Non-use après Accident Vasculaire cérébral : Influence de la Force et de la précision du Geste à Fournir Lors Des Mouvements du Membre supérieur parétique
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Stroke
- Sponsor
- Centre Hospitalier Universitaire de Nīmes
- Enrollment
- 53
- Locations
- 2
- Primary Endpoint
- Evaluate the modifications of the proximal non-use after stroke on the paretic side according to the extent of force constraint
- Status
- Completed
- Last Updated
- 4 months ago
Overview
Brief Summary
After a stroke, 80% of patients have an upper limb deficit, limiting activity. Some develop a non-use: they can, but do not, use their paretic limb. Non-use is a general phenomenon applied to all situations where the patient applies unnecessary compensation. Several rehabilitation techniques are effective to counter non-use, but there is insufficient knowledge to choose the most suitable technique. Optimal control theory could help guide these choices. It assumes that the chosen coordination satisfies the constraints of the task (force, amplitude, tolerance) while reducing the cost of the movement. This study will assess non-use by anticipating the sensitivity to the constraints of force and precision deduced from the logic of optimal control. The study authors expect to observe a weakness effect: in a reaching task (i.e. when the person has to touch an object placed in front of them), lightening the paretic arm makes it possible to reduce non-use, and a precision effect: in a reaching task, non-use increases with the required spatial precision.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Inclusion criteria specific to the stroke group:
- •Patient having had a 1st stroke
- •Patient whose stroke occurred more than a month ago.
- •Patient having had a supratentorial stroke
- •Patient able to touch the opposite knee with the paretic arm
- •Inclusion criteria specific to the control group:
- •Subject who has never had a stroke
- •Subject without motor or orthopedic impairment of the upper limbs and in particular of the shoulder
- •General inclusion criteria:
- •Subject who has given free and informed consent.
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Evaluate the modifications of the proximal non-use after stroke on the paretic side according to the extent of force constraint
Time Frame: Inclusion
Proximal Arm Non Use (PANU) score (%): A significant PANU (\> 7.5%) indicates non-use
Secondary Outcomes
- Evaluate the modifications of the proximal non-use in the control subjects according to the constraints of force or precision(Inclusion)
- Intensity of arm deficit(Inclusion)
- height of the target(Inclusion)
- Model the constraints and costs explaining non-use patient by patient, to distinguish between physiological and psycho-behavioral non-use(Inclusion)
- Evaluate the level of neuromuscular activation during reaching(Inclusion)
- Time since stroke (acute, subacute or chronic phase)(Inclusion)
- Evaluate the modifications of the proximal non-use after stroke on the paretic side according to the precision required(Inclusion)