Does the Enhanced Rehabilitation Programs Facilitate the Motor Recovery After Stroke?

Taipei Medical University WanFang Hospital

Overview

Study purpose This study will explore whether an additional rehabilitation program that focus on either upper or lower extremity training facilitate the recovery in upper or lower extremity. The recovery in both neurological status and motor functions will be explored.

Design A single-blinded (assessor-blinded) randomized controlled trial. Interventions The participants will be randomly assigned into two experiment groups (enhanced upper extremity program; and enhanced lower-extremity program). Both groups receive routine rehabilitation including daily 50 mins of physical therapy and 50 mins of occupational therapy. The enhanced upper extremity program group receives additional daily 50 mins program focusing on training of the hemiplegic upper extremity, while the enhanced lower-extremity program group receives additional daily 50 mins program focusing on training of the hemiplegic lower extremity. The participants receive 20-day training over a 4-week period. The additional program is designed to be specific to either upper-extremity or lower-extremity. Accordingly, one group can be used as the control group of the other one.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Conditions

Poststroke/CVA Hemiparesis

Interventions

UFTOTHER

The EUEP group receives additional daily 50 mins program focusing on training of the hemiplegic upper extremity,

LFTOTHER

The ELEP group receives additional daily 50 mins program focusing on training of the hemiplegic lower extremity.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. First-ever stroke with the onset 10-90 days prior to the enrollment 2. Age: 20-80y 3. With a hemiplegic upper extremity with Brunnstrom stage in I\~IV 4. Able to understand simple orders (1-step orders, such as "raise your hand, touch your head….) 5. Totally independent in activity of daily life before the onset of stroke Exclusion Criteria: 1. Incompliance to the assessments or interventions due to unstable medical condition, abnormal cognition, or other conditions. 2. Stroke of brainstem or cerebellum 3. Had received craniotomy or ventriculoperitoneal shunting 4. Needs of orthoses in walking before the onset of stroke 5. Had had motor dysfunctions (eg, amputation, cerebral palsy, poliomyelitis or other neuromuscular diseases) before the stroke. 6. Intracranial hemorrhage caused by artereovenous malformation, aneurysm, or tumor 7. Able to walk independently for more than 50 meters.

Locations (1)

WanFang Hospital

New Taipei City, Taiwan

Outcomes

Primary Outcomes

Fugl-Meyer Assessment (upper extremity subscale)

The primary outcome is the change from baseline upper extremity subscale of Fugl-Meyer assessment at the end to 4-wk (post-intervention).

Time frame: 0-, 4- week