The goal of this trial is to evaluate the effects of mirror therapy combined with contralaterally controlled functional electrical stimulation on motor recovery and neuroplasticity in patients with peripheral nerve injury. The main questions it aims to answer are Question 1: To compare corticomuscular coherence between the groups of mirror therapy combined with contralaterally controlled functional electrical stimulation, sham mirror therapy combined with contralaterally controlled functional electrical stimulation, and control group. Question 2: To compare sensorimotor recovery between the groups of mirror therapy combined with contralaterally controlled functional electrical stimulation, sham mirror therapy combined with contralaterally controlled functional electrical stimulation, and control group. Question 3: To evaluate the effects of each intervention on corticomuscular coherence and sensorimotor recovery 12 weeks post-intervention. Participants will be asked to exercise their affected hand together with the unaffected hand while receiving contralaterally controlled electrical stimulation in front of the mirror or sham mirror. Researchers will compare the effects of mirror therapy combined with contralaterally controlled functional electrical stimulation on corticomuscular coherence and sensorimotor recovery with the other groups.
The goal of this trial is to evaluate the effects of mirror therapy combined with contralaterally controlled functional electrical stimulation on motor recovery and neuroplasticity in patients with peripheral nerve injury. The main questions it aims to answer are: Question 1: To compare corticomuscular coherence between the groups of mirror therapy combined with contralaterally controlled functional electrical stimulation, sham mirror therapy combined with contralaterally controlled functional electrical stimulation, and control group. Question 2: To compare sensorimotor recovery between the groups of mirror therapy combined with contralaterally controlled functional electrical stimulation, sham mirror therapy combined with contralaterally controlled functional electrical stimulation, and control group. Question 3: To evaluate the effects of each intervention on corticomuscular coherence and sensorimotor recovery 12 weeks post-intervention. Eligible participants will be randomized into three groups: MT and CCFES group: mirror therapy combined with contralaterally controlled functional electrical stimulation Sham MT and CCFES group: Sham mirror therapy combined with contralaterally controlled functional electrical stimulation Control group: conventional physiotherapy. Each participant will receive conventional physiotherapy for 50 minutes daily, twice a week for 12 weeks. Conventional physiotherapy includes scar management, joint range of motion exercise, strengthening, stretching, and functional training. Participants in the MT and CCFES group or Sham MT and CCFES group will receive 30 minutes daily, twice a week of the intervention for 12 weeks in addition to the conventional physiotherapy. In the MT and CCFES group, the participants will sit in front of the mirror and watch the mirror reflection of the unaffected hands. At the same time, contralaterally controlled electrical stimulation will be conducted to make the affected hands move with the unaffected hands. The participants in the Sham MT and CCFES group will sit in front of the mirror without mirror reflection, but doing the exercise with contralaterally controlled functional electrical stimulation. All participants will receive the evaluations at baseline and 12 weeks after the intervention. The evaluations include: Electroencephalography of α and β bands from the sensorimotor cortices will be recorded. Electromyography will be performed during maximum isometric pinch or lateral pinch strength measurements. Maximum isometric grip strength, tip pinch strength, lateral pinch strength, sensation tests, and upper extremity function will be measured.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
7
30 minutes of intervention, twice a week, and a total of 12 weeks
30 minutes of intervention, twice a week, and a total of 12 weeks
50 minutes of intervention, twice a week, and a total of 12 weeks
National Taiwan University Hospital
Taipei, Taiwan
change from baseline in corticomuscular coherence at week 12
coherence will be used to analyze the interaction between the electroencephalogram activation and electromyography activation
Time frame: baseline, week 12
change from baseline in grip strength at week 12
average grip strength measured for 3 times in killograms
Time frame: baseline, week 12
change from baseline in pinch strength at week 12
average lateral pinch and palmar pinch measured for 3 times in killograms
Time frame: baseline, week 12
change from baseline in sensation on Semmes-Weinstein monofilament test at week 12
force in grams
Time frame: baseline, week 12
change from baseline in function on Disabilities of the Arm, Shoulder, and Hand outcome questionnaire at week 12
A total scale from 1 to 100. Higher scores indicate greater disability.
Time frame: baseline, week 12
change from baseline in maximum voluntary isometric contraction in surface EMG at week 12
muscle activities of target muscles measured during pinch strength for 3 times in percentage
Time frame: baseline, week 12
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