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This study aims to compare the effectiveness of three rehabilitation approaches in individuals with stroke: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training.
A total of 45 individuals with subacute and chronic stroke will be randomly assigned to one of three groups. Each group will receive 4 weeks of intervention (5 sessions per week), followed by a 3-month follow-up period.
Outcomes related to motor function, somatosensory function, activities of daily living, participation, and quality of life will be assessed at baseline, after intervention, and at follow-up.
The study aims to determine which intervention approach is more effective in improving functional outcomes in individuals with stroke.
Stroke is one of the leading causes of disability worldwide, often resulting in motor, sensory, and cognitive impairments. Rehabilitation approaches that enhance neuroplasticity are essential for improving functional recovery.
This randomized controlled trial aims to compare the effectiveness of mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), and conventional occupational therapy (COT), all combined with robotic balance training (RBT), in individuals with stroke.
Participants will be recruited from a physical therapy and rehabilitation unit and will be randomly assigned into three groups: MT, CO-OP, and COT. All groups will receive robotic balance training as a priming intervention prior to therapy sessions.
Each intervention will be administered for 4 weeks, 5 days per week. In addition, a transfer package will be applied to enhance the generalization of therapeutic gains to daily life activities.
Outcome measures will include motor function, somatosensory function, occupational performance, activities of daily living, participation, self-efficacy, and quality of life. Assessments will be conducted at baseline, post-intervention, and at a 3-month follow-up.
The findings of this study are expected to provide evidence for the comparative effectiveness of different rehabilitation approaches in stroke and contribute to clinical decision-making.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mirror Therapy Group | Experimental | Participants in this group will receive mirror therapy combined with robotic balance training. Mirror therapy will be applied using task-oriented activities involving upper and lower extremities based on individual needs. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
|
| CO-OP Group | Experimental | Participants in this group will receive cognitive orientation to daily occupational performance (CO-OP) combined with robotic balance training. Individualized goals will be determined and cognitive strategies will be used to improve task performance. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
|
| Conventional Occupational Therapy Group | Active Comparator | Participants in this group will receive conventional occupational therapy combined with robotic balance training. The intervention will include task-oriented activities such as reaching, grasping, coordination, and strengthening exercises. Intervention will be administered 5 days per week for 4 weeks. A transfer package will also be applied. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mirror Therapy | Behavioral | Mirror therapy involves the use of a mirror to create a visual illusion of movement of the affected limb by observing the reflection of the unaffected limb. Task-oriented activities are performed to improve motor function and sensory integration in individuals with stroke. |
| Measure | Description | Time Frame |
|---|---|---|
| Fugl-Meyer Motor Assessment (FMA) | The Fugl-Meyer Assessment will be used to evaluate motor function in individuals with stroke. Higher scores indicate better motor function. | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Revised Nottingham Sensory Assessment (rNSA) | Used to assess somatosensory function including tactile sensation and proprioception. | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Canadian Occupational Performance Measure (COPM) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| NURTEN BİLGİN, PhD Student | Contact | +905546366542 | nurtenncek@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Gokcen Akyurek, Associate Professor | Hacettepe University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bayburt State Hospital | Recruiting | Bayburt | Merkez | 69000 | Turkey (Türkiye) |
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Participants will be randomly assigned to one of three parallel groups: mirror therapy (MT), cognitive orientation to daily occupational performance (CO-OP), or conventional occupational therapy (COT). All groups will receive robotic balance training prior to intervention sessions. Interventions will be applied for 4 weeks, followed by a 3-month follow-up.
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Bu açık etiketli bir çalışmadır. Uygulanan müdahalelerin niteliği nedeniyle herhangi bir körleme yöntemi kullanılmamıştır.
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| Cognitive Orientation to Daily Occupational Performance (CO-OP) | Behavioral | CO-OP is a client-centered, performance-based approach that uses cognitive strategies to enable skill acquisition. Participants identify meaningful goals and use guided discovery and problem-solving strategies to improve task performance. |
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| Conventional Occupational Therapy | Behavioral | Conventional occupational therapy includes task-oriented interventions such as reaching, grasping, coordination training, strengthening exercises, and activities aimed at improving functional independence in daily living. |
|
| Robotic Balance Training | Other | Robotic balance training is used as a priming intervention before therapy sessions. It includes repetitive, task-specific movements involving weight shifting, postural control, and balance training to enhance motor responses. |
|
Used to assess Occupational Performance .
| Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Modified Barthel Index (MBI) | Used to assess activity daily of life | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Stroke Impact Scale (SIS) | Used to assess quality of life | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Stroke Self-Efficacy Questionnaire (SSEQ) | Used to assess self-efficacy | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| Community Integration Questionnaire (CIQ) | Used to assess paticipation | Baseline, post-intervention (4 weeks), and 3-month follow-up |
| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular 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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