Self-Administered Gaming and Exercise at Home (SAGEH) (SAGEH)
Stroke, Hand Weakness
About this trial
This is an interventional treatment trial for Stroke focused on measuring stroke, stroke recovery, hand weakness, video game
Eligibility Criteria
Inclusion Criteria: Age 21 years and over Stroke confirmed by CT or MRI within the previous 6 weeks. Arm and/or hand impairment induced by the stroke. Meet JSTTEP criteria and are enrolled in JSTTEP. Admitted to the Johns Hopkins Hospital (JHH) inpatient stroke service. Proficient in speaking and reading English. Willing and capable to contacted remotely for all necessary telemedicine contacts. No history of prior ischemic or hemorrhagic stroke with associated motor deficits (prior stroke with no upper limb motor symptoms is allowed) Ability to give informed consent. Exclusion Criteria: Arm impairment that is too severe (FM-UE < 40) on day of baseline testing prior to beginning of the study. Recent Botox injection to upper limb (since stroke onset). History of physical or neurological condition that interferes with study procedures or assessment of motor function (e.g. severe arthritis, severe neuropathy, Parkinson's disease). Terminal illness with life expectancy < 6 months. Inability to sit in a chair and perform hand exercises for 20 minutes at the time. Cognitive impairment, with score on Montreal Cognitive Assessment (MoCA) ≤ 20. Social and/or personal circumstances that prevent telemedicine follow-up.
Sites / Locations
- Johns HopkinRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Experimental
No Intervention
Treatment Arm G1
Treatment Arm G2
Control Group (CG)
The interventions will consist of 5 daily sessions over 3 weeks. Because the interventions are self-administered, the sessions are unsupervised in the sense that the sessions do not include synchronous therapy provided by a clinician or a therapist. Instead, during each week, the intervention will include 2 short (less than 15 minutes) telemedicine check-in appointments (not standard of care) provided by a licensed occupational therapist for the purposes of assessing safety and providing guidance for the unsupervised sessions. The intervention will focus on stretches, warm-up and strengthening exercises aimed at improving hand function.
The intervention will consist of 5 daily sessions over 3 weeks. Because the interventions are self-administered, the sessions are unsupervised in the sense that the sessions do not include synchronous therapy provided by a clinician or a therapist. Instead, during each week, the intervention will include 2 short (less than 15 minutes) telemedicine check-in appointments (not standard of care) provided by a licensed occupational therapist for the purposes of assessing safety and providing guidance for the unsupervised sessions. In this treatment arm, participants will use a knob-like computer interface connected to a tablet. The tablet features a series of game-like tasks to be carried out by moving the interface with the fingers. The target intervention is scheduled for 1.5 hours per day, which is typically divided into two sessions of 40 minutes with a 10-minute break in between.
Unlike G1 and G2, the CG will remain in the standard of care treatment plan but will not receive any additional therapy. That is to say, participants will follow standard therapy plans as dictated by normal post-stroke hospital discharge planning. The only difference from the standard of care will be that participants in CG will still receive identical check-in appointments with follow-up questions concerning recovery and activities.