Improving Arm and Hand Functions in Chronic Stroke (CIHR 2012-2015)
Improving Arm and Hand Functions in Chronic Stroke (CIHR 2012-2015)
Improving arm and hand function after stroke has been difficult to achieve within the
 rehabilitation service provided in the acute stage often due to the limited resource in
 health care. While spontaneous recovery plateaus after 6 months, the prolonged disability
 affects quality of life and social participation in stroke survivors. This study is aimed at
 improving chronic motor impairment arm and hand impairment by providing the intervention with
 intensive training schedule. This study will compare two types of rehabilitation intervention
 using a randomized controlled trial. Measurements also will be taken on various brain
 functions non-invasively to help discover how each of the intervention strategies works
 differently to repair the brain.
After unilateral stroke, incomplete recovery of arm and hand movement is common and its
 long-lasting negative effects include increased care giving costs and overall reduced quality
 of life. Recent evidence suggests that a novel behavioral intervention could improve motor
 functions in sub-acute patients with added benefits in cognitive and brain functions. However
 few studies have addressed whether chronic stage patients can also benefit from the
 intervention and how brain plasticity works over the course of rehabilitation. This study
 will investigate the benefits of two types of intervention methods that are extendable for
 community-based intervention services in the future. It also will examine changes in
 integrity of motions before and after the intervention. Further comparisons between brain
 functions and structure will be made using magnetoencephalography (MEG) and magnetic
 resonance imaging (MRI), non-invasively. These behavioural and physiological measures will
 inform the mechanisms of stroke recovery and training.
Inclusion Criteria:

 -  post-acute stroke patients with unilateral first-time MCA stroke sustained . (more
 than 6 months ago prior to the enrolment to the study).

 -  Patients' residual motor impairments in the affected hand and arm should be greater
 than stage 3 on the Chedoke McMaster scale.

 Exclusion Criteria:

 -  Patients with moderate apraxia, aphasia or dementia, and patients with severe sensory
 loss in the paretic hand, severe language-communication disability, posture problems,
 involuntary movements, high-blood pressure, depression or other psychological
 disorders, metal in body that interferes with MEG and MRI measurements.