RecruitingNAINTERVENTIONAL

The Role of Cognition in Motor Learning After Stroke

This study is investigating how thinking skills, like memory and attention, affect how well people learn to move their arm again after a stroke. Many stroke survivors struggle with arm movement, and current treatments aren't always fully effective. Researchers believe that certain types of learning might lead to better recovery. This trial uses a custom virtual reality game where people get magnified feedback on their elbow movement. This 'error augmentation' feedback aims to encourage them to extend their arm further. The study will track arm movement improvements over nine weeks and assess if people with thinking difficulties benefit differently. The goal is to develop more effective rehabilitation tailored to individual needs after a stroke.

At a glance

Status

Recruiting

Phase

Sponsor

McGill University

Enrolment target

Start

01 Apr 2022

Estimated completion

01 Jul 2026

Stroke Hemorrhagic Stroke, Ischemic Cognitive Impairment

What is this study about?

When someone has a stroke, it can often cause lasting problems with using their arm for everyday things. While there are therapies to help, sometimes people don't recover as much movement as hoped. This study is exploring a new way to help people regain arm function by looking at how our brain's thinking skills – like memory, paying attention, and understanding what we see – play a part in learning to move again.

Researchers believe that a certain type of learning, where you improve without thinking too much about it (called implicit learning), might be more helpful. However, many people who have had a stroke also have difficulties with these thinking skills. This study wants to find out if these thinking difficulties affect how well someone can learn to move their arm using this implicit learning approach. They are testing a special training program that uses virtual reality, a bit like a video game, with a unique type of feedback that magnifies small errors in movement to encourage better arm extension.

The main idea is that by making small errors seem bigger in the game, your brain will work harder to correct them, leading to better overall movement. The study will watch how people's arm movement changes over time with this training, especially looking at differences between those with and without thinking difficulties. The hope is that by understanding this better, doctors and therapists can create even more effective and personalised rehabilitation programs to help people get more use back in their arm after a stroke.

Key takeaways

This study explores how thinking skills impact arm recovery after stroke.
It uses a virtual reality game with special 'error augmentation' feedback to improve elbow movement.
Participation involves 30-minute training sessions, 3 times a week for 9 weeks.
Researchers will track arm movement, thinking abilities, and brain changes with scans.
The goal is to develop more effective and personalised stroke rehabilitation.
You can withdraw from the study at any time.

Who may be eligible?

To be considered for this study, you would need to have had your first stroke (either a bleeding stroke or a blockage stroke) less than three years ago and be in good general health. Importantly, you shouldn't be currently receiving other active stroke treatments.

You should have good eyesight, either naturally or with glasses/contact lenses. Your arm needs to show some weakness (known as paresis) and stiffness (spasticity), but you must still be able to bend and straighten your elbow by about 30 degrees in each direction. This means you have some movement, but not full function.

There are also reasons why you might not be able to join. For example, if you have other serious nerve or muscle problems that might affect your arm movement, or if you have severe numbness in your elbow that stops you from feeling its position properly. Also, if you have problems with noticing things on one side of your body (called visuospatial neglect), uncorrected poor vision, or significant symptoms of depression, you wouldn't be able to take part.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Did you have your first stroke less than 3 years ago?
Are you no longer receiving active stroke treatment?
Do you have normal or corrected-to-normal vision?
Can you bend and straighten your elbow by about 30 degrees?
Do you feel your elbow position reasonably well?
Are you generally in good medical health, without major other nerve or muscle problems?

Answer every question to see your result.

What does participation involve?

If you join this study, your training will involve using a custom virtual reality program that focuses on improving your elbow movement. You will train for 30 minutes, three times a week, over a total of nine weeks. During this training, an image of an arm on the screen will show your elbow as being bent a bit more than it actually is. This is designed to encourage you to extend your elbow further, helping you to improve your movement.

Before you start, and then again after 3 weeks, 6 weeks, and at the end of the 9 weeks of training, the research team will measure your arm movement and do some clinical checks. This helps them see how you're progressing. About four weeks after you finish your training, you'll have a final check-up. Throughout the study, you will also have special scans (MRI scans) to look at your brain and understand the stroke's effects and how your brain connections are working.

Potential risks and benefits

Taking part in this study may offer some potential benefits, as you would be receiving a novel and intensive rehabilitation approach directly from the researchers, potentially helping to improve your arm movement after stroke. However, as with any research, there might be some risks, such as discomfort during the virtual reality training, or the possibility that the intervention might not improve your arm movement. The brain scans involve being in an MRI machine, which some people find uncomfortable. It is very important to remember that you have the right to withdraw from the study at any time, for any reason, without affecting your usual medical care.

Locations (1)

Jewish Rehabilitation Hospital
Verified postcode
Laval, Canada· Recruiting

Common questions

What kind of stroke do I need to have had to join?

You need to have had your first stroke, either due to a bleed or a clot, less than three years ago.

What will the virtual reality training feel like?

You'll be using a special virtual reality game where you control an arm on screen. The feedback is slightly exaggerated to help you improve your elbow movement.

How long will I be involved in the study?

You'll train for nine weeks, with follow-up appointments extending to about four weeks after the training ends, plus initial assessments.

Do I need good eyesight?

Yes, you need to have normal or corrected-to-normal vision (e.g., with glasses or contacts) to properly see the virtual reality environment.

What if I have other health problems?

The study has specific criteria. For example, if you have other major nerve or muscle problems, severe numbness in your elbow, or are very depressed, you likely wouldn't be able to participate.

How to find out more

Mindy Levin, PhD, PT

mindy.levin@mcgill.ca (450) 688-9550 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.