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van CCT (UK)

van CCT (UK)

Effect of Virtual Reality training on reach after stroke.

- candidate number7848
- NTR NumberNTR2247
- ISRCTNISRCTN wordt niet meer aangevraagd.
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR18-mrt-2010
- Secondary IDsP10-09, VR1_prt METC
- Public TitleEffect of Virtual Reality training on reach after stroke.
- Scientific TitleVR arm training after stroke.
- hypothesisChronic stroke subjects who will be trained in a stimulus rich context, specifically developed for rehabilitation (rehab game) will show similar or improved restoration of their arm function in comparison with chronic stroke subjects who will be trained in a less rich context (conventional reach exercises).
- Healt Condition(s) or Problem(s) studiedStroke, Chronic
- Inclusion criteria1. At least 6 months post-stroke;
2. First ever stroke;
3. Stroke affecting the medial cerebral artery region (MCA);
4. Demonstrable motor limitations in upper proximal extremity (Fugl-Meyer< 45), with reach(-like) movement ability;
5. Ability to understand and follow instructions;
6. Ability to complete measurement and training sessions.
- Exclusion criteria1. Co-morbidity of disorders affecting use of the upper extremity;
2. Additional training/therapy of the affected arm during participation to the study.
- mec approval receivedyes
- multicenter trialno
- randomisedyes
- masking/blindingSingle
- controlActive
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-apr-2010
- planned closingdate1-apr-2011
- Target number of participants20
- InterventionsTwenty stroke patients receive reach training for the affected arm during 6 weeks, 3 times 30 minutes per week. The intervention group (10 persons, randomized) will train using the FurballHunt game and the control group (10 persons, randomized) will perform standardized reaching exercises in a conventional physical therapy setting, with equal intensity.
- Primary outcomeBefore and after the training (including follow-up after 1 month) changes in general arm function (Action Research Arm test and Fugl-Meyer assessment) and in motivation (Intrinsic Motivation Inventory) are quantified.
- Secondary outcomeBesides clinical measures of arm function, additionally changes in reach performance are determined (during a maximal reach test).
- TimepointsEvaluation of arm function takes place once before and twice after training (within 1 week and follow-up after 1 month), totaling the duration to 12 weeks for each participant.
- Trial web siteN/A
- statusopen: patient inclusion
- Sponsor/Initiator Roessingh Research and Development
- Funding
(Source(s) of Monetary or Material Support)
Wetenschappelijk College Fysiotherapie (WCF)
- PublicationsPrange GB, Kallenberg LAC, Jannink MJA, et al. Influence of gravity compensation on muscle activity during reach and retrieval in healthy elderly. J Electromyogr Kinesiol 2009a; 19(2):e40-e49 (DOI 10.1016/j.jelekin.2007.08.001) Prange GB, Jannink MJA, Stienen AHA, Van der Kooij H, IJzerman MJ, Hermens HJ. Influence of gravity compensation on muscle activation patterns during different temporal phases of arm movements of stroke patients. Neurorehab Neural Rep 2009b;23(5):478-485.
Prange GB, Jannink MJA, Stienen AHA, Van der Kooij H, IJzerman MJ, Hermens HJ. An explorative, cross-sectional study into abnormal muscle synergies during functional reach in chronic stroke patients. accepted for publication in J NeuroEng Rehab 2009c.
Prange GB, Krabben T, Renzenbrink GJ, IJzerman MJ, Hermens HJ, Jannink MJA. Changes in muscle activation after reach training with gravity compensation in chronic stroke patients. submitted 2009d.
- Brief summaryTo stimulate restoration of arm function after stroke, intensive and task-specific training is essential. To implement this, the application of virtual reality (VR) in rehabilitation is promising. Integration of stimuli and feedback in a rehabilitation game, taking principles of motor relearning into account, allows high motivation for patients during training. Additionally, VR can automate and intensify treatment, since patients can practice more independently, without the need for one-to-one supervision. This is an important issue in coming years with respect to the ageing of the population, leading to increased demand, but decreased availability of physical and occupational therapists.
Previous research of this group showed that arm training using a specifically developed game for rehabilitation (FurballHunt), combined with arm support, can improve reaching. However, this pilot study did not discern between the effect of arm support and the added value of training with a rehabilitation game. When training using a rehabilitation game proves (at least) as effective as conventional therapy, this already is promising for applying VR in rehabilitation, regarding independency during training.
- Main changes (audit trail)
- RECORD18-mrt-2010 - 15-apr-2010

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