The Effects of Attentional Focus on Arm Training in Stroke

Not Applicable

Completed

• Conditions: Stroke

• Registration Number: NCT02890446
• Lead Sponsor: New York Presbyterian Hospital

Brief Summary

This study compares the effects of an internal versus an external focus of attention on motor training of the affected arm for individuals with stroke. Participants were randomly assigned to either the internal or external focus treatment groups and received 12 sessions of arm training.

Detailed Description

Participants were randomized to one of two treatment groups and received upper arm reaching training on the InMotion 2 shoulder robot (12 hourly sessions over four weeks). The external focus group received instructions specifically to pay attention to the task goal--hitting targets on the video game, while the internal focus group was instructed to pay attention to the movement of their arm motions (video game monitor was turned off). Both groups practiced the same arm reaching pattern and were matched for level of arm impairment and training dosage.

Study Timeline

• Study Start: 2014-05
• Primary Completion: 2015-11
• Study Completion: 2015-11
• Status Verified: 2016-08
• Study First Submitted: 2016-08-26
• Study First Submitted QC: 2016-08-31
• Last Update Submitted: 2016-08-31
• Study First Posted: 2016-09-07
• Last Update Posted: 2016-09-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 33

Inclusion Criteria

• diagnosis of stroke > 6 months
• moderate to severe arm impairment
• intact visual scanning and spatial orientation of the affected arm
• functional cognitive status
• medically stable

Exclusion Criteria

• concurrent occupational or physical therapy for the arm
• joint contractures at the wrist, forearm, elbow, or shoulder
• moderate to severe spasticity at the elbow or shoulder
• presence of other neurological conditions
• botulinum toxin injection in the affected arm < 3 months prior
• score of 0/5 on manual muscle test at the elbow or shoulder

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change in quality of arm motion measured by smoothness at the start of arm training, at 4week, and 8 weeks.	baseline, 4 weeks, 8 weeks	kinematic assessment of arm motion measured by average velocity decided by maximum velocity
Change in coordination at the shoulder and elbow measured by joint independence after arm training assessed start of training, discharge and at follow up.	baseline, 4 weeks, 8 weeks	kinematic measure of coordination between the shoulder and elbow joint
Change in motor impairment of the arm measured by Fugl-Meyer Assessment (FMA) at the start of training, discharge, and follow up.	baseline, 4 weeks, 8 weeks	performance based assessment of underlying motor impairment of the affected shoulder, elbow, hand after stroke
Change in motor impairment and functional ability of the arm measured by the Wolf Motor Function Test (WMFT) at start of training, discharge, and follow up.	baseline, 4 weeks, 8 weeks	performance based assessment of underlying motor impairment and function of the affected arm after stroke