Cross-Education and Mirror Therapy for Upper Limb in Post-Stroke Patients

Study Overview
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Brief Summary
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This randomized controlled trial will investigate the potential synergistic effects of combining cross-education training with mirror therapy on strength and motor function in the more affected upper limb of post-stroke patients.

Official Title
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Combining Cross-Education and Mirror Therapy for Upper Limb Rehabilitation in Post-Stroke Patients: A Randomized Controlled Trial

Conditions
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Stroke

Intervention / Treatment
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* Other: Cross-education
* Other: Mirror therapy
* Other: Conventional Physical Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Post-stroke patients with upper limb motor impairments Aged 30 years to 60 years old At least 3 months post-stroke Able to participate in the intervention Exclusion Criteria: Severe cognitive impairments Visual impairments Any contraindications to the intervention

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 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: Cross-education training only<br>Participants will perform resistance exercises at 60% of their 1 repetition maximum (1RM) with the less affected limb. | Other: Cross-education<br>* Participants will perform resistance exercises at 60% of their 1 repetition maximum (1RM) with the less affected limb. The intervention will be performed three times per week for 8 weeks. Each session will consist of three sets of 15 repetitions of bicep curls, tricep extensions, and wrist flexion/extension exercises with a 1-minute rest period between sets. The exercises will be performed in a seated position, with the participant's forearm resting on a table and the therapist providing manual resistance. The therapist will be positioned in front of the participant.<br>|
| Experimental: Mirror therapy only<br>Participants will perform bilateral upper limb movements while observing the reflection of the less affected limb in a mirror. | Other: Mirror therapy<br>* Participants will perform bilateral upper limb movements while observing the reflection of the less affected limb in a mirror. The intervention will be performed three times per week for 8 weeks. Each session will consist of 10 minutes of mirror therapy, with the participant seated in front of a mirror. The participant will perform various upper limb movements, such as reaching and grasping, while observing the mirror reflection of the less affected limb. The therapist will be positioned beside the participant, providing verbal cues and feedback as necessary.<br>|
| Experimental: Combined cross-education and mirror therapy<br>Participants will perform resistance exercises with the less affected limb while observing its reflection in a mirror. | Other: Cross-education<br>* Participants will perform resistance exercises at 60% of their 1 repetition maximum (1RM) with the less affected limb. The intervention will be performed three times per week for 8 weeks. Each session will consist of three sets of 15 repetitions of bicep curls, tricep extensions, and wrist flexion/extension exercises with a 1-minute rest period between sets. The exercises will be performed in a seated position, with the participant's forearm resting on a table and the therapist providing manual resistance. The therapist will be positioned in front of the participant.<br>Other: Mirror therapy<br>* Participants will perform bilateral upper limb movements while observing the reflection of the less affected limb in a mirror. The intervention will be performed three times per week for 8 weeks. Each session will consist of 10 minutes of mirror therapy, with the participant seated in front of a mirror. The participant will perform various upper limb movements, such as reaching and grasping, while observing the mirror reflection of the less affected limb. The therapist will be positioned beside the participant, providing verbal cues and feedback as necessary.<br>|
| Active Comparator: Conventional rehabilitation<br>Participants will receive conventional rehabilitation for post-stroke upper limb motor impairments. | Other: Conventional Physical Therapy<br>* articipants will receive conventional rehabilitation for post-stroke upper limb motor impairments, which may include exercises such as range of motion, stretching, and strengthening of the affected limb, as well as other therapies such as electrical stimulation or constraint-induced movement therapy. The intervention will be individualized for each participant and will be performed three times per week for 8 weeks. The frequency, duration, and intensity of the exercises will be gradually increased over the course of the intervention, based on the participant's progress. The exercises may be performed in a seated or standing position, depending on the participant's ability and preference. The therapist will be positioned in front of or beside the participant, providing verbal cues and feedback as necessary.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Upper limb strength | Upper limb strength (measured by hand-held dynamometry) | Changes in Upper limb strength at baseline, 8 weeks, 16 weeks | 
| Changes in motor function | motor function (measured by Fugl-Meyer Assessment) | Changes in motor function at baseline, 8 weeks, 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Quality of life | Quality of life (measured by Stroke Impact Scale) | Changes in Quality of life at baseline, 8 weeks, 16 weeks |