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| Name | Class |
|---|---|
| Clinalliance Villiers-sur-Orge | UNKNOWN |
| Centre de Rééducation Fonctionnelle Pasori | UNKNOWN |
| CHU de Reims | OTHER |
| Clinique Les Grands Chênes |
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Hemiparesis is a common motor disorder after a stroke. The majority of patients do not recover functional use of their paretic upper limb.
The use of mirror therapy allows the activation of the mirror neurons involved to stimulate brain plasticity after brain damage.The IVS (Intensive Visual Stimulation) device allows an easy implementation of mirror therapy by filming the valid upper limb and projecting the inverted image onto a screen placed above the parietal arm thus producing the illusion of movement of the parietal arm.
The main hypothesis of this study is that the structured practice of a large number of upper limb targeted movement repetitions using an intensive visual numerical simulation device as a partial replacement for routine care (conventional occupational therapy) in the sub-acute phase of stroke will increase the active function (motor function and functional abilities) of the distal end of the upper limb compared to conventional rehabilitation.
Objectives: This randomized controlled trial will evaluate the effects of partial substitution of routine care (occupational therapy) by structured movement repetition programs by Intensive Visual Simulation using an IVS3 device, on the distal motor control of the upper hemiparesis limb, between 4 and 10 weeks after the stroke, compared to a program with conventional care alone.
Hemiparesis is a common motor disorder after a stroke. The majority of patients do not reuse their paretic upper limb.
Hypothesis: The structured practice of repeating upper limb movements by Intensive Visual Simulation will increase distal motor control, and improve the objective functional abilities of the upper limb.
Main Objective:Evaluate in a controlled protocol the effects, on the distal motor control of the upper hemiparesis limb, between 4 and 10 weeks after stroke, of 6 weeks of partial substitution of routine care (occupational therapy) by structured movement repetition programs by Intensive Visual Simulation using an IVS3 device, compared to 6 weeks of a program involving only conventional rehabilitation care, in a population of moderate to severe hemiparesis stroke patients in subacute phase.
Device Description: The IVS3 (Intensive Visual Simulation) rehabilitation device, marketed by Dessintey, allows the implementation of intensive mirror therapy by making it more immersive, ergonomic, and accessible. The IVS3 device consists of a hollow table adjustable in height, a touch screen dedicated to the therapist to set up the device and a large screen adjustable in height and sliding laterally to overlap the upper limb and thus allow the illusion that the limb visible on the screen is the paretic upper limb.
Methods: Multicentric randomised controlled Trial.
Risk/Constraint: To our knowledge, this research does not involve any risks other than those of daily life. The medical device will be used under normal conditions of use as described in the user manual. No contraindications are specified for this device. A risk of discomfort may be felt by the patient during the first few minutes of use. Possibility of feeling tired.
Research duration : 8 years Duration of patient participation : 18 weeks
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional Rehabilitation | Active Comparator | at least 4 sessions/week for 6 weeks, from 1 hour of conventional upper limb rehabilitation by an occupational therapist. |
|
| Intensive Visual Simulation | Experimental | at least 4 sessions/week for 6 weeks, of 1 hour of upper limb rehabilitation including 45 minutes of conventional rehabilitation (occupational therapy) and 15 minutes of work with a medical device allowing intensive visual digital simulation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional rehabilitation | Other | upper limb rehabilitation involving submaximal passive amplitude stretching movements, inhibition postures, active efforts assisted of varying difficulty, target approach exercises with or without elbow support and gripping tasks, adapted to the upper limb's paresis abilities. The patient will be encouraged to gradually dispense with the assistance provided by the therapist or any technical assistance (suspension...) and thus to carry out the exercises in free active as soon as possible. |
| Measure | Description | Time Frame |
|---|---|---|
| Change of motor performance score on the Fugl-Meyer sub-score wrist/hand | Fugl-Meyer (FM) assessment for measures of the motor impairment of the upper-limb; the sub-score wrist/hand includes items related to movements of the forearm (proximal arm), wrist, hand (distal arm) and speed/coordination during a finger-nose task. The total sub-score range between 0 and 30. | between Day1(day of program start), Week6 (end of the program) |
| Measure | Description | Time Frame |
|---|---|---|
| Change of motor performance score on the Fugl-Meyer | Fugl-Meyer (FM) assessment for measures of the motor impairment of the upper-limb; the test includes items related to movements of the shoulder, elbow, forearm (proximal arm), and wrist and hand (distal arm). The total scores range between 0 and 66. | between Day1(day of program start), Week6 (end of the program) and Week18 (12 weeks after the end of the program) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| SAS Les POMPON | Contact | +33164718000 | ag.grosmaire@les-trois-soleils.fr | |
| Christophe DURET, MD | Contact | +33 164 718 000 | direction@les-trois-soleils.fr |
| Name | Affiliation | Role |
|---|---|---|
| Christophe DURET, MD | Clinique Les Trois Soleils | Principal Investigator |
| Manuel Wiese, MD | Clinalliance Villiers-sur-Orge | Principal Investigator |
| Nikolay DOBREV, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Sébastopol | Not yet recruiting | Reims | Champagne-Ardenne | 51092 | France |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D010291 | Paresis |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| UNKNOWN |
| Clinique Napoléon | UNKNOWN |
| Clinique Mariénia | UNKNOWN |
| Clinique Verdaich | UNKNOWN |
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|
| Intensive Visual Simulation | Device |
Conventional rehabilitation upper limb rehabilitation involving submaximal passive amplitude stretching movements, inhibition postures, active efforts assisted of varying difficulty, target approach exercises with or without elbow support and gripping tasks, adapted to the upper limb's paresis abilities. The patient will be encouraged to gradually dispense with the assistance provided by the therapist or any technical assistance (suspension...) and thus to carry out the exercises in free active as soon as possible. |
|
| Change of motor capacity on Stroke Upper Limb Capacity Scale (SULCS) | The scale measures active upper limb capacity in hemiparesis based on 10 items, with each item having a possible score of 0 or 1. Three items for arm capacity without active hand capacity, four items for arm capacity and basic hand capacity and three items for complex hand capacity.The total scores range between 0 and 10. | between Day1(day of program start), Week6 (end of the program) and Week18 (12 weeks after the end of the program) |
| Change of spasticity score of the elbow flexors, wrist flexors, finger flexors measured by the Modified Ashworth Scale (MAS) | The Modified Ashworth scale (MAS) measures resistance during passive soft-tissue stretching and is used as a simple measure of spasticity. Scoring :0: No increase in muscle tone
| between Day1(day of program start), Week6 (end of the program) and Week18 (12 weeks after the end of the program) |
| Change in perceived stroke impact on the Stroke Impact Scale (SIS) | The Stroke Impact Scale (SIS) is a 59 item patient reported outcome measure, covering 8 domains: strength (4 items), hand function (5 items), mobility (9 items), activities of daily living (10 items), memory (7 items), communication (7 items), emotion (9 items), and handicap (8 items). Domains are scored on a metric of 0 to 100, with higher scores indicating better self-reported health. Four of the scales of the SIS can be combined into a composite physical domain (strength, hand function, physical and instrumental activities of daily living, and mobility), with scores also presented on a 0 to 100 metric. | between Day1(day of program start), Week6 (end of the program) and Week18 (12 weeks after the end of the program) |
| CRF PASORI |
| Principal Investigator |
| François BOYER, Professor | Hôpital Sébastopol, CHU de Reims | Principal Investigator |
| Caroline TERRACOL, MD | Clinique Marienia Inicea | Principal Investigator |
| Jean-Marc GUEBLE, MD | Clinique Verdaich | Principal Investigator |
| Adrien PETIT, MD | Clinique Les Grands Chênes Inicea | Principal Investigator |
| Magali CAPLANNE, MD | Clinique Napoléon Inicea | Principal Investigator |
| Clinique Napoléon | Not yet recruiting | Saint-Paul-lès-Dax | New Aquitaine | 40990 | France |
|
| Clinique Les Trois Soleils | Recruiting | Boissise-le-Roi | 77310 | France |
|
| CRF Pasori | Recruiting | Cosne-Cours-sur-Loire | 58200 | France |
|
| Clinalliance Villiers-sur Orge | Recruiting | Villiers-sur-Orge | 91700 | France |
|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |