The objective of this explorative study is to examine the potential of motor imagery therapy and gravity compensation training for restoration of arm function after stroke, separated in two parts; to gain insight in the cortical activity of mirror…
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Source
Brief title
Condition
- Central nervous system vascular disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
In this study we are interested in the changes in cortical activity (measured
by electroencephalography, EEG), muscle activity (measured by electromyography,
EMG), and biomechanical aspects (measured by movement analysis techniques)
during arm training.
Secondary outcome
Next to the mentioned aspects on impairment level, we are interested in changes
of functional abilities of the arm during arm training. This will be measured
using the Fugl-Meyer motor assessment (FM), and the Motricity Index (MI).
Background summary
After a stroke, many patients suffer from an impaired motor task performance.
Optimal restoration of arm and hand function is important for stroke patients
to independently perform activities of daily living. Several perceptual and
motor aspects play a role in the restoration of arm function after stroke.
During observation of a movement (motor imagery) similar parts of the brain are
active as during execution of a movement (mirror neurons) in healthy persons.
This may stimulate motor recovery after stroke by means of motor imagery
therapy, where mirror neuron activity during movement observation may
facilitate cortical activity related to movement execution.
To further stimulate restoration of arm function, it is important that
rehabilitation includes intensive, active and functional movement exercise,
adjusted to the abilities of each patient. To achieve a high intensity of
training, active movements may be facilitated by the application of gravity
compensation, or arm support. To optimize motor relearning, augmented feedback
providing additional information about the movement execution can be applied
during training by means of a game-like environment, which can also enhance
patient motivation during training.
In summary, relearning of arm movements may be stimulated perceptually by
facilitation through motor imagery and via motor aspects by training using
gravity compensation in a game-like environment. However, the cortical activity
of mirror neurons in stroke patients as mechanism behind motor imagery is still
unknown. Also, it is unknown if training with gravity compensation and
augmented feedback using a motivating game actually improves arm function of
stroke patients. Therefore, we designed this study to examine the potential of
motor imagery therapy and gravity compensation training for restoration of arm
function after stroke.
Study objective
The objective of this explorative study is to examine the potential of motor
imagery therapy and gravity compensation training for restoration of arm
function after stroke, separated in two parts; to gain insight in the cortical
activity of mirror neurons after stroke (mirror neuron activity), and to
investigate whether arm function improves after gravity compensation training
with augmented feedback by a motivating game (gravity compensation training).
Study design
The first part (mirror neuron activity) has a cross-sectional design, in which
cortical activity is measured during both active movement and movement
observation in one measurement session.
In the second part (gravity compensation training) a longitudinal design is
used, in which arm function is measured before and after gravity compensation
training.
Intervention
No intervention will be given in the part studying the mirror neuron activity.
In the part concerning gravity compensation training, a period of training is
applied in which the arm of the patient is supported by an apparatus, which
compensates gravity during reaching movements. The arm movements with gravity
compensation are practiced in a game-like environment, which provides augmented
feedback and enhances motivation. The training has a duration of 6 consecutive
weeks, with 3 training sessions of 30 minutes per week and is supervised by a
trained physical or occupational therapist.
Study burden and risks
The risks for the subject are limited to a minimum, since the movement tasks
represent functional and familiar arm movements and are performed only within
the scope of the subject*s ability while he/she is seated. In addition, the
measurements used in this study (EEG, EMG, motion analysis, functional scales)
are all non-invasive and involve no risks to the patients in any way.
Participation of a subject in this experiment has no direct benefit for
him/her, other than expanding knowledge about underlying mechanisms relevant
during the restoration of arm function during post-stroke rehabilitation. This
may eventually aid in the development of new applications or adaptations to
existing treatments in the rehabilitation of arm function after stroke.
Roessingsbleekweg 33b
7522 AH Enschede
Nederland
Roessingsbleekweg 33b
7522 AH Enschede
Nederland
Listed location countries
Age
Inclusion criteria
Stroke (>6 months post-stroke)
Active (partial) movement or voluntary noticeable initiation of shoulder abduction and/or elbow flexion/extension
Able to decide whether to participate or not and to sign an informed consent
Exclusion criteria
Pain of in the upper part of the body, (like shoulder pain) in rest or during movements
Additional neurologic, orthopedic of rheumatologic ailments, which might constrain the mobility and/or force of the arm
Inability to understand and/or to obey the instructions given
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL17290.080.07 |