The goal of this clinical trial is to compare the effects of three groups: (1) unilateral robotic therapy with computerized visual feedback plus unilateral innovative mirror therapy, (2) bilateral robotic therapy with computerized visual feedback plus bilateral innovative mirror therapy, and (3) dose-matched conventional rehabilitation as the control. The investigators will also study the factors predictive of treatment success, identify key predictors of clinical improvement, and distinguish patient profiles most likely to benefit from each regimen. The findings of this clinical trial are expected to advance knowledge about the synergistic effects of unilateral and bilateral hybrid programs. The predictive study of treatment outcomes will inform patient selection in precision rehabilitation toward personalized stroke management.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
81
The Bi-Manu-Track (BMT) robot will be provided as the robotic practice. The BMT can be switched from the bilateral practice modules involving bilateral upper limbs to the unilateral module involving the affected upper limb. According to the group assignment, participants will practice the unilateral or bilateral module of BMT training.
The innovative mirror therapy (MT) program will be conducted with computerized mirror visual feedback and the conventional mirror box therapy. The unilateral MT group will practice on the unilateral module, while the bilateral MT group will practice based on the bilateral module. In the unilateral module, the affected hand will be static on the knee. In contrast, during bilateral MT, participants will be asked to do the same movements using the unaffected and affected arms as symmetrically as possible.
Participants in the control group will receive therapist-mediated rehabilitation per session.
Wan Fang Hospital, Taipei Medical University
Taipei, Taiwan
National Taiwan University Hospital
Taipei, Taiwan, Taiwan
Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE)
Time frame: Baseline, 6 weeks, and 18 weeks
Grip and pinch strength
Time frame: Baseline, 6 weeks, and 18 weeks
Box and Block Test (BBT)
Time frame: Baseline, 6 weeks, and 18 weeks
Revised Nottingham Sensory Assessment (rNSA)
Time frame: Baseline, 6 weeks, and 18 weeks
Motor Activity Log (MAL)
Time frame: Baseline, 6 weeks, and 18 weeks
ABILHAND Questionnaire
Time frame: Baseline, 6 weeks, and 18 weeks
Functional Ambulation Category (FAC)
Time frame: Baseline, 6 weeks, and 18 weeks
Stroke Impact Scale Version 3.0 (SIS 3.0)
Time frame: Baseline, 6 weeks, and 18 weeks
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