12 patients from this cohort who demonstrated an improvement greater than 10% in one or two motor task when wearing magnifying glasses. These participants will be invited to take part in a clinical study in which they will undergo a training phase: subjects will wear magnifying lenses at home for 30 minutes daily for 14 days while completing a jigsaw puzzle; a log will be kept to document participation. Participants' performance on different motor tasks will be assessed before, immediately after and 1 month after the training session. Standardized measures of motor performance will include the the Action Research Arm test and the Rivermead Assessment of Somatosensory Performance (RASP). In addition, participants will undergo grip strength, finger tapping tasks and a reaching and grasping task. We expect the repeated use of magnifying lenses to generate an improvement of patients' performance across tasks and this effect to be persistent in time.

Detailed Description
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Altering the apparent size of a body part with magnifying changes tactile acuity, tactile distance judgments and pain perception. In a recent study we have tested if motor abilities (grip strength, finger tapping and reaching and grasping) of patients with stroke improve wearing magnifying lenses. The results of this study showed that a beneficial effect of magnifying lenses on movement can be observed in some patients with stroke. The present study aims at following up these results and investigating the possible use of magnifying lenses in the rehabilitation to improve motor controls of stroke patients. To pursuit this aim, we will identify 12 patients in our previous study cohort who demonstrated an improvement greater than 10% in the grip strength or finger tapping task when wearing magnifying glasses. These participants will be invited to take part in the present clinical study in which they will undergo a training phase: subjects will wear magnifying lenses at home for 30 minutes daily for 14 days while completing a jigsaw puzzle; a log will be kept to document participation. Participants' performance on different motor tasks will be assessed before, immediately after and 1 month after the training session. Standardized measures of motor performance will include the the Action Research Arm test and the Rivermead Assessment of Somatosensory Performance (RASP). In addition, participants will undergo grip strength (6 trials), finger tapping tasks (6 trials) and a reaching and grasping task, inn which they will be asked to reach and grasp 3 different objects (30 trials). We expect the repeated use of magnifying lenses to generate an improvement of patients' performance across task and this effect to be persistent in time.

Official Title
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Effect of Body Representation in Movement

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Magnification hand size
* Device: magnifying lenses


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients suffering from stroke who showed an improvement with magnifying lenses in our previous study. Exclusion Criteria: Patients suffering from stroke who did not show an improvement with magnifying lenses in our previous study.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 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
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Magnification hand size<br>magnifying lenses used for 30 minutes daily for 14 days while completing a jigsaw puzzle | Behavioral: Magnification hand size<br>* Participants will use magnifying lenses while completing a jigsaw puzzle for 30 min a day for 14 days.<br>Device: magnifying lenses<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Action Research Arm test | 19 item measure of motor control (i.e. (grasp, grip, pinch, and gross arm movement). Max score is 57 | Baseline, immediately after the training (two weeks) and after one month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rivermead Assessment of Somatosensory Performance | Battery designed to test somatosensory functions, comprising of 7 subtests (sharp/dull discrimination, surface pressure touch, surface localization, sensory extinction, two-point discrimination, temperature discrimination, proprioception movement and direction discrimination). Max score for each subtest is 60, except for sensory extinction (max is 12) and two-point discrimination (fail or pass). | Baseline, immediately after the training (two weeks) and after one month | 
| Grip strength | A grip dynamometer measures participants' grip strength | Baseline, immediately after the training (two weeks) and after one month | 
| Finger tapping | Electronic tapping test measures participants' tapping rate of the index finger | Baseline, immediately after the training (two weeks) and after one month | 
| Reach and grasping | Motion tracking equipment used to measure participants kinematic parameters (movement time, peak velocity, grip aperture, etc.) when reaching and grasping 3 objects, for a total of 30 movements. | Baseline, immediately after the training (two weeks) and after one month |