Mirror Therapy and Augmented Reality in Stroke Rehabilitation
Outcomes of Mirror Therapy Preceding Augmented Reality in Stroke Rehabilitation
National Taiwan University Hospital
75 participants
May 5, 2023
INTERVENTIONAL
Conditions
Summary
This research is in line with the National Health Research Institutes (NHRI) Innovative Research Grant priority to address innovative treatment strategies for neurological disorders that are in desperate need of scientific scrutiny. Stroke is one of the major medical conditions that leads to long-term disability and causes a heavy health care and financial burden. To meet multidimensional needs of patients with stroke, hybrid interventions that combine different approaches are needed due to the complexity of stroke. Our previous research funded by the NHRI has been published and translated to stroke rehabilitation, particularly in the priming and synergic effects of robotic-assisted training and/or mirror therapy (MT). To extend from our previous research, the investigators will combine MT with augmented reality (AR), an emerging adjunct therapy in stroke rehabilitation. An AR-based intervention provides an intensive, repetitive, and context-rich training program, leading to an interesting environment with real-time feedback to increase motivation and participation.
Eligibility
Inclusion Criteria10
- a first-ever unilateral stroke ≥3 months and ≤3 years
- age between 30 and 80 years (Kwakkel et al., 1999)
- baseline Fugl-Meyer Assessment Upper Extremity (FMA-UE) score \>10 (Fugl-Meyer et al., 1975)
- no severe spasticity in any joints of the affected arm (modified Ashworth scale \<3) (Charalambous, 2014)
- ability to follow the instructions of the evaluator and therapists
- the ability to maintain a step-standing position for at least 30 seconds (Lloréns et al., 2015)
- ability to walk a minimum of 10 meters, with or without a device (Park et al., 2017)
- no severe vision impairments or other major neurologic diseases
- no participation in other studies during the study period
- willingness to provide informed written consent.
Exclusion Criteria2
- acute inflammation
- serious medical problems or poor physical conditions that might be detrimental to study participation.
Interested in this trial?
Get notified about updates and connect with the research team.
Interventions
Each participant will practice two different MT protocols: UMT and BMT. During UMT, the affected hand is static, whereas during BMT, the affected hand moves in an attempt to duplicate the unaffected hand as best as possible. The MT activities include gross motor movements (i.e., shoulder flexion, elbow flexion/extension, forearm pronation/supination, and wrist flexion/extension and circumduction), fine motor movements (i.e., opposition, grasp, and release), and object manipulation (i.e., reaching out to grasp a cup, flipping coins).
The training program with different levels of difficulty provides goal-directed exercises designed to be adjustable in order to match the patient's ability to minimize compensatory movements. The goal-directed exercise includes balance training (i.e., weight shifting, standing on one leg, etc.), activities of daily living training (i.e., reaching to grasp functionally relevant objects), and cognitive enhancement (i.e., memory training). By using the AR system, participants can observe the real performance of motions and interaction between the body and the virtual environment.
Participants will perform 90 minutes of therapist-mediated conventional therapy. The treatment protocols will be formulated by using occupational therapy techniques, such as neurodevelopmental techniques and functional task training. Specifically, the affected arm exercise or gross motor training, muscle strengthening of the affected arm, fine motor or dexterity training, and functional tasks of daily life or compensatory techniques will be used to alleviate functional deficits. In addition, the therapist will work with the participant to select functionally relevant tasks, such as picking up items from a box, lifting soft drink bottles, hanging clothes, and so on.
Locations(5)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT05993091