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NCT Number: NCT02890446

The Effects of Attentional Focus on Arm Training in Stroke

This study compares the effects of an internal versus an external focus of attention on motor training of the affected arm for individuals with stroke. Participants were randomly assigned to either the internal or external focus treatment groups and received 12 sessions of arm training.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Neurologic Manifestations Paresis Pathological Conditions, Signs and Symptoms Signs and Symptoms Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Participants were randomized to one of two treatment groups and received upper arm reaching training on the InMotion 2 shoulder robot (12 hourly sessions over four weeks). The external focus group received instructions specifically to pay attention to the task goal--hitting targets on the video game, while the internal focus group was instructed to pay attention to the movement of their arm motions (video game monitor was turned off). Both groups practiced the same arm reaching pattern and were matched for level of arm impairment and training dosage.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • diagnosis of stroke > 6 months
  • moderate to severe arm impairment
  • intact visual scanning and spatial orientation of the affected arm
  • functional cognitive status
  • medically stable

Exclusion criteria

  • concurrent occupational or physical therapy for the arm
  • joint contractures at the wrist, forearm, elbow, or shoulder
  • moderate to severe spasticity at the elbow or shoulder
  • presence of other neurological conditions
  • botulinum toxin injection in the affected arm < 3 months prior
  • score of 0/5 on manual muscle test at the elbow or shoulder

Treatment and study plan

upper arm training on the InMotion 2 shoulder robot

Behavioral

Both groups practiced shoulder and elbow exercises on a robotic arm device under an external focus or internal focus practice condition.

Practiced arm reaching in a clock-like design to facilitate horizontal shoulder flexion, extension, abduction, adduction.

12 sessions--3 times a week for 4 weeks

Primary outcomes

  1. Change in coordination at the shoulder and elbow measured by joint independence after arm training assessed start of training, discharge and at follow up.

    Time frame: baseline, 4 weeks, 8 weeks

    kinematic measure of coordination between the shoulder and elbow joint

  2. Change in quality of arm motion measured by smoothness at the start of arm training, at 4week, and 8 weeks.

    Time frame: baseline, 4 weeks, 8 weeks

    kinematic assessment of arm motion measured by average velocity decided by maximum velocity

  3. Change in motor impairment of the arm measured by Fugl-Meyer Assessment (FMA) at the start of training, discharge, and follow up.

    Time frame: baseline, 4 weeks, 8 weeks

    performance based assessment of underlying motor impairment of the affected shoulder, elbow, hand after stroke

  4. Change in motor impairment and functional ability of the arm measured by the Wolf Motor Function Test (WMFT) at start of training, discharge, and follow up.

    Time frame: baseline, 4 weeks, 8 weeks

    performance based assessment of underlying motor impairment and function of the affected arm after stroke

Sponsors and collaborators

Lead sponsor

New York Presbyterian Hospital

Other

Collaborators

  • New York University

Registry information

Official study title

A Randomized Control Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics With Individuals After Chronic Stroke

Important dates

Study start
2014
Primary completion
2015
Study completion
2015
First posted
Sep 7, 2016
Registry last updated
Sep 7, 2016

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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