NCT04165616Recruiting

Motor rECovery witH eArly imagiNg In STroke

Northwestern University

Start Date

6/21/2022

Completion Date

4/30/2026

Summary

This study will contribute to the field of stroke rehabilitation research by expanding the investigator's understanding of the neural mechanisms responsible for the development and expression of abnormal flexion synergy, a primary movement impairment due to stroke. The study will longitudinally evaluate motor tract morphology and motor impairment/function in an attempt to develop early neuroimaging-based predictors of the development of flexion synergy and its impact on reaching and hand recovery (6 month). The study will utilize quantitative motor testing (kinematics and kinetics) to measure motor impairment and reaching and hand function. Both neuroimaging and quantitative motor testing will be conducted within 96 hours-, 2 weeks-, 3 months-, and 6 months-post stroke. The knowledge gained by this study will provide crucial structural and functional neuroimaging evidence that demonstrates the timeline of progressive ipsi- and contralesional motor pathway (including bulbospinal pathways) changes and the associated development of flexion synergy that grossly impacts reaching and hand function in individuals with moderate to severe stroke.

Eligibility Criteria

Age Range: 18 years to 85 years

Inclusion Criteria: 1. Stroke within the middle cerebral artery distribution based on brain MRI done within 48 hours of admission 2. 18 to 85 years old 3. Isolated motor deficits (hemiparesis) without significant aphasia, visual disturbances, or neglect based on the following scores on the NIH Stroke Scale: 1a (level of consciousness) = 0- Alert; keenly responsive. 1b (LOC questions) = 0- Asked month and age; Answers both correctly. 1c (LOC commands) = 0- Asked to open/close eyes, grasp/release hand; Performs both correctly. 2 (Best Gaze) = 0- Horizontal eye movements; Normal. 5 (Motor Arm) = 1, 2, 3, or 4- Arm placed at 90 (sitting) or 45 (supine), Drift, Some effort, No effort against gravity, or No movement. 7 (Limb Ataxia) = 0- Finger-nose-finger or heel-shin test; Absent. 8 (Sensory) = 0 or 1- Pin prick; Normal or Mild-to-moderate sensory loss. 9 (Best Language) = 0 or 1- Describe picture; No or Mild-to-moderate Aphasia. 11 (Extinction and Inattention) = 0 or 1- No abnormality or Inattention to one modality. Exclusion Criteria: 1. Premorbid disability or sensorimotor impairment 2. Comorbidity medically contraindicating the administration of subsequent MRI scanning and motor assessments 3. Pain or hypersensitivity limiting motor assessment 4. Limb edema limiting motor assessment

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Conditions

Stroke

Locations

Department of Physical Therapy and Human Movement Sciences

Chicago, Illinois 60611

United States

Northwestern Memorial Hospital

Chicago, Illinois 60611

United States

Shirley Ryan AbilityLab

Chicago, Illinois 60611

United States