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The aim of the study is to determine the comparative effects of perceptual motor training and repetitive facilitation exercises on upper limb quality of movement and motor function in Stroke patients.
Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation.
This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks.
Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A Perceptual Motor Training with Routine Physical Therapy | Experimental | Group A will receive treatment session of 60 minutes including Perceptual motor training for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention. |
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| Group B Repetitive Facilitation Exercises with Routine Physical Therapy | Experimental | Group B will receive treatment session of 60 minutes including Repetitive facilitation exercises for 40 minutes along with routine physical therapy of 20 minutes. Treatment session will be given 4 days per week for 8 weeks. Effects will be measured at baseline, 4th week and post intervention. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perceptual Motor Training | Other | 8 set of exercises
|
| Measure | Description | Time Frame |
|---|---|---|
| 1. Motor Evaluation Scale For Upper Extremity In Stroke Patients (MESUPES) | A 17-items into two sub scales ; MESUPES Arm function; 8 items(score 0-5) MESUPES-Hand function; 9 items (score0-2) objective evaluation scale designed to assess quality of movement of arm and hand function after stroke. MESUPES takes 5-15 min to complete. Total score 58. A higher score indicates the greater the quality of movement | 8 week |
| 2. Fugl-Meyer Assessment (FMA): | The Fugl-Meyer Assessment is used to assess motor function. It is a well-designed, feasible and efficient clinical examination method that has been tested widely in the stroke population. A three-level ordinal scale (0, can perform no part of the test; 1, performs test partially; 2, performs test normally) is applied to each item. A total possible score for the upper extremity is 66. The higher the score, the better the performance. | 8 weeks |
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Inclusion Criteria;
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hira Jabeen, MS-NMPT | Contact | 03234116506 | hira.jabeen@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Hira Jabeen, MS-NMPT | Riphah International University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dr. Faisal Masood Teaching Hospital | Sargodha | Punjab Province | 40100 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30230990 | Background | McGregor HR, Cashaback JGA, Gribble PL. Somatosensory perceptual training enhances motor learning by observing. J Neurophysiol. 2018 Dec 1;120(6):3017-3025. doi: 10.1152/jn.00313.2018. Epub 2018 Sep 19. | |
| 32440127 | Background | Soltani Kouhbanani S, Arabi SM, Zarenezhad S, Khosrorad R. The Effect of Perceptual-Motor Training on Executive Functions in Children with Non-Verbal Learning Disorder. Neuropsychiatr Dis Treat. 2020 May 5;16:1129-1137. doi: 10.2147/NDT.S252662. eCollection 2020. |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Repetitive Facilitation Exercises | Other | Eight set of exercises:
|
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| 34925173 | Background | Bergmann F, Gray R, Wachsmuth S, Honer O. Perceptual-Motor and Perceptual-Cognitive Skill Acquisition in Soccer: A Systematic Review on the Influence of Practice Design and Coaching Behavior. Front Psychol. 2021 Dec 2;12:772201. doi: 10.3389/fpsyg.2021.772201. eCollection 2021. |
| 941962 | Background | Platzer WS. Effect of perceptual motor training on gross-motor skill and self-concept of young children. Am J Occup Ther. 1976 Aug;30(7):422-8. |
| 38456153 | Background | Fujimoto K, Ueno M, Etoh S, Shimodozono M. Combined repetitive facilitative exercise under continuous neuromuscular electrical stimulation and task-oriented training for hemiplegic upper extremity during convalescent phase after stroke: before-and-after feasibility trial. Front Neurol. 2024 Feb 22;15:1356732. doi: 10.3389/fneur.2024.1356732. eCollection 2024. |
| 36111388 | Background | Purton J, Sim J, Hunter SM. Stroke survivors' views on their priorities for upper-limb recovery and the availability of therapy services after stroke: a longitudinal, phenomenological study. Disabil Rehabil. 2023 Sep;45(19):3059-3069. doi: 10.1080/09638288.2022.2120097. Epub 2022 Sep 15. |
| 33820711 | Background | Hokazono A, Etoh S, Jonoshita Y, Kawahira K, Shimodozono M. Combination therapy with repetitive facilitative exercise program and botulinum toxin type A to improve motor function for the upper-limb spastic paresis in chronic stroke: A randomized controlled trial. J Hand Ther. 2022 Oct-Dec;35(4):507-515. doi: 10.1016/j.jht.2021.01.005. Epub 2021 Jan 26. |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D001519 | Behavior |