Clinical Research Directory

Perceived Social Support in Adult Stroke

Given the limited evidence in the literature regarding the effect of perceived social support on life satisfaction and social participation in adults with stroke, this study aimed to investigate the effect of perceived social support on these outcomes.

Functional Improvement in Subacute/Chronic Stroke Through Non-invasive Virtual-reality-Based Telerehabilitation

Stroke is the leading cause of disability in adults worldwide. Rehabilitation after a stroke is crucial, even after the acute phase: initially, it aims to recover the deficits caused by the stroke, but in the subacute/chronic phases the objective is to maintain the functional abilities already acquired. After the acute phase, traditional rehabilitation methods usually include exercises prescribed by a therapist that the patient performs on their own. However, their effectiveness is limited due to the lack of supervision, adherence, and insufficient information provided to the patient about their progress, which would require regular in-person contact with the patient. To date, public health systems have been unable to provide this kind of access to rehabilitation for post-stroke patients, with the risk of worsening deficits and a decline in quality of life. We plan to develop an individualized home-based monitoring program enhanced by telerehabilitation based on non-immersive virtual reality (without the need for VR goggles or other "gadgets") (MUVITY) for patients who suffered a stroke in the subacute/chronic phase. Patients seen during an outpatient consultation who require rehabilitation will be randomly assigned either the usual treatment (they will receive a document describing the exercises to perform and a suggested schedule, togheter with an app for communication and health-education, Nora) or the MUVITY treatment: patients will be provided with the telerehabilitation system using a computer and camera where they will perform the rehabilitation exercises, which will be individually adapted according to their progress by a physiotherapist, together with Nora. We believe that MUVITY will lead to improved motor function, emotional well-being, and quality of life, increasing adherence to rehabilitation treatment compared with usual care, and that it can be used in terms of patient satisfaction and pain levels. Our findings could confirm that telerehabilitation improves motor function and quality of life after stroke. Furthermore, since it is a home-based system, its use would considerably increase the number of patients who can receive treatment compared with in-person therapies, eliminating geographic barriers related to distance from rehabilitation centers and offering cost-effective access to effective treatment for all patients. Additionally, our system allows continuous interaction between patients and healthcare professionals, and provides information about their progress, which helps reduce stress related to uncertainty about the future and supports key aspects of monitoring patients in the subacute/chronic phase of stroke such as risk factor control and early detection of complications.

Stroke Mobility and Caregiver Outcomes

This study was designed to determine the effect of functional mobility levels of stroke patients on caregiver burden, anxiety, and depression in their caregivers.

Cerebellar Brain Stimulation Plus Language Therapy for People at Risk of Poor Aphasia Recovery After Stroke

This pilot study tests whether a mild form of brain stimulation to the cerebellum, combined with computer-based language therapy, helps people recover language after a stroke when a poor natural recovery is predicted. People already taking part in a Johns Hopkins study of stroke and language recovery, whose early data suggest the aphasia is unlikely to resolve without treatment, are invited about 3 months after the stroke. Half begin 15 treatment sessions right away and half begin about 3 months later. Each session pairs 25 minutes of transcranial direct current stimulation (tDCS) over the right cerebellum with 45 to 60 minutes of language exercises, with a speech-language pathologist present. The main question is whether language ability, measured with the Western Aphasia Battery-Revised Aphasia Quotient, improves more by 6 months after stroke in the group treated first than in the group still waiting. The study also checks how accurately a machine learning model, built from data collected in the first days after stroke, predicted each person's language ability 12 months after stroke.

Remote Ischaemic Conditioning for Fatigue After Stroke 2 (RICFAST 2)

Post-stroke fatigue is an overwhelming tiredness or lack of energy that does not get better with rest. It affects around half of people who have had a stroke. It can hold back recovery, make it harder to take part in everyday and social activities or to return to work, and reduce quality of life. There are currently no proven treatments for it. Remote ischaemic conditioning (RIC) is a simple treatment that people can do at home using a blood pressure cuff on the upper arm. The cuff is inflated for 5 minutes and then let down for 5 minutes, and this is repeated 4 times, taking about 40 minutes in all. RIC briefly and safely reduces blood flow to the arm before letting it return. Research suggests this may help the body's cells produce energy more efficiently, improve blood flow and reduce inflammation. In our earlier small study (RICFAST), RIC done 3 times a week for 6 weeks was safe and well tolerated, and there were early signs that it might reduce fatigue. This study (RICFAST 2) will find out: * whether people with post-stroke fatigue can safely and comfortably do RIC at home more often (5 times a week) or for longer (12 weeks) * whether enough people can be recruited to a study like this * whether doing RIC more often or for longer might reduce fatigue more, and for longer, than the usual schedule or a comparison treatment * how RIC might work in the body Who can take part? Adults who had a stroke between 3 months and 3 years ago and who have had troublesome fatigue for at least 6 weeks. People are being identified through stroke services, GP practices and community organisations in Sheffield, Doncaster, Rotherham and Barnsley (South Yorkshire, England). What does the study involve? 60 people will take part. Each person will be put into one of four groups by chance (randomisation), with 15 people in each group. The groups differ in the pressure the cuff is inflated to (called "Pressure 1" and "Pressure 2"), and in how often and for how long the treatment is done: * Group A (comparison group): cuff inflated to Pressure 1, 3 times a week for 6 weeks * Group B: cuff inflated to Pressure 2, 3 times a week for 6 weeks * Group C: cuff inflated to Pressure 2, 5 times a week for 6 weeks * Group D: cuff inflated to Pressure 2, 3 times a week for 12 weeks All the treatments cause a feeling of pressure in the upper arm. So that the results are fair, participants will not be told which cuff pressure is expected to have an effect. Everyone will continue with their usual care. Participants will be shown how to use the cuff at home, can do the treatment at any time of day, and will keep a simple treatment log and symptom diary. The research team will phone or video call each week to check how things are going. Each participant will also wear a wrist activity tracker (Fitbit) throughout the study to record their steps, activity and sleep. Questionnaires and tests of fatigue, mood, independence in daily activities, quality of life and walking will be done at the start of the study and 6 weeks, 12 weeks and 24 weeks (about 6 months) after starting treatment. The first three assessments take place at Sheffield Teaching Hospitals, and the 24-week assessment can be done remotely. Travel expenses are paid. Thirty participants from Groups A, B and C will be invited to have extra tests before treatment and after 6 weeks: an exercise test on a bike, a magnetic resonance (MRI) scan of the lower leg muscles to measure how much energy is stored in the muscle, and a blood test for markers of inflammation. Some participants will also be invited to an interview about their experience of doing the treatment at home. What do investigators expect to find? Investigators expect that people in all groups will be able to do the treatment at home, and that RIC done more often or for longer will lead to bigger and longer-lasting improvements in fatigue. The findings will be used to design a larger trial to test whether RIC is an effective treatment for post-stroke fatigue.

Effects of Flexion and Extension Type Arm Slings on Walking Kinematics and Balance in Stroke Patients

In the clinic, stroke patients are seen to use flexor or extensor type arm slings, but no study was found investigating the effects of these different types of arm slings on walking kinematics and balance. The aim of the presented study was to investigate the effects of different types of arm slings on walking kinematics and balance in stroke patients and to compare them with healthy individuals.

The Immediate Effect of Motor Imagery on Functional Upper Limb Movement in Stroke Survivors Assessed Using Surface Electromyography and Kinematic Analysis

The study aims to evaluate the immediate effect of motor imagery on functional upper limb movement in stroke survivors using surface electromyography and kinematic analysis.

"Experimental Study on Stroke Rehabilitation Based on Dual-Task Exercises"

This study will evaluate whether adding computerized cognitive exercises to perturbation-based balance training improves balance and other recovery outcomes in adults who have experienced a stroke within the previous two months. Participants, reside in the Donostialdea catchment area, and are referred to our outpatient neurorehabilitation unit by the Basque Health Service (Servicio Vasco de Salud), will be randomly assigned to one of two groups, Both groups will receive rehabilitation including perturbation-based balance training using the BalanceTutor system. Participants in the experimental group will also complete computerized cognitive exercises using NeuronUP at the same time as balance training. The primary outcome is balance performance measured with the Berg Balance Scale. Other assessments will examine mobility, cognitive performance, functional independence, emotional symptoms, frailty, and quality of life. Assessments are planned at baseline, during treatment, at the end of treatment, and during follow-up (6 and 12 months follow ups). The study will be conducted at the Neurorehabilitation Unit of Bermingham Hospital ( Matia Fundazioa), located in Donostia-San Sebastian, Spain. Expected Impact. The expected outcomes of this project aim to provide scientific evidence on the efficacy of a dual-task intervention in the evolutionary prognosis of subacute stroke.

Motor Learning in Health and Movement Disorders: Role of Physical Activity and Advanced Devices

The goal of this clinical trial is to investigate motor responses in healthy subjects and patients with movement disorders, brain and spinal cord injury, neuromuscular diseases, or cardiovascular diseases. This study aims to evaluate the effectiveness of traditional physical activities combined with innovative interventions such as cryotherapy, ultrasound therapy, laser therapy, transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS). It will also assess the impact of proprioceptive stimuli provided by either the immersive virtual reality (CAREN), or visuo-cognitive-motor enhancement (S.V.T.A.), and music therapy. The main questions it aims to answer are: How do these interventions affect motor activities and their functional recovery? What are the temporal and spatial changes in activation sequences related to motor learning and maintenance? When there is a comparison group: Researchers will compare outcomes between different intervention arms (e.g., physical activity with advanced devices vs. traditional methods) to find out if the advanced interventions result in better motor control and functional recovery. Participants will: * Undergo various rehabilitation protocols including physical activity and advanced interventions. * Be assessed using different tool, such as fMRI, dtMRI, and NIRS to study in vivo neuroimaging and assess changes in brain function and connectivity.

Constraint-induced Movement Therapy Versus Task-oriented Training On Upper Extremity Function Post-Botox Injection in Stroke Patients

This study will be conducted to determine the impact of Constraint-Induced Movement Therapy versus Task-Oriented Training on upper extremity function post-Botox injection in stroke patients.

Effects of Jaw Clenching on Gait and Mobility in Stroke

The aim of this study is to investigate the immediate effects of jaw clenching on gait and functional mobility in patients with chronic stroke.

Comparative Effects of Vestibular Rehabilitation With and Without Cervical JPS Training in Stroke Patients

Stroke is a neurological disorder that often causes long-term disability and affects an individual's quality of life. Patients suffering from stroke commonly experience difficulties with balance, gait, and sensory integration due to disturbances in proprioception, postural control, and vestibular function, leading to decreased functional mobility and increased risk of falls. Sensory integration is an essential element of postural stability as it involves vestibular, visual, and somatosensory inputs to maintain orientation and balance. The cervical joint position sense is essential for maintaining balance and spatial perception by providing proprioceptive feedback from the neck region. Vestibular rehabilitation is frequently used to improve balance, gaze stability, and gait disturbance in stroke patients. Although vestibular rehabilitation has shown improvement in stroke survivors, limited evidence is available regarding the combined effects of cervical joint position sense training and vestibular rehabilitation on sensory integration, balance, and gait in subacute stroke patients. The objective of this study will be to compare the effects of vestibular rehabilitation with and without cervical joint position sense training on sensory integration, balance, and gait in stroke patients. The study design will be a randomized controlled trial. Evaluation will be done by using outcome measures for sensory integration, balance, proprioception, and gait, which include the Berg Balance Scale, Timed Up and Go Test, Joint position error, and CTSIB/mCTSIB. The non-probability convenience sampling method will be used, and participants will be randomly assigned to two groups. Group A will receive vestibular rehabilitation in conjunction with cervical joint position sense training and conventional physiotherapy, while Group B will only receive vestibular rehabilitation and conventional physiotherapy. Both groups will receive intervention for 6 weeks, three sessions per week. All outcome variable measurements will be recorded at baseline and once the intervention is completed. The result will be analyzed by using SPSS 27.

Development, Validation and Normative Data of the Italian Battery for the Recognition of Famous Faces (FAME)

The I-FACE project aims to develop and validate a battery to assess famous-face recognition in people with neurodegenerative diseases and stroke. It will examine face naming, familiarity, and semantic knowledge, establish norms for the Italian population, and test how well the measures identify recognition difficulties in patients with frontotemporal dementia, Alzheimer's disease, and stroke.

Long-Term Clinical, Health Economic, and Process Evaluation of Intensive Technology-Integrated Motor Rehabilitation in Chronic Neurological Conditions (INTeRAcT-bis)

Rehabilitation remains important in the chronic phase after stroke or spinal cord injury, as meaningful improvements may still be achieved through intensive, goal-directed, and personalized training. INTeRAcT-bis is a follow-up study of the original INTeRAcT program, which consisted of a 3-week intensive rehabilitation intervention (90 therapy hours) combining conventional therapy, goal-directed training, self-management, and advanced rehabilitation technologies. The study has two main objectives: (1) to evaluate the long-term clinical and health economic effects of the original INTeRAcT program, and (2) to assess the clinical effects and implementation of a second intensive rehabilitation period ("boost"). Participants receive a personalized 3-week rehabilitation program targeting upper and/or lower limb impairments based on their individual goals. In addition to clinical and health economic outcomes, the study examines participant experiences and implementation factors to support a broader implementation of intensive rehabilitation in the future.

Foot Drop Rehabilitation and Mobility in Chronic Stroke

Stroke is a leading cause of long-term disability, frequently resulting in motor impairments, balance deficits, and walking difficulties that limit functional independence and quality of life. Conventional rehabilitation approaches, including gait training and assistive devices, may not fully address these limitations. Functional electrical stimulation (FES) offers a complementary approach by activating targeted muscles through electrical impulses, potentially improving ankle control, gait performance, and mobility in individuals with post-stroke foot drop. However, variations in clinical outcomes, treatment protocols, and accessibility highlight the need for further investigation. Therefore, this study aims to evaluate the effects of FES on functional mobility and quality of life in individuals with chronic stroke.

Post-Stroke Apraxia, Motor Function, Balance, and Gait

The goal of this observational study is to examine whether ideomotor apraxia is associated with motor function, balance, walking performance, and independence in daily activities in adults with hemiplegia after stroke. Ideomotor apraxia is a condition in which a person has difficulty planning and correctly performing learned movements, despite understanding the instructions. It is common after stroke, particularly when the left side of the brain is affected. The main questions this study aims to answer are: * Do participants with ideomotor apraxia have lower independence in daily activities, as measured by the motor subscale of the Functional Independence Measure (Motor FIM), than participants without apraxia? * Is the severity of ideomotor apraxia associated with upper limb motor function, balance, and walking performance? Participants will attend one assessment session during routine follow-up at the Physical Medicine and Rehabilitation Clinic. They will undergo standardized clinical assessments of apraxia, upper limb motor function, balance, walking performance, and independence in daily activities. No treatment, medication, blood sampling, or imaging will be performed as part of this study.

Ideomotor Apraxia and Robotic Gait Rehabilitation Outcomes After Stroke

After a stroke, some people have difficulty planning and carrying out familiar movements. This difficulty is called ideomotor apraxia and cannot be explained by muscle weakness alone. It may influence how people improve during rehabilitation. This study will examine whether ideomotor apraxia is associated with changes in walking, balance, and independence in adults receiving rehabilitation after stroke at Izmir City Hospital. Participants will be assessed for apraxia before rehabilitation and followed during their usual rehabilitation program, which includes conventional rehabilitation and RehaWalk-supported gait training. Walking and other functional abilities will be evaluated before and after the rehabilitation program. Changes will be compared between participants with and without apraxia. The study will observe routine care. Participants will not be assigned to different treatments, and no experimental treatment will be provided. The findings may help clinicians understand whether apraxia is useful for predicting rehabilitation outcomes after stroke.

Philips Intracardiac Echocardiography (ICE) Clinical Registry

The purpose of this observational registry is to report real-world safety and performance of VeriSight for ultrasound guided ICE imaging in percutaneous cardiac intervention procedures when used in standard clinical practice.

Electroacupuncture and rTMS for Post-Stroke Motor Recovery

This study aims to evaluate the combined efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) and Electroacupuncture (EA) in improving motor function recovery post-stroke, compared to rTMS combined with sham EA. Participants will receive either active EA or sham EA alongside standard rTMS treatment. Outcomes will be assessed using standardized clinical scales and neuroimaging techniques to explore underlying neuroplasticity mechanisms.

The Changes of Masticatory / Swallowing Functions and Oropharyngeal Muscle Mass on Sonography After Comprehensive Swallowing Training and Tongue - Pressure Resistance Training in Stroke Patients With Dysphagia

The aims of this study are: 1. Comparing the ultrasound imaging performance of swallowing and chewing function, tongue pressure and oropharyngeal muscle thickness in stroke patients with different levels of swallowing function 2. To explore the changes in clinical mastication and swallowing functions, tongue pressure and oropharyngeal muscle thickness in patients with dysphagia and stroke after swallowing treatment and neuromuscular electrical stimulation training. 3. To explore the correlation between clinical mastication and swallowing functions, tongue pressure, oropharyngeal muscle thickness and ultrasound imaging results in patients with dysphagia and stroke.

ZEPU-AI1 Gait Robot Training Study (ZEPUAI1RCT)

Walking problems caused by stroke, spinal cord injury, or orthopedic surgery are common and can seriously limit a person's independence. Robotic-assisted gait training devices, which use a computer-controlled system to help patients practice standing and walking, have shown promise in improving strength, balance, and walking ability in other countries. However, this type of technology has not yet been carefully studied in Bangladesh. This study will test a robotic gait training and evaluation device called ZEPU-AI1 in adults aged 19 to 60 years who have difficulty walking due to stroke, incomplete spinal cord injury, or gait problems following surgery. The main goals are to find out whether using this robotic device alongside standard physical therapy is feasible (practical to carry out) and safe, and to explore whether it helps improve walking speed, balance, muscle strength, and daily function compared with standard physical therapy alone. Fifty-one participants took part (32 were originally planned; more were enrolled because additional eligible patients were available). Twenty-five received robot-assisted gait training three times a week for 12 weeks in addition to usual rehabilitation therapy, while 26 received usual rehabilitation therapy alone. Participants were assessed regularly using standard walking, balance, and strength tests over the 12-week period. The results of this study will help doctors and researchers understand whether this robotic technology can be safely and effectively introduced into rehabilitation care in Bangladesh.

Assessment and Comparison of Osteoporosis Risk Factors After Stroke

The aim of this study is to evaluate the effects of stroke and associated clinical, functional, nutritional, and muscular factors, including handgrip strength, on bone mineral density and osteoporosis by comparing patients with subacute stroke, patients with chronic stroke, and non-stroke controls. By identifying factors associated with reduced bone mineral density and osteoporosis across these groups, the study is expected to contribute to the identification of high-risk patients and provide a basis for future research aimed at improving screening and treatment strategies. No significant risks are anticipated from participation in this study.

Strength Training in Hospitalized Patients Using the Ghostly App: a Feasibility Study

The goal of this feasibility study is to evaluate the use of the Ghostly app in rehabilitation of stroke patients, elderly and patients recovering from COVID-19 or ICU patients. In three randomized controlled trials, the effect of a strength training program incorporated in the Ghostly app will be assessed for 1) stroke patients suffering from weakness of the lower limb, 2) frail elderly with gait difficulties and 3) patients recovering from COVID-19 or ICU patients who suffer from muscle weakness. Additionally, the effect of BFR on strength gain in all these three populations will be tested.

Accelerated Theta-Burst Stimulation for Refractory Central Post-Stroke Pain

This pilot study aims to evaluate the feasibility, safety, and preliminary efficacy of accelerated intermittent theta burst stimulation (aiTBS) as a noninvasive neuromodulation treatment for individuals with severe, refractory central post-stroke pain (CPSP). Participants will be randomized to receive either a high-dose or low-dose aiTBS protocol, and outcomes will include pain intensity and imaging biomarkers to assess treatment response.