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This clinical trial aims to compare the effects of coupling rehabilitation and constraint-induced movement therapy (CIMT) on improving arm function, hand skills, and daily activity performance in people who have upper limb weakness after a stroke. Participants will be randomly assigned to one of two groups and receive 12 weeks of therapy, including either CIMT or coupling rehabilitation along with conventional physical therapy. The study will evaluate which method is more effective in restoring movement and independence by using standardized assessments before, during, and after the intervention. The findings may help guide future rehabilitation approaches for stroke survivors
This study focuses on improving upper limb recovery in people who have experienced a stroke. Stroke often leads to long-term weakness or difficulty using one arm, which can limit a person's ability to perform everyday tasks such as dressing, eating, or writing. The study explores two promising rehabilitation strategies-Constraint-Induced Movement Therapy (CIMT) and Coupling Rehabilitation-that may help improve arm movement, hand coordination, and independence in daily life.
Participants will take part in therapy sessions over a 12-week period, during which they will engage in structured, goal-oriented exercises tailored to their physical abilities. The research team will monitor changes in motor function and hand dexterity through standard assessments administered at the beginning, mid-point, and end of the study. By comparing outcomes between the two groups, the study seeks to identify which therapy method is more effective in promoting functional recovery after stroke, with the goal of enhancing rehabilitation practices in clinical settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Constraint-Induced Movement Therapy (CIMT) Group | Experimental | Participants in this group will receive Constraint-Induced Movement Therapy (CIMT) along with conventional physical therapy. CIMT involves structured, task-specific exercises that focus on improving the use of the affected upper limb by restricting the unaffected arm. Sessions will include activities such as fine motor training, reaching tasks, strengthening exercises, and functional movement tasks. Therapy will be delivered three times per week for 12 weeks. |
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| Coupling Rehabilitation Group | Experimental | Participants in this group will receive Coupling Rehabilitation along with conventional physical therapy. Coupling Rehabilitation involves bilateral arm training and task-specific activities that encourage coordinated use of both upper limbs to stimulate recovery in the affected arm. Exercises will include trunk-supported reaching, object manipulation, and simulated daily tasks. Therapy will be provided three times per week for 12 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Constraint-Induced Movement Therapy (CIMT) | Other | Participants in this group will receive modified CIMT in combination with conventional physical therapy. The unaffected arm will be restrained to encourage use of the affected upper limb. Task-specific exercises will include fine motor tasks, strengthening, reaching, and functional movement training. Each session will last approximately 45-60 minutes and will be conducted three times per week for 12 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Improvement in Upper Limb Motor Function Using the Fugl-Meyer Assessment (FMA) | This outcome assesses changes in motor control and function of the affected upper limb using the Fugl-Meyer Assessment, a validated stroke-specific performance test. Higher scores reflect better motor recovery. | Baseline, 6 weeks, and 12 weeks after start of intervention |
| Change in Hand Dexterity Using the Box and Block Test (BBT) | This outcome evaluates fine motor skills and hand coordination by measuring the number of blocks a participant can move from one compartment to another in one minute using the affected hand. Higher scores indicate better hand dexterity. | Baseline, 6 weeks, and 12 weeks after start of intervention |
| Change in Performance of Daily Activities Using the Motor Activity Log (MAL) | This outcome assesses real-world use of the affected upper limb in daily activities using the MAL questionnaire. It includes two subscales: Amount of Use (AOU) and Quality of Movement (QOM). Higher scores indicate better function and limb use. | Baseline, 6 weeks, and 12 weeks after start of intervention |
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Inclusion Criteria: •Age 40-65 years old
Amount of use scale<2.5 Quality of movement scale<3
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Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Laraib Akbar, MSPTN | Contact | +923056926352 | laraibakbar9@gmail.com | |
| Ayesha Jamil, BSPT, TDPT, M PHIL. PT | Contact | +923244481031 |
| Name | Affiliation | Role |
|---|---|---|
| Maryam Shabbir, PH.D. PT | University of Lahore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Lahore Teaching Hospital | Lahore | Punjab Province | 54600 | Pakistan |
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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 |
|---|---|
| D000098483 | Constraint Induced Movement Therapy |
| ID | Term |
|---|---|
| D005081 | Exercise Therapy |
| D026741 | Physical Therapy Modalities |
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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| Coupling Rehabilitation | Other | Participants in this group will receive Coupling Rehabilitation in addition to conventional physical therapy. This method involves bilateral arm training and functional tasks designed to improve coordination between both upper limbs, using the unaffected limb to guide movement in the affected one. Exercises will include trunk-supported reaching, object retrieval, and posture-supported task practice. Sessions will occur three times per week for 12 weeks, each lasting approximately 45-60 minutes. |
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| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |