Effect of Interactive Games Based Hand Training on Hand Dexterity and Functional Outcome in Patients With Stroke
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Cairo University
- Enrollment
- 40
- Primary Endpoint
- 1. Power and Pinch grip strength by hand dynamometer.
Study Overview
Brief Summary
This current study will be designed to determine the effect of smart tablets hand training applications on hand functions and functional outcome in patients with stroke. Tablet-based hand function training app with smart tablet exercises:
Patients in the study group will receive 20 min of smart tablet active hand therapy. Patients in the study and control group will receive 30 min of conventional physical therapy program. This program consists of neurodevelopmental facilitation techniques organized specifically for each patient, range of motion exercises, strengthening exercises .
It includes the following functional tasks (reaching, grasping, lifting and placing objects).
Detailed Description
CHAPTER I INTRODUCTION Stroke is the third leading cause of disability in the world-wide due to brain tissue damage following ischemic or hemorrhagic lesions. Survivors present problems carrying out basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs) and their perception of their functional outcome decreases.
Impaired fine motor control of fingers is common after stroke, reducing the ability to grasp and manipulate objects and negatively impacting daily activities and functional outcome .
Various rehabilitation approaches focusing on upper extremity motor rehabilitation, such as constraint induced movement training, task-oriented training, mental practice, and mirror therapy, have been widely applied in clinical practice, although effective to some extent, are often limited by therapist availability, treatment intensity, and patient motivation .
Hand rehabilitation after a stroke is a long process, and motivation is crucial for the patient's outcome. The treatment outcome depends not only on the physical therapist's rehabilitation process but also on the patient's motivation for the training protocols .To make rehabilitation more appealing, game-based training protocols are incorporated into the training system Smart tablets have emerged as an innovative rehabilitation tool that combines visual feedback, gamification, and repetitive task-oriented exercises to promote motor learning. These devices provide flexible and engaging environments for home-based or clinical therapy and allow real-time monitoring of progress . The interactive nature of tablet-based applications helps stimulate neuroplasticity, especially when combined with conventional physiotherapy. Furthermore, technology-enhanced rehabilitation may improve motivation, adherence, and ultimately the functional outcome for stroke survivors and developed as an approach for hemiplegia rehabilitation in the upper extremities in recent decades .
Meanwhile, smart tablet-based hand exercises delivers electrical currents to stimulate peripheral nerves, inducing muscle contractions that may enhance voluntary motor control and cortical reorganization .
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 45 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Forty chronic ischemic stroke patients from both sexes.
- •Their ages will range from 45 - 65 years old.
- •Stroke duration between six months and two years.
- •Spasticity grade of the upper limb is from 1+to 2 according to the Modified Ashworth scale.
- •MMSE score > 24 to ensure adequate cognitive function for following instructions.
- •Patients with at least 20° of wrist flexion/extension and at least 10° of finger flexion and extension of the paretic limb.
- •Brunnstrom stages ≥ 4 were included
- •Medically stable patients.
Exclusion Criteria
- •Other neurological disorders (e.g.: Multiple sclerosis, Parkinsonism…etc).
- •Visual, auditory, and cognitive deficits.
- •Patients with psychological or sever cognitive disorders.
- •Patients with musculoskeletal problems (deformity or contracture).
- •Medically unstable and uncooperative patients.
Arms & Interventions
Group A
This group will receive smart tablet hand training applications for 20 minutes in addition to 30 minutes of conventional physical therapy program
Intervention: interactive games (Other)
Group A
This group will receive smart tablet hand training applications for 20 minutes in addition to 30 minutes of conventional physical therapy program
Intervention: conventional physical therapy (Other)
Group B
This group will receive the same conventional physical therapy program in the form of for prolonged stretch, active upper extremity exercises, balance, gait training and hand function
Intervention: conventional physical therapy (Other)
Outcomes
Primary Outcomes
1. Power and Pinch grip strength by hand dynamometer.
Time Frame: from baseline to 6 weeks post intervention
Hand dexterity by Purdue peg board test.
Time Frame: from baseline to 6 weeks post intervention
Secondary Outcomes
No secondary outcomes reported
Investigators
Marwa Mostafa Abdel Moneim Afifi
Lecturer of physical therapy cairo university
Cairo University