32 Participants Needed

Shoulder Abduction for Stroke

NR
MM
Overseen ByMichelle Medina, BS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Northwestern University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how the brain and nervous system collaborate to control shoulder movement after a stroke. Researchers will use MRI scans to identify active brain regions during shoulder movements, specifically focusing on shoulder abduction (lifting the arm away from the body). The trial targets individuals who can perform a shoulder movement task and have experienced a stroke affecting one side of their body, resulting in noticeable arm weakness. Participants should not have additional brain conditions and must be comfortable undergoing an MRI scan. As an unphased trial, this study offers participants the chance to contribute to groundbreaking research that could enhance understanding of post-stroke recovery.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are using medications that suppress central nervous system activity.

What prior data suggests that shoulder abduction is safe for stroke patients?

Research shows that shoulder exercises are generally safe for people recovering from a stroke. Studies have examined shoulder mobility soon after a stroke and found it can predict recovery outcomes. For instance, patients who moved their shoulder two days post-stroke had a 98% chance of improving arm function.

Although specific studies on negative effects of shoulder exercises are lacking, their early use in stroke recovery suggests safety. These exercises form part of the standard rehabilitation process, indicating they are widely accepted as safe and beneficial for recovery.12345

Why are researchers excited about this trial?

Most treatments for stroke rehabilitation focus on improving general mobility and function through physical therapy and medications. However, shoulder abduction as a treatment is unique because it specifically targets shoulder movement, which is crucial for regaining upper body function after a stroke. Researchers are excited about this technique because it emphasizes a specific movement that can lead to better results in restoring independence and daily function for stroke survivors. This targeted approach could potentially speed up recovery by focusing on a critical area that impacts overall arm and hand use.

What evidence suggests that shoulder abduction is effective for stroke?

Research has shown that lifting the arm to the side can indicate recovery in stroke patients. Studies have found that those who perform this movement soon after a stroke often have better chances of regaining arm function. One study found that lifting the arm to the side predicts a better recovery, with patients more likely to achieve a high level of arm movement. Another study showed that improving this movement can help increase the range of motion for reaching tasks in those with long-term stroke effects. Overall, these findings suggest that lifting the arm to the side might help improve arm movement after a stroke.

In this trial, participants will engage in shoulder abduction exercises to evaluate their impact on recovery and arm function post-stroke.36789

Who Is on the Research Team?

MG

Molly G Bright, DPhil

Principal Investigator

Northwestern University

Are You a Good Fit for This Trial?

This trial is for individuals who have experienced a stroke and are living with hemiparesis, which means they have weakness on one side of their body. Participants should be able to perform a shoulder abduction task, which involves lifting the arm away from the body.

Inclusion Criteria

I do not have any severe health problems besides my cancer.
I can concentrate and focus on tasks.
I do not have cancer in my brainstem or cerebellum.
See 5 more

Exclusion Criteria

Pregnant women
I am currently taking medication that affects my brain's activity.
MRI contraindications
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Imaging and Data Collection

Participants undergo fMRI to map neural activity during shoulder abduction tasks

3 days to 3 months

Follow-up

Participants are monitored for safety and effectiveness after imaging

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Shoulder Abduction
Trial Overview The study is using functional magnetic resonance imaging (fMRI) to observe and map how different parts of the brain and nervous system are activated during a shoulder abduction exercise in people who have had a stroke.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Shoulder AbductionExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Northwestern University

Lead Sponsor

Trials
1,674
Recruited
989,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials
2,103
Recruited
2,760,000+

Published Research Related to This Trial

A study involving 31 participants with severe stroke demonstrated significant improvements in both reaching distance and peak reaching velocity after undergoing targeted rehabilitation robotics with progressive abduction loading therapy.
This research highlights the potential of progressive abduction loading as an effective rehabilitation strategy for restoring function in individuals with chronic stroke, addressing the common issue of impaired joint control.
Progressive abduction loading therapy targeting flexion synergy to regain reaching function in chronic stroke: Preliminary results from an RCT.Ellis, MD., Carmona, C., Drogos, J., et al.[2020]
In a study of 22 stroke patients, fluoroscopically guided analysis revealed significant differences in shoulder abduction motion between affected and unaffected sides in patients at Brunnstrom stages 3-4, indicating potential for targeted rehabilitation strategies.
The analysis showed that patients with more synergistic movement patterns relied on compensatory motions, such as shoulder shrugging, rather than proper scapular stabilization, highlighting the need for tailored interventions to improve shoulder biomechanics in hemiplegic patients.
Abduction motion analysis of hemiplegic shoulders with a fluoroscopic guide.Yoon, TS., Lee, SJ.[2018]
Individuals with hemiplegia post-stroke exhibit significantly less scapular upward rotation during passive humeral abduction compared to normal subjects, particularly at angles of 90°, 120°, and 150°, which may increase the risk of shoulder pain.
Incorporating scapular upward rotation during passive humeral abduction is crucial for individuals with hemiplegia, especially beyond 90° of abduction, to maintain proper shoulder mechanics and potentially prevent complications like hemiplegic shoulder pain.
Scapular Upward Rotation During Passive Humeral Abduction in Individuals With Hemiplegia Post-stroke.Ratanapinunchai, J., Mathiyakom, W., Sungkarat, S.[2020]

Citations

Presence of Finger Extension and Shoulder Abduction ...Depending on the outcome measures used, 5% to 20% achieve full functional recovery of upper limb function at 6 months. Early prediction of final functional ...
Progressive Shoulder Abduction Loading is a Crucial Element ...This study demonstrated that functionally relevant reaching range of motion (work area) can be improved in individuals with chronic hemiparetic stroke and, most ...
Early prediction of upper limb functioning after stroke using ...The results showed that the ability to grasp and lift an ARAT cube of 2.5 cm was a good predictor for excellent and full functional outcome ...
Upper-extremity motor recovery after stroke: A systematic ...Additionally, finger-extension and shoulder-abduction within 3 days post-stroke were associated with favorable outcome at 6 months [68].
Easily Conducted Tests During the First Week Post-stroke ...Results: Patients with partial shoulder abduction (OR 14.6), elbow extension (OR 15.9), and finger extension (OR 9.5) were more likely to reach FMA-UE ≥ 32.
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/38340009/
Prevalence of Arm Weakness, Pre-Stroke Outcomes and ...Upper limb weakness (SAFE≤8) was present in 35% [95% CI: 30%-39%] at a median of 1-day post-stroke, with 22% presenting with mild-moderate weakness (SAFE5-8).
Prevalence of Arm Weakness, Pre-Stroke Outcomes and ...Upper limb weakness (SAFE≤8) was present in 35% [95% CI: 30%-39%] at a median of 1-day post-stroke, with 22% presenting with mild-moderate weakness (SAFE5-8).
Predicting Recovery Potential for Individual Stroke Patients ...If the sum of these grades (the Shoulder Abduction and Finger Extension [SAFE] score) is ≥8 within 72 hours after stroke, the patient is ...
PRALINE: study protocol for a phase IIb inpatient stroke ...The primary objective of this study is to compare the effects of reaching exercise with the affected upper extremity using progressive shoulder ...
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