Added-value of early post-stroke spasticity reduction during arm-hand rehabilitation treatment on improving functional arm-hand skill performance in sub acute stroke patients with a severely or moderately affected arm-hand

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 10

Inclusion Criteria

- Age ><=18 years;
- supratentorial stroke, i.e. arteria cerebri media infarction;
- sub acute phase after stroke, i.e. between 2 weeks and 3 months post-stroke;
- severe paretic arm and hand: UAT score 1-3;
- eligible to participate in a specific arm-hand rehabilitation program (CARAS) for a period of 12 weeks;
- sufficient cognitive level, i.e. being able to understand the questionnaires and measurement instructions;
- functional disabling spasticity in the upper extremity: Modified Ashworth Scale (MAS) score 1+ to 3 (developing within 5 weeks after the start of CARAS).;As to functional disabling spasticity in the upper extremity, patients developing spasticity in the early subacute phase after stroke (i.e. within 5 weeks after the start of CARAS) with a Modified Ashworth Scale (MAS) score of 1+ to 3 will continue to participate in the study. In contrast, in patients who have a severe paretic arm and hand (UAT score 1-3) at admission to the rehabilitation centre, but who do not develop early signs of spasticity within 5 weeks after start of arm-hand treatment (thereby not being in the target group), measurements will cease.

Exclusion Criteria

- severe non-stroke related co-morbidity that may interfere with arm-hand function;
- additional orthopaedic, neurological or rheumatologic impairments of the arms and/or hands and or trunk that may interfere with the execution of the measurements;
- no informed consent.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>- Action Research Arm Test (ARAT), gauging functional capacity.</p><br>

Secondary Outcome Measures

Name	Time	Method
<p>- Fugl-Meyer Motor Assessment (FM), gauging arm-hand function level;<br /><br>- JAMAR strength test, gauging muscle strength;<br /><br>- Motricity Index (MI): Functional strength measurement during performance of<br /><br>daily tasks;<br /><br>- Modified Ashworth Scale (MAS): gauging spasticity levels in the upper<br /><br>extremity;<br /><br>- ABILHAND, gauging perceived level of arm-hand skill/activity proficiency;<br /><br>- Bilateral arm activity monitoring: As to actual arm-hand skill performance,<br /><br>bilateral activity monitors (3D accelerometry, AX3, Axivity Ltd) will be worn<br /><br>around both wrists.</p><br>