Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: a protocol for a pilot randomised clinical trial

 

Who from your hospital is following this research? If no one is assigned that duty.

  Nobody? Then have your doctor, the stroke department head, the president and the board of directors fired. Think that is too extreme?  It should have been done decades ago. The dead wood in stroke needs to be removed.

Effects of home-based mirror therapy and cognitive therapeutic exercise on the improvement of the upper extremity functions in patients with severe hemiparesis after a stroke: a protocol for a pilot randomised clinical trial

Josefa Gonzalez-Santos  ¹ , Raul Soto-Camara  ² , Paula Rodriguez-Fernández  ¹ , Maria Jimenez-Barrios  ¹ , Jeronimo Gonzalez-Bernal  ¹ , Carla Collazo-Riobo  ¹ , Maha Jahouh  ¹ , Yolanda Bravo-Anguiano  ³ , Jose M Trejo-Gabriel-Galan  ³

Affiliations

• PMID: 32978182
• DOI: 10.1136/bmjopen-2019-035768

Free article

Abstract

Introduction: Neuroplasticity is defined as the capacity of the brain to reorganise new neuronal pathways. Mirror therapy (MT) and cognitive therapeutic exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to improve the motor functions of the affected upper extremity in patients with severe hemiparesis after a stroke. Home-based interventions are an appropriate alternative to promote independence and autonomy. The objective of this study is to evaluate which of these techniques, MT and CTE, combined with task-oriented training, is more effective in functional recovery and movement patterns of the upper extremities in patients with severe hemiparesis after a stroke.

Methods and analysis: This is a home-based, single-blind, controlled, randomised clinical trial with three parallel arms, including 154 patients who had a stroke aged above 18 years. The primary outcome will be the functionality of the affected upper extremity measured using the Fugl-Meyer Assessment. Secondary variables will include cognitive performance, emotional state, quality of life and activities of daily living. During 6 weeks, one of the intervention groups will receive a treatment based on MT and the other one on CTE, both combined with task-oriented training. No additional interventions will be provided to the control group. To assess the progress of patients who had a stroke in the subacute phase, all variables will be evaluated at different visits: initial (just before starting treatment and 4 weeks post-stroke), post-intervention (6 weeks after initial) and follow-up (6 months).

Ethics and dissemination: This protocol has been approved by the Institutional Review Board (CEIm-2.134/2.019) and registered at ClinicalTrials.gov (NCT04163666). The results will be disseminated through open-access peer-reviewed journals, conference presentation, broadcast media and a presentation to stakeholders. These study results will provide relevant and novel information on effective neurorehabilitation strategies and improve the quality of intervention programmes aimed at patients after a stroke.

Trial registration number: ClinicalTrials.gov (NCT04163666).

Keywords: neurology; rehabilitation medicine; stroke.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.