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NCT Number: NCT06251661

Cognitive Multi-sensory Rehabilitation on Upper Limb Function and Fatigue in Stroke

This interventional study aims to investigate the therapeutic efficacy of Cognitive multi-sensory rehabilitation (CMR) on upper limb function and fatigue in chronic stroke patients. The main question is:

• Does cognitive multi-sensory rehabilitation significantly affect upper limb function and fatigue in stroke patients? Participants will be assigned into two groups. They will receive 12 sessions of study group CMR and traditional physical therapy and control group traditional physical Therapy rehabilitation. CMR 40 minutes immediately followed by 20 minutes of selected physical therapy program, three sessions per week for four weeks.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Fatigue Ischemia Ischemic Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Signs and Symptoms Vascular Diseases

Age range

45 year–65 year

Sex eligibility

Male

Study type

Interventional

Phase

Not applicable

Primary location

Faculty of Physical Therapy Cairo University

Cairo, Giza Governorate, 12612, Egypt

About this study

About 70% of people with stroke are unable to use their affected hand efficiently in activities of daily living. Further, post-stroke fatigue affects up to 92% of post-stroke patients. Post-stroke fatigue is a multifaceted motor and cognitive process, in which the patient experiences tiredness and lack of energy that develops during physical or mental activity which may persist for years. Post-stroke fatigue impacts the mental/physical functions of the patient through decreased energy, and thus, is a significant barrier to recovery.

Preliminary evidence indicates sensory rehabilitation may enhance motor recovery in people with stroke. Cognitive Multisensory Rehabilitation (CMR) is a therapist-guided sensorimotor rehabilitation approach, that targets the patients' ability to solve sensory discrimination exercises, where the patient compares the sensations felt by the hand to the shapes observed with the eyes. Cognitive processes are encouraged by asking the patient to determine the limb movement or its position, how the movement was felt in the body, how the limb moved in relation to other parts of the body, and to spatial parameters in the environment. Because CMR integrates cognitive processes with sensory and motor tasks, it may be a novel method to address post-stroke fatigue, and it may increase connectivity in sensory and motor areas of the brain.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 45 and 65 years.
  • 6-18 months after ischemic stroke
  • living in the community (i.e., not in a long-term care home).
  • medically stable.
  • normal score in the Montreal Cognitive Assessment (MoCA: 25 to 30, maximum score = 30).
  • Spasticity of upper limb muscles ranged from (grade 1:2) according to the Modified Ashworth scale.

Exclusion criteria

  • severe spasticity (Modified Ashworth Scale score of 4)
  • any medical condition that hinders full participation,
  • another neurological diagnosis beyond stroke including cognitive impairment, or
  • upper extremity pain > 4/10 on the Numeric Pain Rating Scale (maximum 10/10).

Treatment and study plan

Cognitive multi-sensory Rehabilition

Other

Kinetic awareness: Initially, only one joint will be moved at a time. Then the therapist will reposition the joint and ask the participants to report their perception of the joint position. Initially, the participants will distinguish between just two positions. If they reliably answer correctly, increase up to five points and integrate speed and dexterity in functional movements. Participants will be asked to relax and feel the movement during this training. Discrimination exercise: The therapist places a part of the participant's limb, the fingertip, on an external object (a block) and the participant will be asked to actively move his or her limb over the object and try to sense the shape of the object. If the participants differentiate between the two objects, then increase the number of objects (up to five). Functional training: The patient reaches toward many objects functionally (cup, ball, cane) from different angles, holds them, and relocates them again.

selected traditional physical therapy program.

Other

The selected physical therapy program session will be occupational therapy training for the hand, strengthening exercises for the weak upper limb stretching exercises for short upper limb muscles, balance exercise, and gait training.

Primary outcomes

  1. Fugl-Meyer Assessment for upper extremity (FMT-UE).

    Time frame: from baseline to four weeks after the beginning of intervention

    Changes in upper limb function.

  2. Serum levels of Brain-Derived Neurotrophic Factor (BDNF)

    Time frame: from baseline to four weeks after the beginning of intervention

    Changes in serum levels of neural plasticity factors

  3. Changes in hand grip strength

    Time frame: from baseline to four weeks after the beginning of intervention

    Hand grip strength was measured by an electronic hand dynamometer device.

  4. Fatigue Assessment Scale (FAS)

    Time frame: from baseline to four weeks after the beginning of intervention

    determine the degree of self-reported fatigue in daily living activities.

    Each item of the FAS is answered using a fi ve-point, Likert-type scale ranging from 1 ("never") to 5 ("always"). Items 4 and 10 are reverse-scored. Total scores can range from 10, indicating the lowest level of fatigue, to 50, denoting the highest.

Secondary outcomes

  1. Box and Blocks Test (BBT)

    Time frame: from baseline to four weeks after beginning of the intervention.

    Changes in gross hand function intervention.

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Official study title

Cognitive Multi-sensory Rehabilitation on Upper Limb Functions and Fatigue in Different Grades of Spasticity in Stroke Patients

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Feb 9, 2024
Registry last updated
Jan 21, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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