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The goal of this clinical trial is to examine the effects of mirror therapy combined with task- vs. Impairment-oriented rehabilitation programs as novel hybrid approaches in individuals with stroke. Participants will receive mirror therapy combined with the task-oriented rehabilitation program (MTT), mirror therapy combined with the impairment-oriented rehabilitation program (MTI), or task-oriented rehabilitation program combined with the impairment-oriented rehabilitation program (TI) 90 minutes per day, three days per week, for six weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mirror therapy combined with the task-oriented approach (MTT) | Experimental | Each participant will receive the mirror therapy combined with the task-oriented approach 90 minutes daily, three days per week for six weeks. |
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| Mirror therapy combined with the impairment-oriented approach (MTI) | Experimental | Each participant will receive the mirror therapy combined with the impairment-oriented approach 90 minutes daily, three days per week for six weeks. |
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| Task-oriented rehabilitation program combined with impairment-oriented rehabilitation program (TI) | Active Comparator | Each participant will receive the task-oriented rehabilitation program combined with the impairment-oriented rehabilitation program 90 minutes daily, three days per week for six weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mirror therapy | Behavioral | In mirror therapy, a wooden mirror (41×50×33 cm3) will be positioned in the participant's sagittal midplane, blocking the participant's view of the affected arm performance. We will also provide a foldable bed tray table to ensure that the participants focus on the mirror reflection of the less affected arm. The mirror therapy will consist of movement and functional practices. |
| Measure | Description | Time Frame |
|---|---|---|
| Fugl-Meyer Assessment | A standardized tool for evaluating motor impairment for stroke | Baseline, six weeks, and 3 months after completing the intervention |
| Revised Nottingham Sensory Assessment | A standardized tool for evaluating sensory impairment for stroke | Baseline, six weeks, and 3 months after completing the intervention |
| Chedoke Arm and Hand Activity Inventory | An assessment for bilateral functional abilities | Baseline, six weeks, and 3 months after completing the intervention |
| Wolf Motor Function Test | An assessment for both unilateral and bilateral functional abilities | Baseline, six weeks, and 3 months after completing the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Grip and pinch power | The measurements of the strength of hand movements | Baseline, six weeks, and 3 months after completing the intervention |
| Box and block test | A measurement for evaluating functional hand use by measuring the number of blocks moved within a set time |
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Inclusion Criteria:
Exclusion Criteria:
1. Serious medical problems or poor physical conditions that might be detrimental to study participation.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yi-chun Li, Doctor | Contact | +886-7-6151100 | 7514 | joyjoyfish@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Yi-chun Li, Doctor | I-Shou University | Principal Investigator |
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| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D000088762 | Mirror Movement Therapy |
| ID | Term |
|---|---|
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D013812 | Therapeutics |
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| Task-oriented approach | Behavioral | The task-oriented approach will provide both bimanual common-goal and dual-goal tasks for the participants. |
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| Impairment-oriented approach | Behavioral | The impairment-oriented approach will focus on the movement components. Arm BASIS or Arm Ability training will be provided based on the severity of the participant's impairment. |
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| Baseline, six weeks, and 3 months after completing the intervention |
| Ten-meter walk test | A test for measuring walking speed and stride length over a fixed distance to assess mobility and functional status | Baseline, six weeks, and 3 months after completing the intervention |
| Berg Balance Scale | A measurement for evaluating balance abilities through a series of functional tasks | Baseline, six weeks, and 3 months after completing the intervention |
| Motor Activity Log | A self-report tool used to assess the amount and quality of use of an affected limb during daily activities | Baseline, six weeks, and 3 months after completing the intervention |
| ABILHAND Questionnaire | A self-reported assessment tool used to measure manual ability by evaluating their perceived difficulty in performing bimanual tasks | Baseline, six weeks, and 3 months after completing the intervention |
| Functional independent measure | An assessment tool that evaluates a person's level of disability and functional independence in performing daily activities, covering areas such as self-care, mobility, communication, and social cognition | Baseline, six weeks, and 3 months after completing the intervention |
| Nottingham Extended Activities of Daily Living Scale | An assessment tool designed to measure a person's ability to perform daily activities | Baseline, six weeks, and 3 months after completing the intervention |
| Stoke Impact Scale | A comprehensive self-reported questionnaire that assesses the impact of a stroke on life | Baseline, six weeks, and 3 months after completing the intervention |
| Stroke Self-Efficacy Questionnaire | A tool used to evaluate a stroke survivor's confidence to perform daily activities | Baseline, six weeks, and 3 months after completing the intervention |
| Stroke-Specific Measure of Adherence to Home-based Exercises | A questionnaire designed to assess how consistently stroke participations follow prescribed home programs | Six weeks |