Rapid Movement Therapy for Stroke Rehabilitation

Recruitment & Eligibility

Inclusion Criteria

have single stroke with onset >1 year,
have unilateral paresis,
are 50 years of age or older,
able to stand without aid for at least 15min,
have moderate level of motor impairment in the affective upper limb, i.e. 15≤ Fugl-Meyer Assessment for upper-extremity(FMA-UE) ≤ 45,
have some level of deficit in balance control, i.e. Berg Balance Scale(BBS)< 52/56,
have a minimum Snellen visual acuity of 20/40 with/without spectacles,
have a minimum Mini-Mental-Status-Examination score of 22/30, and
have to be able to follow the training procedures.

Exclusion Criteria

enrolled in other rehabilitation program in the study duration,
have other neurological conditions in addition to stroke (e.g. Parkinson's disease),
have unstable cardiovascular disease (e.g. history of heart disease, or poorly controlled hypertension, i.e. blood pressure >160mmHg/100mmHg), or
have other serious diseases or conditions (e.g. osteoporosis, recent joint replacement surgery, amputation) that preclude them from participating in the study.

Study & Design

Arm && Interventions

Group	Intervention	Description
Kinect based Rapid Movement Therapy	Balance training	Kinect based Rapid Movement Therapy (RMT) training requires participants to move their limbs very rapidly to reach-to-grasp or step towards a virtual target appear suddenly on a screen, which is designed to their range of motion as well as response speed.
Conventional balance training	Balance training	Conventional balance training involves some slow and low-impact muscle strengthening and mobilizing exercises.

Primary Outcome Measures

Name	Time	Method
Timed Up and Go (TUG)	3-month follow-up	It is used to assess mobility, balance, walking ability, and fall risk in older adults
Berg Balance Scale (BBS)	3-month follow-up	A 14-item objective measure designed to assess static balance and fall risk in adult populations

Secondary Outcome Measures

Name	Time	Method
Fugl-Meyer Assessment (FMA) of Motor Recovery after Stroke	3-month follow-up	It is used to evaluate and measure recovery in post-stroke hemiplegic patients
Barthel Index of Activities of Daily Living	3-month follow-up	It is used to assess the ability of an individual with a neuromuscular or musculoskeletal disorder to care for him/herself
Activities-specific Balance Confidence (ABC) Scale	3-month follow-up	Subjective measure of confidence in performing various ambulatory activities without falling or experiencing a sense of unsteadiness
Electromyography (EMG)	3-month follow-up	It is used to detect the muscle activity
"lean-and-release" postural system	3-month follow-up	It is used to evaluate balance-recovery in chronic stroke patients. Participants will wear a safety harness designed to prevent impact between body and floor, and they will be asked to stand on two force plates in standardized stance and lean forward with around 10% body weight supported by a cable attached to a release mechanism. Compensatory balance-recovery reactions will be evoked by the sudden release of the support cable, inducing a forward fall. Participants will be evaluated under three different conditions: no handrail, handrail on the unaffected side, and handrail on the affected side.

Recruitment & Eligibility