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TEchnology-Supported Task-oriented TRaining of Arm-hand function in persons with Chronic Stroke
ISRCTN ISRCTN82787126
ClinicalTrials.gov identifier
Public title TEchnology-Supported Task-oriented TRaining of Arm-hand function in persons with Chronic Stroke
Scientific title TEchnology-Supported Task-oriented TRaining of Arm-hand function in persons with Chronic Stroke: a multicentre, single-blind, randomised controlled trial
Acronym TEST-TRACS
Serial number at source N/A
Study hypothesis An 8-week technology-supported task-oriented training program improves skilled arm-hand performance and quality of life in chronic stroke patients. This improvement is larger after technology supported task-oriented training than after task-oriented training without technology support. Differences in improvement of skilled arm-hand performance between training conditions will last for at least 6 months.

Please note that as of 09/02/09 this record was updated to include an amended anticipated start date. The initial anticipated start date was 01/09/2008.
Ethics approval Added 09/02/2009: The study was approved by the Medical Ethics Committee of Rehabilitation Foundation Limburg on 7th July 2008 (ref: METC-08-0006; NL23303.022.08)
Study design Multicentre, single-blind, randomised controlled trial.
Countries of recruitment Netherlands
Disease/condition/study domain Stroke/Neurorehabilitation
Participants - inclusion criteria 1. First ever stroke
2. 18 - 85 years old, male and female
3. Clinically diagnosed as having a central paresis of the arm/hand (strength: Medical Research Council grade 2-3-4 at entry into the study)
4. Post-stroke time greater than or equal to 12 months
5. Fair-good cognitive level (Mini Mental State Examination [MMSE] score greater than or equal to 26 or CogLog score greater than or equal to 26)
6. Ability to read and understand Dutch language
7. Impaired as to at least two of the following skills: drinking from a cup, eating with knife and fork, open/close clothing, taking money from purse, wash/dry body, holding reek/broom/spade, grooming, keyboard work, balancing object while holding it
8. Motivated to train on above mentioned skills
Participants - exclusion criteria 1. Neglect: Bells Test, Letter Cancellation Test: minimum omission score of 15% is considered to indicate unilateral spatial neglect
2. Hemianopsia, retrieved from patient's medical file
3. Severe spasticity: Modified Ashworth Scale total arm greater than 4
4. Severe additional neurological, orthopaedic or rheumatoid impairments prior to stroke that may interfere with task performance
5. Broca aphasia, Wernicke aphasia, global aphasia: as determined by the Akense Afasie Test
6. Apraxia: Apraxietest of Van Heugten
Anticipated start date 01/03/2009
Anticipated end date 30/06/2010
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 60
Interventions Intervention group:
Participants train on at least two skills they select from a list of 10 skills established in prior research. Participants will receive video-based instruction of predefined task-oriented exercises required for the training. Exercises are offered with increasing difficulty levels for skill components that keep a strong relation with the skill itself. Task-oriented training will be supported by technology, i.e. upper limb kinematics will be recorded during skill performance in stroke patients while training. Feedback about exercise performance (knowledge of performance and knowledge of results) is given both during and after exercise, based on registration of kinematic parameter information. Patients train for 8 weeks at a minimum of 4 days per week, 30 minutes twice per day.

Control group:
Participants train on at least two skills from a list of 10 skills on offer. Participants will receive video-based instruction of predefined task-oriented training exercises required. Exercises are offered with increasing difficulty levels for skill components that keep a strong relation with the skill itself. Patients train for 8 weeks at a minimum of 4 days per week, 30 minutes twice per day. The control group will perform training without technology support or technology-based feedback on performance.
Primary outcome measure(s) Arm-hand function:
1. As measured on function level by Brunnstrom-Fugl-Meyer Test
2. As measured on activity level by the Action Research Arm Test and the Motor Activity Log

The outcomes above will be assessed at the following timepoints:
T0: Baseline
T1: After training for 4 weeks
T2: After training for 8 weeks
T3: 6 months after finishing the training programme
Secondary outcome measure(s) Quality of life at T0, T2 and T3:
1. The 36-item Short Form health survey (SF-36)
2. EuroQol-6D questionnaire

T0: Baseline
T1: After training for 4 weeks
T2: After training for 8 weeks
T3: 6 months after finishing the training programme
Sources of funding 1. Philips Research (Netherlands)
2. Technical University Eindhoven (Netherlands)
3. Rehabilitation Foundation Limburg (Stichting Revalidatie Limburg [SRL]) (Netherlands)
Trial website
Publications
Contact name Mrs  Annick  Timmermans
  Address Zandbergsweg 111
  City/town Hoensbroek
  Zip/Postcode 6432 CC
  Country Netherlands
  Tel +31 45 5282372
  Fax +31 45 5282227
  Email A.Timmermans@tue.nl
Sponsor Rehabilitation Foundation Limburg (Stichting Revalidatie Limburg [SRL]) (The Netherlands)
  Address c/o Dr Henk Seelen
Zandbergsweg 111
  City/town Hoensbroek
  Zip/Postcode 6432 CC
  Country Netherlands
  Sponsor website: http://www.srl.nl
Date applied 11/04/2008
Last edited 09/02/2009
Date ISRCTN assigned 17/04/2008
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