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This study will examine the feasibility of providing task-oriented arm training in standing or during walking in individuals with movement deficits due to stroke. Participants will received 24 sessions of arm training in standing over an 8-week period that focus on arm and hand function.
Residual motor deficits are common after stroke and often have a negative impact on the performance of functional activities and overall quality of life. A frequently reported contribution to these functional limitations is an inability to incorporate the weaker arm and hand into daily activities. While rehabilitation interventions can improve arm functional capacity, these improvements often do not translate into increased real-world arm use which is often reduced after stroke.
The performance of skilled arm and hand movements in standing requires precise coordination between upper extremity movement and balance control. Many everyday functional tasks that require the arm are performed in standing (e.g. opening a door or meal preparation at the kitchen counter), however, training of arm function in rehabilitation is often done in sitting. An important rehabilitation approach may be to create a training environment that resembles the way the arm is used in everyday life (i.e. standing). This study will examine the feasibility of providing task-oriented, functional arm training in standing and during walking in individuals with motor deficits due to stroke.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm Training in Standing | Experimental | Task-oriented, functional arm training completed in standing or during walking. All participants receive the same arm training intervention. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Arm training in standing | Behavioral | Arm training will be provided in one hour sessions, 3 time per week for 8 weeks. In each session, you will practice functional tasks with your weaker arm and hand in standing or during walking. Practice will be scaled to match your current level of function and progressed over time as able. |
| Measure | Description | Time Frame |
|---|---|---|
| Sessions Completed | Total number of treatment sessions completed | 8 weeks |
| Fatigue | Mean change in self-reported fatigue from the start to the end of each intervention session | 8 weeks |
| Treatment intensity | Total number of arm repetitions per session and the percent of arm repetitions completed in standing or walking | 8 weeks |
| Action Research Arm Test | Clinical measure of arm and hand function | Change from Baseline to 8 weeks |
| Arm Use Measured with Accelerometers | Arm use measured during a typical day using accelerometers worn on the wrist | Change from Baseline to 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Upper Extremity Fugl-Meyer | Clinical Measure of arm and hand impairment | Change from Baseline to 8 weeks |
| Box & Blocks Test | Clinical measure of hand function |
| Measure | Description | Time Frame |
|---|---|---|
| Berg Balance Scale | Clinical measure of balance. 14-item performance measure with a maximum score of 56; higher score is better. | Change from Baseline to 8 weeks |
| Functional Gait Assessment | Clinical measure of balance |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jll Stewart, PT, PhD | University of South Carolina | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of South Carolina | Columbia | South Carolina | 29208 | United States |
De-identified data will be made available per reasonable request to the principal investigator 1 year after study completion.
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1 year after study completion
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000078783 | Standing Position |
| ID | Term |
|---|---|
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Change from Baseline to 8 weeks |
| Nine-Hole Peg Test | Clinical measure of hand dexterity | Change from Baseline to 8 weeks |
| Stroke Impact Scale Hand Domain Subscale | Patient-reported measure of hand related quality-of-life. Score ranges from 0 to 100 with higher being better. | Change from Baseline to 8 weeks |
| Timed Up and Go | Clinical measure of mobility and balance | Change from Baseline to 8 weeks |
| Activities Specific Balance Confidence Scale | Patient-reported measure of balance confidence. Score ranges from 0 to 100 with higher being better | Change from Baseline to 8 weeks |
| Change from Baseline to 8 weeks |
| Stroke Impact Scale Mobility Subscale | Patient-reported measure of mobility related quality-of-life. Score ranges from 0 to 100 with higher being better | Change from Baseline to 8 weeks |
| Action Research Arm Test | Clinical measure of arm and hand function | Change from Baseline to 12 weeks |
| Arm Use Measured with Accelerometers | Arm use measured during a typical day using accelerometers worn on the wrist | Change from Baseline to 12 weeks |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |