Therapies for Recovery of Hand Function After Stroke

Completed · Not applicable

Conditions studied: Stroke, Upper Extremity Paresis, Hemiplegia

In brief

After a stroke, it is very common to lose the ability to open the affected hand. The purpose of this study is to compare the effects of three different therapies on recovery of hand function after stroke and determine if any one is better than the other.

Key facts

Study ID

NCT03574623

Run by

MetroHealth Medical Center

People needed

132

Starts

2019-02-15

Expected to finish

2024-10-16

Last updated by the study team

2026-03-20

Who can join

Age: 21 and older, up to 90. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• 6 to 24 months since a first clinical cortical or subcortical, hemorrhagic or nonhemorrhagic stroke
• unilateral upper limb hemiparesis with finger extensor strength of grade no more than 4 out of 5 on the Medical Research Council (MRC) scale
• score of at least 1 and no more than 11 out of 14 on the hand section of the upper extremity Fugl-Meyer Assessment
• adequate active movement of the shoulder and elbow to position the hand in the workspace for table-top task practice (necessary for the lab task practice sessions)
• able to follow 3-stage commands
• able to recall at least 2 of a list of 3 items after 30 minutes
• skin intact on the hemiparetic arm
• surface stimulation of the paretic finger and thumb extensors produces functional hand opening without pain (this will exclude those who have too much flexor spasticity)
• able to hear and respond to cues from stimulator
• not receiving occupational therapy (no concomitant OT)
• full voluntary opening/closing of the contralateral (less affected) hand
• demonstrates ability to follow instructions for operating the stimulator or have a caregiver who will assist them

You may not qualify if…

• co-existing neurologic diagnosis of peripheral nerve injury, Parkinson's disease, spinal cord injury, traumatic brain injury, or multiple sclerosis
• uncontrolled seizure disorder
• brainstem stroke
• uncompensated hemineglect
• severe shoulder or hand pain
• insensate forearm or hand
• history of potentially fatal cardiac arrhythmias with hemodynamic instability
• implanted electronic systems (e.g. pacemaker)
• botulinum toxin injections to any upper extremity muscle within 3 months of enrolling
• pregnant women due to unknown risks of surface NMES during pregnancy
• lack of functional passive range of motion of the wrist or fingers of affected side
• diagnosis (apart from stroke) that substantially affects paretic arm and hand function
• deficits in communication that interfere with reasonable study participation
• lacking sufficient visual acuity to see the stimulator's display
• concurrent enrollment in another investigational study

Where it is running

• Emory University and Atlanta VA — Atlanta, Georgia, United States
• Johns Hopkins University — Baltimore, Maryland, United States
• Kessler Foundation — West Orange, New Jersey, United States
• MetroHealth Rehabilitation Institute — Cleveland, Ohio, United States

Full record on ClinicalTrials.gov

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