Hybrid Approach to Mirror Therapy and Transcranial Direct Current Stimulation for Stroke Recovery
Cerebrovascular Accident
About this trial
This is an interventional treatment trial for Cerebrovascular Accident focused on measuring Stroke Rehabilitation, Hybrid therapy, Mirror Therapy, Transcranial Direct Current Stimulation
Eligibility Criteria
Inclusion Criteria:
- First episode of stroke in cortical regions
- Time since stroke more than 6 months
- Initial motor part of UE of FMA score ranging from 24 to 52, indicating moderate to mild movement impairment
- No severe spasticity in any joints of the affected arm (Modified Ashworth Scale ≤ 2)
- No serious cognitive impairment (i.e., Mini Mental State Exam score≧ 24)
- Willing to sign the informed consent form.
Exclusion Criteria:
- Aphasia that might interfere with understanding instructions
- Visual/attention impairments that might interfere with the seeing of mirror illusion, including hemineglect/hemianopsia
- Major health problems or poor physical conditions that might limit participation
- Currently participation in any other research
- Previous brain neurosurgery
- Metallic implants within the brain.
Sites / Locations
- Yong Cheng Rehabilitation Clinic
- Xing Cheng Rehabilitation Clinic
- Chang Gung Memorial Hospital
- Lo-Sheng Sanatorium and Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Active Comparator
Active Comparator
Mirror therapy with tDCS
Mirror Therapy
Control Intervention
Mirror Therapy with sham-tDCS
Functional training will consist of unilateral and bilateral functional tasks in daily living, and last for 30 minutes. Some examples are mopping the table by using the affected hand or scooping beans from a bowl with one hand while the other hand stabilizes the bowl. The principles of part-task practice and whole-task practice will be applied based on the participant's performance level.Functional training will consist of unilateral and bilateral functional tasks in daily living, and last for 30 minutes. Some examples are mopping the table by using the affected hand or scooping beans from a bowl with one hand while the other hand stabilizes the bowl. The principles of part-task practice and whole-task practice will be applied based on the participant's performance level.
The MT only group will receive a 60-minute MT per session followed by a 30-minute functional training. Participant will go through the same protocol as that for the MT+tDCS and MT+sham tDCS groups with no tDCS presented in setting. This group is for evaluating placebo effect of the present of tDCS application.
The CI group will receive a 60-minute conventional stroke rehabilitation training followed by a 30-minute functional training. During the 60-mimute conventional training, interventions will include passive range of movement and muscle tone normalization techniques of the affected arm, and gross motor training (e.g., shoulder ladder activity), fine motor training (e.g., grasping cones), and muscle strength training in a unilateral and bilateral manners. During the 30-minute functional training, the same principles to those in the MT groups will be applied.
Functional training will consist of unilateral and bilateral functional tasks in daily living, and last for 30 minutes. Some examples are mopping the table by using the affected hand or scooping beans from a bowl with one hand while the other hand stabilizes the bowl. The principles of part-task practice and whole-task practice will be applied based on the participant's performance level.