Practice Structure on Motor Learning in Post-Stroke Patients

Sponsor

University of Sao Paulo (Other)

Overall Status

Completed

CT.gov ID

NCT00604747

Collaborator

(none)

Enrollment

Location

Arm

Duration (Months)

3.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Background: The literature indicates that, in relation to motor learning, healthy subjects benefit more from random practice than from constant practice. However, this effect is not well known in post-stroke patients. Objective: The goal of this study was to investigate the effects of practice structure on motor learning in post-stroke patients. Methods: Participants included an experimental group (EG) of post-stroke patients: 17 males and females; and a control group (CG) of healthy individuals: 17 males and females. At the acquisition phase, all participants performed 30 trials of a coincident timing task. Nine individuals from each group practiced constantly (C) at a stimulus propagation speed of 3 mph, and eight from each group practiced randomly (R) at speeds of 2, 3, and 5 mph. Subsequent phases included: 1) transfer, 2) retention after 15 minutes, and 3) retention after 3 days. Each of these phases included 20 trials: 10 at a speed of 1 mph, and 10 at a speed of 4 mph. Intra- and inter-group comparisons were made employing an alpha level of 0.05 (5%).

Condition or Disease	Intervention/Treatment	Phase
Stroke	Other: Structure practice	N/A

Detailed Description

Utilized was Bassin's anticipation timer (Lafayette Instruments #50575), which is comprised of a control screen, one 1.52 m gutter with 32 diodes placed on it linearly, and a response button. The screen has a digital display, with commands that permit the operator to control the stimulus propagation speed and the preparatory interval speed. Once activated, the screen exhibits an alert signal, and, after the preparatory interval, it initiates the propagation of a luminous stimulus, lighting the 32 diodes successively. The task required participants to press the response button simultaneously with the illumination of the last diode. The digital display showed the error measure (em): that is, the difference between the illumination of the last diode and the response.

Study Design

Study Type:

Interventional

Actual Enrollment :

34 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

The Effects of Practice Structure on Motor Learning in Post-Stroke Patients

Study Start Date :

Aug 1, 2006

Actual Primary Completion Date :

Jul 1, 2007

Actual Study Completion Date :

Jul 1, 2007

Arms and Interventions

Arm	Intervention/Treatment
Other: 1, 2	Other: Structure practice there were 2 groups which received random practice and constant practice during acquisition phase Other Names: experimental group (EG) control group (CG)

Arm

Intervention/Treatment

Other: 1, 2

Other: Structure practice

there were 2 groups which received random practice and constant practice during acquisition phase

Other Names:

experimental group (EG)

control group (CG)

Outcome Measures

Primary Outcome Measures

change in performance during the acquisition; performance exhibited during the transfer phase was maintained during retention phases 1 and 2; and differences between the groups during the transfer phase and retention phases [time in miliseconds]

Eligibility Criteria

Criteria

Ages Eligible for Study:

40 Years to 62 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

First cerebrovascular accident
Lesion covering the middle and the anterior cerebral artery territories
Presence of hemiplegia or hemiparesis
Mini-Mental State Examination (MMSE) score above 24 (19)
Sufficient attention and comprehension to perform the task
Absence of other associated neurological diseases.

Exclusion Criteria:

Acute medical problems
Uncorrected vision loss
Previous history of psychiatric admission
History of multiple strokes, transient ischemic attacks
Pathology of the less affected, ipsilateral to stroke upper extremity that would affect ability to perform the task
Score of 23 or less on the MMSE
Difficulty in comprehension of verbal command and simple instructions
Aphasia of comprehension.