RecruitingNot ApplicableNCT04119544

Mirror Therapy Rehabilitation of the Upper Limb After Stroke (NEURO-MIROIR 2)

Intensive Rehabilitation Program With Intensive Visual Numerical Simulation Device for Improving Distal Motor Performance and Upper Limb Functional Capacity in Subacute Hemiparetics After Stroke. Randomized Controlled Trial.

Sponsor

Clinique Les Trois Soleils

Enrollment

66 participants

Start Date

Dec 10, 2019

Study Type

INTERVENTIONAL

Conditions

Stroke

Summary

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.

Eligibility

Min Age: 18 YearsMax Age: 100 Years

Inclusion Criteria5

Age ≥18 years;
Stroke hemiparesis on unilateral focal lesion dating from 4 to 10 weeks at baseline;
Total sub-scores wrist and hand of th Fugl-Meyer < 16
Patient having agreed to sign an informed consent
patient being affiliated to the French Social Security

Exclusion Criteria7

Cognitive dysfunction or progressive intercurrent illness making effective communication or participation in the study impossible
Phasic disorders that prevent the understanding of instructions
Patient include in an other clinical trial
Neurological conditions prior to stroke
Patient who had mirror therapy or IVS rehabilitation before inclusion
Rheumatological pathology of the hand and wrist
Person under legal protection measure.

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Interventions

OTHERConventional 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.

DEVICEIntensive Visual Simulation

* First week: observation, mentalization and then attempt to perform the movements on the screen. * Second and third weeks: production of analytical movements of wrist flexion/extension, pronation/supination, finger flexion/extension, thumb opposition. * From the 4th week until the end: depending on the patient's motor capacities, continuation of the work of the previous 2 weeks or introduction of more functional work with object manipulation, gripping work. 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.