Clinical trial NCT06688812: Comparing Perceptual Motor Training and Repetitive Facilitation Exercises on UE in Stroke
Official title: Comparative Effects of Perceptual Motor Training and Repetitive Facilitation Exercises on Upper Limb Quality of Movement and Motor Function in Stroke Patients
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Stroke
Keywords: exercise
motor skills
rehabilitation
stroke
upper extremity
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-11-14
Enrollment: 50
Sex: ALL
Minimum age (years): 40
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of the study is to determine the comparative effects of perceptual motor training and repetitive facilitation exercises on upper limb quality of movement and motor function in Stroke patients.

Detailed description: Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation.

This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks.

Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.

Eligibility criteria: Inclusion Criteria;

* Both male and female patients.
* Age 40-65 years
* 1st ever stroke confirmed by MRI
* mild-to-moderate upper-limb motor paralysis
* sub-acute and chronic stroke patients
* ability to understand tasks such as evaluations in the intervention
* Modified Ashworth scale score \< 3
* Mini Mental State Examination Score should be\>24 out of 30

Exclusion Criteria:

* Participants who have a history of significant neurological or psychiatric disorders, other than stroke, that could interfere with upper limb motor recovery
* Patients with pain, contracture and profound atrophy in arm and fingers.
* Participants with severe cognitive dysfunction that would interfere with understanding instructions from the physician or therapist.
* Presence of any other musculoskeletal condition. e.g. (Frozen shoulder, any recent fractures of upper limb.
* Any accompanying diseases or disorders, other than stroke, that could interfere with upper extremity training.
* Uncontrolled health conditions for which exercise was contraindicated.

Primary outcomes:
measure: 1. Motor Evaluation Scale For Upper Extremity In Stroke Patients (MESUPES)
timeFrame: 8 week
measure: 2. Fugl-Meyer Assessment (FMA):
timeFrame: 8 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Sargodha
country: Pakistan
facility: Dr. Faisal Masood Teaching Hospital
state: Punjab
Study officials:
affiliation: Riphah International University
name: Hira Jabeen, MS-NMPT
role: STUDY_CHAIR
References:
citation: McGregor HR, Cashaback JGA, Gribble PL. Somatosensory perceptual training enhances motor learning by observing. J Neurophysiol. 2018 Dec 1;120(6):3017-3025. doi: 10.1152/jn.00313.2018. Epub 2018 Sep 19.
citation: Soltani Kouhbanani S, Arabi SM, Zarenezhad S, Khosrorad R. The Effect of Perceptual-Motor Training on Executive Functions in Children with Non-Verbal Learning Disorder. Neuropsychiatr Dis Treat. 2020 May 5;16:1129-1137. doi: 10.2147/NDT.S252662. eCollection 2020.
citation: Bergmann F, Gray R, Wachsmuth S, Honer O. Perceptual-Motor and Perceptual-Cognitive Skill Acquisition in Soccer: A Systematic Review on the Influence of Practice Design and Coaching Behavior. Front Psychol. 2021 Dec 2;12:772201. doi: 10.3389/fpsyg.2021.772201. eCollection 2021.
citation: Platzer WS. Effect of perceptual motor training on gross-motor skill and self-concept of young children. Am J Occup Ther. 1976 Aug;30(7):422-8.
citation: Fujimoto K, Ueno M, Etoh S, Shimodozono M. Combined repetitive facilitative exercise under continuous neuromuscular electrical stimulation and task-oriented training for hemiplegic upper extremity during convalescent phase after stroke: before-and-after feasibility trial. Front Neurol. 2024 Feb 22;15:1356732. doi: 10.3389/fneur.2024.1356732. eCollection 2024.
citation: Purton J, Sim J, Hunter SM. Stroke survivors' views on their priorities for upper-limb recovery and the availability of therapy services after stroke: a longitudinal, phenomenological study. Disabil Rehabil. 2023 Sep;45(19):3059-3069. doi: 10.1080/09638288.2022.2120097. Epub 2022 Sep 15.
citation: Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M. Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. J Hand Ther. 2022 Oct-Dec;35(4):507-515. doi: 10.1016/j.jht.2021.01.005. Epub 2021 Jan 26.