Unilateral Strength Training and Mirror Therapy for Enhancing Upper Limb Motor Function Post Stroke: A Pilot Randomised Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Institute of Technology, Sligo
- Enrollment
- 35
- Locations
- 1
- Primary Endpoint
- Maximal Peak Torque Isometric elbow extension strength.
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
This is a pilot randomised controlled trial investigating a combination of unilateral strength training (cross-education) and mirror therapy for the rehabilitation of upper limb impairment following a stroke. This study has been conducted as part of a PhD qualification at the Institute of Technology Sligo in Ireland with all assessments being conducted at the institute and all therapy sessions taking place at the participant's home. The study was conducted in conjunction with Sligo University Hospital and it attained ethical approval through the relevant University Hospital Ethics Committee.
Detailed Description
The study necessitated patients with chronic stroke to perform a strength training programme with their less-affected upper limb. The mirror and strength training group observed the reflection of the training limb in a mirror, the strength training only group exercised without a mirror entirely. Patients were referred through Hospital Health Professionals. Prior to trial commencement all participants were given comprehensive trial information and provided signed written informed consent. A total of 32 participants were recruited. After a warm-up participants performed 4 sets of 5 maximal isometric elbow extensions with their less-affected upper limb, three days per week, for four weeks. Patients received outcome assessment prior to the beginning of the intervention, directly after it and at three-month follow-up assessment. All assessments were carried out by a blinded Chartered Physiotherapist specialising in stroke rehabilitation. Patients were assessed using established outcome measures for upper limb isometric strength, motor function, muscle tone, and self-perceived participation.
Investigators
Dr. John Bartlett
Head of Research
Institute of Technology, Sligo
Eligibility Criteria
Inclusion Criteria
- •Chronic stroke diagnosed by a physician at least 6 months prior to study begin Discharged from formal rehabilitation services (not receiving outpatient rehabilitation on more than a monthly basis, but may still be in receipt of occupational or language therapy).
Exclusion Criteria
- •Impaired cognition (Mini mental state examination (MMSE) \< 21) Cardiovascular, neurological or musculoskeletal impairments of the upper extremity not related to stroke that would prevent strength training.
- •Visual impairments that would interfere with the ability to participate safely in isometric training and observe mirror images.
Outcomes
Primary Outcomes
Maximal Peak Torque Isometric elbow extension strength.
Time Frame: 10 minutes
Assessed with the Biodex System 3 Pro Isokinetic Dynamometer with the Biodex Advantage Software version 3.45 (Biodex Medical Systems, Inc., Shirley, New York, USA). Highest Peak Torque out of 5 single isometric contractions was analysed. A higher peak torque measurement indicates a greater contraction strength.
Maximal Rate of Torque Development Isometric elbow extension strength.
Time Frame: 10 minutes
Assessed with the Biodex System 3 Pro Isokinetic Dynamometer with the Biodex Advantage Software version 3.45 (Biodex Medical Systems, Inc., Shirley, New York, USA). Average Torque Development out of 5 single isometric contractions was analysed. A higher average torque measurement indicates a greater contraction strength.
Secondary Outcomes
- Modified Ashworth Scale (MAS).(10 minutes.)
- Chedoke Arm and Hand Activity Inventory - 8 Version(10 mins)
- ABILHAND Questionnaire(10 mins)
- London Handicap Scale (LHS).(10 minutes)