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

Cairo University (CU)

Status: Completed

Conditions: Upper Extremity Function; Stroke; Constraint Induced Movement Therapy; Botox Injection; Task Oriented Training

Treatments: Other: The designed physiotherapy program; Other: Constrained induced movement therapy; Other: Task oriented training; Drug: The Botulinum toxin injection

Study type: Interventional

Funder types: Other

Identifiers

NCT07057050

Reem-Phd

Details and patient eligibility

About

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.

Full description

Arm and hand movement problems are significant contributors to disability in stroke patients, with only 5% regaining full arm function and 20% regaining no functional use. Alternative strategies are needed to reduce long-term disability and upper limb impairment in hemiparesis patients. Previous studies have used various treatment methods, including botulinum toxin, but the degree of motor improvement depends on task complexity. Future research should focus on adjunct therapy, such as task-specific training and constrained induced therapy, in addition to botulinum toxin treatments, to facilitate functional improvement in spastic upper extremity.

Enrollment: 51 patients

Sex: All

Ages: 45 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The study focuses on patients aged 45-60 years
• Patients who have subacute spastic hemiplegia with occlusion of the middle cerebral artery
• Patients who are able to maintain balance in sitting positions.
• Patients are diagnosed with the affected upper extremity being the dominant side.
• Physiotherapy sessions are initiated 3-7 days post-injection,
• Patients have pre-injection Modified Ashworth scores equal to 2 (moderate spasticity) in wrist or elbow flexors.
• Patients can actively extend joints at least 10° at metacarpophalangeal and interphalangeal joints and 20° at the wrist of the affected upper limb.

Exclusion criteria

• Joint immobility in the upper limb due to contracture, bony deformity, or heterotopic ossification
• Significant cognitive deficits (Mini-Mental Status Examination score <24).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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51 participants in 3 patient groups

constrained induced movement therapy

Experimental group

Description:

Patients will undergo a 60-minute physiotherapy program, such as traditional upper extremity training, following botulinum toxin A injection, as well as constrained induced movement therapy tasks for 12 consecutive weeks.

Treatment:

Drug: The Botulinum toxin injection

Other: Constrained induced movement therapy

Other: The designed physiotherapy program

task-oriented training

Active Comparator group

Description:

Patients will undergo a 60-minute physiotherapy program, such as traditional upper extremity training, following botulinum toxin A injection, as well as task-oriented training tasks for 12 consecutive weeks.

Treatment:

Drug: The Botulinum toxin injection

Other: Task oriented training

Other: The designed physiotherapy program

designed physical therapy program

Active Comparator group

Description:

Patients will undergo a 60-minute physiotherapy program, such as traditional upper extremity training, following botulinum toxin A injection, for 12 consecutive weeks.

Treatment:

Drug: The Botulinum toxin injection

Other: The designed physiotherapy program