About this trial
Human development as a species has been strongly associated with the ability to dexterously manipulate objects and tools. Unfortunately, current therapy efforts typically fail to restore fine manual control after stroke. The goal of this study is to evaluate a new intervention that would combine targeted electrical stimulation of selected nerves with use a soft, pneumatically actuated hand exoskeleton to enhance repetitive practice of independent movements of the fingers and thumb in order to improve rehabilitation of hand function after stroke.
The investigators will recruit stroke survivors in the subacute phase of recovery (2-18 months post-stroke). These participants will be involved in a 5-week intervention involving 15 training sessions. During these sessions, participants will train independent movement of the digits of the paretic hand. Evaluation of motor control of the paretic hand will occur prior to initiation of training, at the midpoint of the training period, after completion of training, and one month later.
Eligibility criteria
Qualifiers
A single, unilateral stroke 2-18 months prior to enrollment
Moderate to mild hand impairment, as determined by a rating of Stage 4-6 on the Stage of Hand section of the Chedoke-McMaster Stroke Assessment
Visual capacity to discern specific shapes on the computer screen
Capacity to provide informed consent
Disqualifiers
Rigid contractures in the joints of the upper limbs, or orthopedic issues precluding joint movement
Hemispatial neglect (as assessed by the Behavioral Inattention Test)
Excessive pain in the paretic upper limb (visual analog scale of shoulder pain < 70)
Trial design
Treatments tested in this trial
- Actuated Virtual Keyboard (AVK) system
- Occupational Therapy (OT)
Treatment groups
Sponsors and collaborators
North Carolina State University
Lead sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborator