Effects of robotic priming of bilateral arm training, mirror therapy, and impairment-oriented training on sensorimotor and daily functions in patients with chronic stroke: study protocol of a single-blind, randomized controlled trial

Abstract

Background Combining robotic therapy (RT) with task-oriented therapy is an emerging strategy to facilitate motor relearning in stroke rehabilitation. This study protocol will compare novel rehabilitation regimens that use bilateral RT as a priming technique to augment two task-oriented therapies: mirror therapy (MT) and bilateral arm training (BAT) with a control intervention: RT combined with impairment-oriented training (IOT). Methods This single-blind, randomized, comparative efficacy study will involve 96 participants with chronic stroke. Participants will be randomized into bilateral RT+MT, bilateral RT+BAT, and bilateral RT+IOT groups and receive 18 intervention sessions (90 min/day, 3 d/week for 6 weeks). The outcomes will include the Fugl-Meyer Assessment, Stroke Impact Scale version 3.0, Medical Research Council scale, Revised Nottingham Sensory Assessment, ABILHAND Questionnaire, and accelerometer and will be assessed at baseline, after treatment, and at the 3-month follow-up. Analysis of covariance and the chi-square automatic interaction detector method will be used to examine the comparative efficacy and predictors of outcome, respectively, after bilateral RT+MT, bilateral RT+BAT, and bilateral RT+IOT. Discussion The findings are expected to contribute to the research and development of robotic devices, to update the evidence-based protocols in postacute stroke care programs, and to investigate the use of accelerometers for monitoring activity level in real-life situations, which may in turn promote home-based practice by the patients and their caregivers. Directions for further studies and empirical implications for clinical practice will be further discussed in upper-extremity rehabilitation after stroke. Trial registration This trial was registered December 12, 2018, at www.clinicaltrials.gov (NCT03773653).

Effect of Rhythmic Auditory Stimulation against Mirror Therapy on Hand Function in Stroke Patients

“…During mirror therapy, mirror neurons that are already present in brain cells get stimulated. The presence of a mirror neuron system in the fronto-temporal region and superior temporal gyrus gets activated in response to a goal-directed hand movement or when someone else performs a similar movement (16) .Training with rhythmic auditory stimulation helps the cerebellum, supplementary motor region, premotor cortex, and basal ganglia to activate. At the perceptual level, auditory stimuli reach the brain faster than visual and tactile stimuli (17) .As per the above discussions based on analysis, it is understood that Mirror Therapy, Rhythmic Auditory Stimulation and conventional therapy is effective in hand functions.…”

Predictors for Upper-Limb Functional Recovery Trajectory in Individuals Receiving Stroke Rehabilitation: A Secondary Analysis of Data from Randomized Controlled Trials

“…Data analyzed in this secondary analysis were from both projects. Available results and one of the protocols were published [ 16 , 17 ]. The research designs and methods of the original studies were approved by the Institutional Review Boards of all involved clinical settings.…”

Biopsychosocial effects and experience of use of robotic and virtual reality devices in neuromotor rehabilitation: A study protocol

“…So far, diverse clinical trials protocols have been recently developed with the purpose of estimating the motor and functional benefits of RAT and VR-based therapy in different clinical populations [76][77][78][79][80][81][82][83]. Nevertheless, it must be noted that for the most, although factors like patient's mental status or technology acceptance were investigated, these were considered as secondary outcomes essentially.…”