Clinical trial NCT05847595: Implicit Versus Explicit Motor Training for Upper Extremity Rehabilitation in Chronic Stroke Patients
Official title: Implicit Versus Explicit Motor Training for Upper Extremity Rehabilitation in Chronic Stroke Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: CVA (Cerebrovascular Accident)
Lead sponsor: Egyptian Chinese University
Sponsor class: OTHER
First posted: 2023-05-06
Enrollment: 66
Sex: ALL
Minimum age (years): 50
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Training methods that improve proprioception of the shoulder joint involve specific tasks targeting joint position sense, kinesthesia, or sense of force. These exercises can involve explicit or implicit motor learning. Explicit learning involves verbal knowledge of movement performance, while implicit learning involves minimal verbal knowledge and learning in a less conscious manner. The purpose of the study is to identify the efficacy and difference between implicit and explicit motor training in improving upper extremity functions in chronic stroke patients. The study will use laser pointer pattern tracking exercises and precise repositioning tasks for explicit motor training and a cognitive-motor dual-task training for implicit motor training. The laser-pointer assisted angle reproduction test, Wolf Motor Function Test and Arm Motor Ability Test will be used for evaluation.


Eligibility criteria: Inclusion Criteria:

1. Age is ranging between 50 to 65 years
2. Diagnosis of a single stroke 6 months to 2 years prior to study entry confirmed by neuroimaging reports (to minimize the chance that improvements occur because of spontaneous recovery).
3. Sufficient cognitive and language abilities to understand and follow multiple-step instructions (a score of 24 or more on the mini mental state examination).
4. Adequate vision to track the laser beam.
5. Muscle strength of ≥ 3/5 for all upper extremity joints on manual muscle testing.
6. Subjects are able at least to partially move outside of synergies at the affected elbow (Brunnstrom recovery stage in the upper limb following stroke is 4 or greater)
7. Spasticity at the paretic elbow, wrist, or fingers, defined as a score less than 2 on the modified Ashworth scale.

Exclusion Criteria:

1. Uncontrolled seizure disorders.
2. Additional neurological impairments, for example, Parkinson disease that (severely) influence their upper limb functions.
3. Excessive spasticity at the paretic upper limb muscles defined as a score equal or more than 2 on the modified Ashworth scale.
4. Excessive pain in the affected UE, as measured by a score of 5 or higher on a 10-point visual analog scale.
5. Patients with musculoskeletal disorders of upper limb joints, such as severe arthritis, fractures, or fixed deformities.
6. Patients with cognitive, visual, or auditory impairments.

Primary outcomes:
measure: Upper extremity motor ability
timeFrame: 4-weeks
measure: ADL functions of the upper extremity
timeFrame: 4-weeks
Secondary outcomes:
measure: Shoulder joint proprioception
timeFrame: 4-weeks
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Egyptians Chinese University
Study officials:
References: