This trial is examining the effectiveness of training and non-invasive brain-stimulation on changing abnormal hand movements after a stroke. The main outcomes to be measured are individual finger function and the ability to use the arms for normal daily activities. This study is being conducted in Maryland, the United States.
The details
Sometimes after a stroke patients’ arms and legs may be held in abnormal positions due to muscle weakness. When the muscles that straighten out the arm and hand are weak, the arm, wrist and fingers may stay bent and held close to the chest. This is called flexor synergy. This condition makes normal tasks such as dressing and washing (activities of daily living) very difficult. Transcranial direct current stimulation (tDCS) involves delivering a low current of electricity to the brain through some stickers placed on the head. It has shown promising results on improving arm function after stroke.
The aim of this trial is to see if tDCS and usual arm training together can change abnormal hand synergy after a stroke. The main outcomes to be measured are finger independence, ability to do activities of daily living (ADLs) and mobility of the arm.
Who are they looking for?
This study is recruiting 40 patients. Patients must have evidence of flexion synergy in the hand (wrist and fingers stay bent) but must be able to straighten fingers out at least 5 degrees.
Patients must not have memory or reasoning problems or have any joint/muscle/neurological conditions such as arthritis or Parkinson’s disease. Patients must not have any conditions or implants that would interfere with tDCS (e.g. metal in the skull, heart stimulator, skull defect). Patients must be able to sit in a chair and do arm exercises for 1-hour at a time. Patients must not be involved in any other rehabilitation study, be pregnant, have a terminal illness or have any social/personal reasons that would interfere with therapy and follow-up sessions.
How will it work
Patients will be randomized into two groups. One group will receive tDCS and usual task training for 5 days in a row. The other group will receive fake tDCS and usual task training for 5 days in a row. After 5 days of treatment, patients arm abilities will be re-assessed and changes in abilities will be recorded. Assessment includes the strength of fingers, ability to do ADLs and speed and ability to do tasks. Patients will then be re-assessed again 1 week later.
