Dynamic Perturbation Training for Home-Based Upper Limb Rehabilitation in Chronic Stroke

Launched by UNIVERSITY HOSPITAL OF FERRARA · May 19, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating a new way to help people who have had a stroke regain movement in their arms. The study focuses on whether a special training program, called Dynamic Perturbation Training, can improve upper limb function. Participants will be divided into two groups: one group will use an arm brace that provides resistance during exercises at home, while the other group will use a similar brace but without the resistance. This way, researchers can compare the results to see if the resistance helps more with rehabilitation.

To be eligible for the trial, participants must be at least 18 years old and have experienced their first stroke at least six months prior. They should also have some difficulty using their arm or hand but still be able to perform basic movements. Participants will engage in a 10-day home rehabilitation program, with remote support from study staff. They will complete daily exercises and report their fatigue and satisfaction with the program. Importantly, if someone in the control group wants to try the arm brace with resistance after the study, they will be given that opportunity. Overall, the trial aims to find effective ways to support stroke recovery and improve quality of life.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Males and females aged 18 years or older;
• • Diagnosis of first cerebral stroke (ischaemic or haemorrhagic) in the chronic phase (i.e. at least 6 months after the onset of the acute event) verified by brain imaging (brain computed tomography and/or magnetic resonance imaging);
• • Motor deficit in the upper limb - and in particular in the hand - caused by stroke, not attributable to other conditions or diseases and not such as to preclude the ability to perform movements with the fingers and to perform movements to grasp objects;
• • Ability to express informed consent correctly.
• • Availability of a webcam and Internet connection at home for remote supervision of activities by the staff involved in the study.
• Exclusion Criteria:
• • Medical conditions that may interfere with the ability to safely complete the study protocol;
• • Cognitive dysfunction that precludes informed consent;
• • Severe neuropsychological disorders;
• • Severe visual problems;
• • Upper limb pain assessed with Visual Analogue Scale (VAS) \> 7;
• • Severe internal diseases (e.g. cardiopulmonary, renal, hepatic);
• • Diseases with inflammatory skin lesions, wounds, sensory and circulatory disorders below the elbow and on the hand in the area of application;
• • Contraindications to transcranial magnetic stimulation (TMS) procedures, assessed as indicated by international reference, such as: presence of intracranial metal implants, positive history of epilepsy, frequent migraines, implantable devices (ventricular-peritoneal shunts, pacemakers, intrathecal pumps, intracranial metal implants). It should be noted that the presence of this type of exclusion criterion will preclude the performance of TMS assessments, but not the remaining procedures of the study;
• • Pregnancy.