The Application of a Mental Practice Protocol in the Acute Inpatient Rehabilitation Setting

Not Applicable

Completed

• Conditions: Upper Extremity Paresis; Stroke
• Interventions: Other: Traditional Therapy; Other: Repetitive-Task Practice; Other: Mental Practice

• Registration Number: NCT04927728
• Lead Sponsor: Adventist HealthCare

Brief Summary

The purpose of this randomized controlled trial is to compare the effect of audio-guided mental practice (MP) and video-guided MP on the impairment and functional abilities of upper extremity (UE) hemiparesis following a stroke. Participants are recruited from Adventist Healthcare Rehabilitation Hospital. All participants must be less than one-month post-stroke with moderate UE hemiparesis. Eligible participants are randomly assigned to an experimental group, (MP or repetitive-task practice (RTP)), or the control group.

The MP groups will perform either audio-guided MP or video-guided MP, five days a week, with 20 repetitions of the following tasks: wiping a table, picking up a cup, brushing hair, and turning the pages of a book. The RTP group physically performed the same tasks. The control group received traditional stroke rehabilitation.

The investigators hypothesize that video MP will have greater improvements in UE impairments and functional abilities than audio MP, RTP, and/or traditional therapy.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-01-28
• Primary Completion: 2020-11-25
• Study Completion: 2020-11-25
• Status Verified: 2021-06
• Study First Submitted: 2021-06-01
• Study First Submitted QC: 2021-06-09
• Last Update Submitted: 2021-06-09
• Study First Posted: 2021-06-16
• Last Update Posted: 2021-06-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

• Primary diagnosis of stroke
• Less than one-month post-stroke
• Hemiparesis of one upper extremity
• Moderate upper extremity impairment

Exclusion Criteria

• History of prior stroke
• Comorbidities (severe neurological, orthopedic, rheumatoid, or cardiac impairments)
• Severe spasticity
• Severe cognitive impairments
• Inability to perform mental imagery
• Severe aphasia based on speech therapist evaluation
• Low English proficiency
• Severe pain

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Traditional Therapy	Traditional Therapy	The control group received traditional occupational therapy stroke rehabilitation.
Repetitive-Task Practice	Repetitive-Task Practice	Participants of the repetitive-task practice group will complete repetitive practice of one of four tasks: (1) wiping a table (2) picking up a cup (3) brushing hair and/or (4) turning the page of a book. The assigned motor task is based upon the functional abilities of the patient. MP will be performed followed by physical practice of the same task with a research therapist 3x/week and independent MP 2 days/week. Each participant completed at least 20 repetitions of the task.
Audio MP	Mental Practice	Participants of the audio mental practice (MP) group will complete MP via audio-guided multisensory cues of one of four tasks: (1) wiping a table (2) picking up a cup (3) brushing hair and/or (4) turning the page of a book. The assigned motor task is based upon the functional abilities of the patient. MP will be performed followed by physical practice of the same task with a research therapist 3x/week and independent MP 2 days/week. Each audio recording consists of 20 repetitions of the task.
Video MP	Mental Practice	Participants of the video mental practice (MP) group will complete MP via video-guided multisensory cues of one of four tasks: (1) wiping a table (2) picking up a cup (3) brushing hair and/or (4) turning the page of a book. The assigned motor task is based upon the functional abilities of the patient. MP will be performed followed by physical practice of the same task with a research therapist 3x/week and independent MP 2 days/week. Each audio recording consists of 20 repetitions of the task.

Primary Outcome Measures

Name	Time	Method
Fugl Meyer Assessment-Upper Extremity Portion (FMA-UE) (Measuring pre/post intervention change)	Within 3 days of admission and within 3 days prior to discharge	The Fugl Meyer Assessment-upper extremity(FMA-UE) portion will be administered to measure the impairment of the upper extremity. Upper extremity movements are rated on 3-point ordinal scale where 0= unable to perform, 1= performs partially, 2= performs fully. Cumulative scores range from 0-66 where a lower score indicates increased impairment.
Wolf Motor Function Test (WMFT) (Measuring pre/post intervention change)	Within 3 days of admission and within 3 days prior to discharge	The Wolf Motor Function Test (WMFT) is used to measure the functional abilities of the UE. 15 tasks are performed including six timed joint-segment movements and eight timed integrative functional movements. Tasks are rated on a 6-point ordinal scale where 0= does not attempt to 5=movement appears to be normal. Timed and functional ability scores are calculated to indicate the functional abilities of the UE.

Trial Locations

Locations (1)

Adventist Healthcare Rehabilitation; 🇺🇸 Rockville, Maryland, United States