Arm Motor Rehabilitation, Entertainment and Cognition System for the Elderly (Clinical Trial)

This is an interventional treatment trial for Acute Stroke focused on measuring acute stroke, sub-acute stage Read More

Inclusion Criteria (general)

• Age 50 to 85;
• Healthy age-matched volunteers
• diagnosis of CVA that occurred more than 5 days prior and less than 21 days prior (for the stroke survivors group);
• English speakers;
• UE unilateral or bilateral involvement (from new bilateral CVA)
• motor involvement (FMA score 20 to 45);
• ability to actively move UE more than 10o for shoulder and elbow flexion/extension;
• ability to actively extend fingers at least 5o
• cognitive skills to participate (Montreal Cognitive Assessment (MoCA) [Nasreddine et al 2005] score 10-30).
• The adaptive nature of BBC system hardware and therapeutic games can compensate for the motor limitations due to other co-morbidities. Therefore potential participants will not be excluded due to co-morbidities such as Parkinson or arthritis.

Subjects may have normal cognition, MCI or dementia, since the games can compensate for diminished cognition through built-in cues and instructions.

• Inclusion Criterion for the controlled clinical trials arm at Kessler Foundation

  • Living within 25 miles radius of Kessler Foundation West Orange location. This will facilitate participation in the outpatient clinic training, which follows inpatient rehabilitation.

• Exclusion Criteria. (general)

  • being younger than 50 or older than 85 years of age
  • previous stroke
  • Stroke that occurred more than 20 days prior to enrolment
  • Inability to actively extend fingers at least 5 degrees; v. 7/8/2018
  • Fugl-Meyer scores of 19 or less;
  • severe visual neglect or legally blind
  • severe hearing loss or deafness
  • receptive aphasia or severe expressive aphasia;
  • severe spasticity (Modified Ashworth Scale 4/4)
  • contractures of the upper limb joints
  • uncontrolled hypertension (>190/100 mmHg)
  • severe cognitive impairment determined by Montreal Cognitive Assessment (MoCA) [Nasreddine et al, 2005] test of 9 and below;
  • No chemodenervation or nerve block to upper limb involved during the experimental period (e.g., botulinum toxin injection)
  • inability to speak English;
  • a history of violence or drug abuse.
  • paranoia and psychotic behaviour.
  • inability participate in the neuropsychological pre-study assessment for reliable scores (e.g., cognitive impairment, communication disorders).

Exclusion Criteria. (Controlled study arm)

o Those living outside approximately 25 miles radius of Kessler Foundation West Orange location. Those living too far will have a harder time completing the study as outpatients, as they will probably choose clinics closer to home.