Deficit Fields for Stroke Recovery
- Conditions
- Stroke
- Interventions
- Behavioral: Deficit-fields to reduce errorBehavioral: Deficit-fields to improve functionBehavioral: Deficit-fields to expand range of motion
- Registration Number
- NCT02570256
- Lead Sponsor
- Shirley Ryan AbilityLab
- Brief Summary
This study investigates the potential of customized robotic and visual feedback interaction to improve recovery of movements in stroke survivors. While therapists widely recognize that customization is critical to recovery, little is understood about how take advantage of statistical analysis tools to aid in the process of designing individualized training. Our approach first creates a model of a person's own unique movement deficits, and then creates a practice environment to correct these problems. Experiments will determine how the deficit-field approach can improve (1) reaching accuracy, (2) range of motion, and (3) activities of daily living. The findings will not only shed light on how to improve therapy for stroke survivors, it will test hypotheses about fundamental processes of practice and learning. This study will help us move closer to our long-term goal of clinically effective treatments using interactive devices.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 45
STROKE SURVIVORS:
- adult (age >18)
- Chronic stage stroke recovery (8+ months post)
- available medical records and radiographic information about lesion locations
- strokes caused by an ischemic infarct in the middle cerebral artery
- primary motor cortex involvement
- a Fugl-Meyer score (between 15-50) to evaluate arm motor impairment level
HEALTHY CONTROL PARTICIPANTS:
- adult (age >18)
- healthy individuals with no history of stroke or neural injury
- bilateral paresis;
- severe sensory deficits in the limb
- severe spasticity (Modified Ashworth of 4) preventing movement
- aphasia, cognitive impairment or affective dysfunction that would influence the ability to perform the experiment
- inability to provide an informed consent
- severe current medical problems
- diffuse/multiple lesion sites or multiple stroke events
- hemispatial neglect or visual field cut that would prevent subjects from seeing the targets.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Deficit-fields to reduce error Deficit-fields to reduce error We hypothesize that a deficit-field design, using the statistics of a patient's errors to customize training, will provide optimal augmentation that varies during motion as needed. We will compare the training effects of error deficit-fields with previous methods of error augmentation to improve reaching ability. Deficit-fields to improve function Deficit-fields to improve function Here we present visual distortion of whole body movement during manual tasks during standing, including reaching, grasping, and object manipulation. We compare the training effects of feedback based on deficit-fields versus practice with normal vision. Deficit-fields to expand range of motion Deficit-fields to expand range of motion Amplifying augmentation can expand motor exploration and improve skill retention in patients. Using motor exploration patterns from each patient, we will form customized deficit-fields to recover normal joint workspace. We will compare augmentation training that either amplifies or diminishes the observed deficits (Expt-1). We also compare deficit-fields with our prior augmentation methods to determine the added value of increased customization (Expt-2).
- Primary Outcome Measures
Name Time Method Arm motor recovery scores on the Fugl-Meyer Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change from baseline in arm motor recovery as measured by Fugl-Meyer
- Secondary Outcome Measures
Name Time Method Modified Ashworth Scale (MAS) Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change from baseline in amount of spasticity in elbow flexors and extensors
Time and completion score for Action Research Arm Test (ARAT) Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change in baseline score and time for completion of functional measures as part of ARAT
Number of blocks transferred in Box and Blocks Test Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change from baseline in number of blocks transferred during Box and Blocks Test
Elbow active range of motion (ROM) Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change from baseline measured in degrees for elbow flexion and extension
Chedoke McMaster Stroke Assessment for Hand Baseline at beginning of week 1 and 3 prior to intervention; post-evaluation at end of week 4; follow-up evaluation at end of week 5 Change in baseline in amount of hand motor recovery as measured by Chedoke scale
Trial Locations
- Locations (1)
Rehabilitation Institute of Chicago
🇺🇸Chicago, Illinois, United States