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Trial registered on ANZCTR
Registration number
ACTRN12612000695808
Ethics application status
Approved
Date submitted
29/02/2012
Date registered
29/06/2012
Date last updated
1/10/2015
Type of registration
Retrospectively registered
Titles & IDs
Public title
A pilot study to evaluate an intensive upper limb rehabilitation program after stroke
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Scientific title
A pilot study investigating whether adults with stroke experience greater dexterity after using a Saebo splint in addition to their usual rehabilitation program compared to usual rehabilitation program alone.
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Secondary ID [1]
279754
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Nil.
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Universal Trial Number (UTN)
Nil.
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Trial acronym
Nil.
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Upper limb hemiplegia
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Stroke
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Condition category
Condition code
Stroke
285811
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0
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Ischaemic
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Stroke
285812
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0
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Haemorrhagic
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Physical Medicine / Rehabilitation
287102
287102
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0
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Occupational therapy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Use of a specific mechanical dynamic orthosis plus Occupational Therapy training (intensive one-on-one movement training sessions, behavioural strategies to increase patient motivation, and a task-specific home exercise program using the mechanical dynamic orthosis).
The mechanical dynamic orthosis (Saebo splint) is worn on the hemiplegic arm only, and may be used up to twice daily (5 x per week) for a maximum session length of 60 minutes for 8 weeks. All sessions are administered by an occupational therapist within the hospital clinic environment.
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Intervention code [1]
284202
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Rehabilitation
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Comparator / control treatment
Usual Occupational Therapy rehabilitation program: at the participating hospitals this will include a minimum of 1 x session per day with an occupational therapist focused on improving range of movement, active grasp and release, and reach. Treatment sessions are based on task-specific motor training, and will be approximately 45 minute session length. The program duration is 8 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Range of movement measured using a goniometer: Trapezius (shoulder elevators)
Deltoid middle (shoulder abductors)
Pectoralis major (shoulder adductors)
Deltoid anterior (shoulder flexors)
Deltoid posterior (shoulder extensors)
Subscapularis
(shoulder internal rotators)
Infraspinatus (shoulder external rotators)
Biceps brachii (elbow flexors)
Triceps (elbow extensors)
Wrist extensors (extensor carpi ulnaris/radialis)
Wrist flexors (flexor carpi radialis/ulnaris)
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Assessment method [1]
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Timepoint [1]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Primary outcome [2]
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Grip Strength measured with Dynamometry
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Assessment method [2]
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Timepoint [2]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Secondary outcome [1]
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Dexterity as measured using the Box and Block test of dexterity.
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Assessment method [1]
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Timepoint [1]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Secondary outcome [2]
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Functional task performance as measured using the Motor Assessment Scale for Stroke.
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Assessment method [2]
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Timepoint [2]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Secondary outcome [3]
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Pain, as measured using the Stroke Impact Scale.
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Assessment method [3]
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Timepoint [3]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Secondary outcome [4]
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Caregiver assistance required as measured using the Stroke impact Scale.
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Assessment method [4]
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Timepoint [4]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Secondary outcome [5]
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Spasticity as measured using the Tardieu Scale for Stroke
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Assessment method [5]
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Timepoint [5]
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Baseline (prior to intervention) and post-intervention (after 8-weeks of intervention).
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Eligibility
Key inclusion criteria
1. 18 years of age or older (adult),
2. diagnosis of stroke ,
3. Upper limb hemiplegia (score of < 6 on 6 items 6 and/or 7 of the motor Assessment scale [16NL]Alert and oriented to person and place with the ability to complete at a minimum a one step verbal command,
4. Score of 21 or greater on the Mini mental State Examination.
5. Adequate English to communicate with the therapist/participate in a rehabilitation program.
6. Demonstrated active range of motion of 10 degrees shoulder flexion / abduction and 10 degrees of elbow flexion / extension.
7. Patient must be independent with seated posture in a chair with a firm seat and back support but no arm rests
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Minimum age
18
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Medically unsuitable for rehabilitation intervention, for example, inpatients who have been diagnosed as palliative.
2. Using the affected hand and arm, able to volitionally grasp and release a tennis ball x10 at maximal volitional shoulder flexion with wrist extension of 10 degrees or more.
3. Complete flaccidity in the affected upper limb and hand
4. Fixed joint deformities, contractures or joint hypermobility that prevents proper joint positioning in the orthosis.
5. History of rheumatoid arthritis, carpal tunnel syndrome or other hand neuropathy.
6. Moderate to severe oedema
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
As eligible patients are identified and agree to participate, the onsite investigator will contact a person off site who will have 10 sealed condition envelopes. The allocation to the control or treatment group will be advised by phone when the person opens the allocation envelope and this will be recorded.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random computer-generated number table.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2011
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Actual
29/09/2011
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Date of last participant enrolment
Anticipated
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Actual
9/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
9
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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National Stroke Foundation
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Address [1]
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Level 7, 461 Bourke Street, Melbourne VIC, 3000
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Associate Professor Natasha Lannin
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Address
Alfred Hospital
Occupational Therapy Department
55 Commercial Road, Prahran VIC 3004
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney
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Address [1]
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PO Box 6, Ryde NSW, 1680
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Country [1]
283559
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Australia
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Other collaborator category [1]
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University
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Name [1]
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University of Newcastle
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Address [1]
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University of Newcastle
Hunter Building
University Drive
Callaghan NSW 2308
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Country [1]
276883
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286646
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Sydney South Eastern Health Human Research Ethics Committee - Northern Sector
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Ethics committee address [1]
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Room G71, East Wing Edmund Blacket Building Prince of Wales Hospital Avoca Street Randwick NSW 2031
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Ethics committee country [1]
286646
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Australia
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Date submitted for ethics approval [1]
286646
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27/04/2011
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Approval date [1]
286646
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01/07/2011
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Ethics approval number [1]
286646
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1/11/0050
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Ethics committee name [2]
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University of Newcastle Human Research Ethics Committee
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Ethics committee address [2]
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University of Newcastle Hunter Building University Drive Callaghan NSW 2308
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
287542
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Approval date [2]
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28/10/2011
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Ethics approval number [2]
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H-2011-0263
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Summary
Brief summary
This project aims to develop and test the feasibility of a clientcentred intervention for improving dexterity for people with stroke. Upper limb hemiplegia is common after stroke, and such people typically achieve lower levels of functional recovery. Many individuals suffering from hemiplegia after stroke exhibit some shoulder and elbow movement but little or no hand function, preventing them from participating in Constraint Induced Movement Therapy (CIMT). Using newer technologies such as a mechanical orthoses offers promise for stroke survivors with hemiplegia. However, no direct evidence exists for optimum wearing regimes, training protocols and timing of therapy. This study will therefore make a significant contribution to healthcare decision making. Participants in the 'treatment' group will be recruited from the Prince of wales inpatient hospital service and will receive an 8-week intervention which will include intensive one-on-one movement training sessions, behavioural strategies to increase patient motivation, and a task specific home exercise program using a hand splint. Participants in the 'control group' will be recruited from the same centre and will receive usual rehabilitation. Outcomes will be assessed at baseline, post intervention, and at 3 months following the conclusion of intervention and will include assessment of range of movement, dexterity, functional task performance, and quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Natasha Lannin
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Address
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Occupational Therapy Department
The Alfred
55 Commercial Road
Prahran Victoria, Australia 3004
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Country
33653
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Australia
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Phone
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+61 41 7135153
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Fax
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Email
33653
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[email protected]
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Contact person for public queries
Name
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Natasha Lannin
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Address
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Occupational Therapy Department, The Alfred, 55 Commercial Road, Melbourne Vic 3004
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Country
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Australia
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Phone
16900
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(+61) 03 90763230
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Fax
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(+61) 0390762920
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Email
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[email protected]
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Contact person for scientific queries
Name
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A/Professor Natasha Lannin PhD
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Address
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Occupational Therapy Department, The Alfred, 55 Commercial Road, Melbourne Vic 3004
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Country
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Australia
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Phone
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(+61) 03 90763230
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Fax
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(+61) 0390762920
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Email
7828
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF