Characterising the Neuromuscular Function of Post Stroke Patients
ConditionStroke (CVA) or TIA
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age40-85
SponsorUniversity of Nottingham
About this trial
Strokes are a leading cause of death and disability in developed countries, with significant economic and social impacts. Defined by the WHO, strokes cause rapid and lasting disturbances in cerebral function. In the UK, strokes occur every five minutes, affecting 100,000 people annually and resulting in substantial physical impairments and financial costs. Although stroke-related deaths have decreased due to improved treatments and awareness, strokes remain a major cause of death and disability worldwide, especially in lower-income countries. Strokes typically cause unilateral deficits, leading to significant daily challenges and necessitating tailored rehabilitation strategies such as CIMT, FES, and VR Rehab. As the population ages, innovative neurorehabilitation approaches are essential to enhance functional recovery post-stroke. This pilot study aims to better understand the neuromuscular deficits caused by stroke to inform and improve future rehabilitation interventions, including the potential use of force accuracy training (FAT)
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
• Aged between 40-85 years
Willing and able to give informed consent for participation in the study
Had a confirmed stroke within the last 5 years
Self-reports persisting post-stroke loss of unilateral limb function
Disqualifiers
• Diagnosis of cognitive impairment/dementia
Current or recent (<2y) malignancy
Severe respiratory disease (e.g., uncontrolled asthma, COPD, pulmonary hypertension)
Active cardiovascular disease: Uncontrolled hypertension (BP>160/100mmHg); Recent (<12mo) cardiac event; Heart failure (Class III/IV); Significant arrhythmia; Unstable angina
Trial population
Post-stroke survival
Trial design
Design model
Cohort
Time perspective
Cross-sectional
Treatments tested in this trial
Neuromuscular function
Other interventionAssessing their neuromuscular abilities using some functional and electromyography assessments
Treatment groups
16 Participants
are divided into 1 treatment groupGroup A: Stroke patients1 intervention
Trial outcomes
Primary outcomes
1
Isometric dynamometry
to determine maximum voluntary contraction (MVC) for upper and lower limb extension and flexion, including handgrip dynamometry (in Newton unit)
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 years2
High-Density Surface electromyography (HDsEMG) and intramuscular electromyography (iEMG) of the muscles of the upper (bicep and tricep) and lower limbs (vastus lateralis and tibialis anterior) to determine muscle activation patterns
Intramuscular electromyography (iEMG) and high-density sEMG (HD-sEMG) will be used to determine motor unit structure (size \& number) and function (firing rate, firing complexity, neuromuscular junction transmission reliability). sEMG will also be used to determine muscle activation patterns and the largest compound muscle action potential (M-wave). This will be performed using skin electrodes (HDsEMG) and a small pin-type electrode (iEMG) inserted into the upper and lower limb muscles (measured in µVms).
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 years3
Motor control assessments for the upper and lower limbs (i.e., force tracking tasks for knee and elbow extension).
Participants will be requested to follow a force trace line on a monitor during extension and flexion movements. The intensity of this force will be relative to their individual capabilities (measured as CoV of force)
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 years4
Balance tests
Using a platform that can assess features such as Centre of Pressure (COP) and sway, participants will be asked to stand on both feet, and then on one foot with their eyes open and closed. Time to failure (i.e., need to place second foot on the floor and/or open eyes) will be recorded. A chair will be located behind participants for this assessment and a researcher will remain within touching distance. Participants will only be requested to complete the aspects of this assessment that they feel comfortable doing (measured in millimeter).
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 yearsSecondary outcomes
1
The Grooved Pegboard Test to assess dexterity
This simply involves participants placing small metal pegs into small holes in a specific order. This assessment is timed (in seconds).
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 years2
The Trail Making Test (TMT)
is a timed, neuropsychological test that involves visual scanning and working memory (measured in seconds).
Time frame
During the single testing session (baseline) for the eligible stroke survivors who had a stroke within the past 5 yearsSponsors and contacts
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Source ClinicalTrials.gov