RecruitingNot ApplicableNCT05492513

Constraint-Induced Movement Therapy for Adults Post-Stroke With Mild Upper Extremity Impairment

Constraint-Induced Movement Therapy for Adults Post-Stroke With Mild Upper Extremity Impairment and Deficits in Desired Occupational Performance: A Pilot Study

Sponsor

University of Alabama at Birmingham

Enrollment

12 participants

Start Date

Dec 8, 2022

Study Type

INTERVENTIONAL

Conditions

Stroke Upper Extremity Paresis CVA (Cerebrovascular Accident)

Summary

Constraint-Induced Therapy (CI Therapy) is a behavioral approach to neurorehabilitation and consists of multi-components that have been applied in a systematic method to improve the use of the limb or function addressed in the intensive treatment. CI Therapy for the more-affected upper extremity (UE) post-stroke is administered in daily treatment sessions over consecutive weekdays. Sessions include motor training with repeated, timed trials using a technique called shaping, a set of behavioral strategies known as the Transfer Package (TP) to improve the use of the more-affected hand in the life situation, and strategies to remind participants to use the more-affected UE including restraint. Robust improvements in the amount and qualify of use have been realized with stroke participants from mild-to-severe UE impairment.

Eligibility

Min Age: 18 Years

Inclusion Criteria3

At least 6 months post stroke
The ability to demonstrate the minimum UE active movement criteria of 20 degrees of wrist extension from a fully flexed position, 10 degrees of thumb extension or abduction, and 10 degrees of extension of all finger joints.
Mean score of \>2.5 on the Motor Activity Log indicating the participant's use of the more-affected UE.

Exclusion Criteria3

Score\< 24 on the Mini Mental State Exam
Inability to answer the MAL questions and/or provide informed consent
The inability to come in to the laboratory setting for treatment.

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Interventions

BEHAVIORALGrade 1 CI Therapy +Sensory Components

All participants will receive Grade 1 CI Therapy + Sensory Components over a two-week period of time. The treatment intervention will include all CI Therapy treatment strategies including: 1) supervised motor training in the form of shaping with repeated trials and task practice for 1.5 hours per day for 5 weekdays for 2 weeks 2) a behavioral Transfer Package (TP) will be employed to aid carry-over of skills gained by the participant in the laboratory to the life situation 3) each participant will wear a mitt on the less-affected hand for most of their waking hours to encourage use of the more-affected hand 4) participants will be given home assignments to be carried out for at least 30 minutes each day. Sensory component strategies will be added to stimulate sensory input through the more-affected arm and hand as well as to train sensory discrimination skills.