Characterising Arm Recovery in People With Severe Stroke

University of British Columbia50 enrolled

Overview

The main goal of this program of research is to advance our understanding of how the severely damaged brain changes over the first 12-months post stroke. The investigators will determine 'who recovers', 'who does not recover', and 'why'

The main goal of this program of research is to advance our understanding of how the severely damaged brain changes over the first 12-months post stroke. The prevalence and severity of stroke related arm disability is increasing and the prospect of optimal recovery is poor. Studies have demonstrated that stroke survivors with severe disability lack early indicators (\<7-days to \<1-month post-stroke) of a good prognosis, such as active movement at the shoulder and wrist and integrity of the corticospinal tract. This has propagated the clinical belief that this cohort are unlikely to functionally benefit from rehabilitation efforts. However, it is possible that indicators of potential for recovery - either neuroanatomical or clinical - may present in individuals with severe stroke later, that is beyond the early time-period. Indeed, there is increasing evidence of the potential for ongoing improvements in motor performance in response to intensive interventions that are undertaken 6-months or more post-stroke. This therefore, implies that there is some degree of untapped recovery potential. However, as very few studies have longitudinally explored the potential indicators of recovery in a severe cohort, the dynamic capacity of the severely damaged remains unknown. Thus, there is a need to determine 'who recovers', 'who does not recover', and 'why' to be able to promote optimal arm recovery in people with severe impairment after stroke. We will assess stroke survivors \<4-weeks, 3-months, 6-months and 12-months post stroke using a range of neuroimaging and clinical outcome measures. The findings from this study will build the foundations for more personalized health care options for people with severe arm impairment post stroke.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Stroke

Interventions

Longitudinal evaluation of recoveryOTHER

Stroke survivors will be assessed at four time frames post stroke to evaluate neuroplastic and clinical changes in arm recovery over the first 12-months post stroke.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * adults aged 18 to 90 years; * sustained their first stroke; * demonstrate subacute (\<1 month) and severe upper limb motor deficits (defined by a SAFE \[shoulder abduction and finger extension\] score of \<5 out of 10 points); and * can follow single stage commands Exclusion Criteria: * neurological condition other than stroke e.g., Parkinson's disease

Locations (1)

University of British Columbia

Vancouver, British Columbia, Canada

RECRUITING

Outcomes

Primary Outcomes

3T Magnetic Resonance Imaging (MRI)

Determine the structural and functional connectivity of the brain using diffusion weighted imaging, resting state-functional magnetic resonance imaging and myelin water fraction imaging.

Time frame: up to 12-months

Secondary Outcomes

Shoulder abduction and finger extension (SAFE)

Measurement of upper limb strength

Time frame: 12-months

Fugl-Meyer Assessment (arm and sensory)

Measurement of upper limb impairment