Effects of a Neurorehabilitation Program Based on CIMT and Non-invasive Neuromodulation Through C-tDCS on the Recovery of Paretic Upper Limb Function, Quality of Life, and Therapeutic Alliance in Women From the Araucanía Region Who Suffered a Stroke (CIMT + tDCS).

MI-összefoglaló

A vizsgálat saját részvételi feltételeiből. Gép olvasta ki az oldalon álló regiszterszövegből, ezért tévedhet. Hogy ki vehet részt, azt a lenti regiszterszöveg és a vizsgálat csapata dönti el.

A vizsgálat olyan nőket keres, akiknek több mint 1 hónapja volt agyi történése (stroke), és az érintett karjukat, kezüket még tudják használni. Egy rehabilitációs programot vizsgál agyi stimulációval.

Életkor

30 és 80 év közötti nők (a nyilvántartás legfeljebb 85 éves felső korhatárt is megad).

Nem

Csak nők.

A betegség stádiuma

CT-vel igazolt vérzéses vagy érelzáródásos stroke, több mint 1 hónapja, zárójelentéssel igazolva. Ülve meg tudja tartani a törzsét.

Biomarker vagy leletérték

A Minimental vizsgálaton 14 pontnál több pont. Az érintett kezével fel tud venni és el tud engedni egy kis labdát.

A részvétel fő kizáró okai

• Vállfájdalom a VAS skálán 4 felett, vagy görcsösség (spaszticitás) a Módosított Ashworth skálán 2 felett
• Látás- vagy hallászavar
• Súlyos afázia (beszédzavar)
• Cochleáris implantátum, aneurizmaklip, agyi elektróda vagy szívritmusszabályozó
• Az elmúlt 3 hónapban diagnosztizált epilepszia vagy pszichiátriai zavar, terhesség, vagy pszichotróp gyógyszerek szedése

A regiszter feltételei, szó szerint

Nézd meg, megfelelhetsz-e

Magadról válaszolj. Ez nem döntés: hogy részt vehetsz-e, azt csak a vizsgálat csapata mondhatja meg.

• 30 és 85 év között vagy?IgenNem

Mit akar kideríteni a vizsgálat

General Objective To determine the effects of a neurorehabilitation program based on Constraint-Induced Movement Therapy (CIMT) and non-invasive neuromodulation through cerebellar transcranial direct current stimulation (C-tDCS) on the recovery of paretic upper limb function, quality of life, and therapeutic alliance in women from the Araucanía Region who suffered a stroke. Methodology An experimental design consisting of a single-blind randomized controlled clinical trial is proposed. The study will include two independent groups of women diagnosed with stroke, who will participate in five assessment time points (pre-treatment, intermediate, post-treatment, and two follow-ups). Motor function (Motor Activity Log-30 and ARAT), quality of life (ECVI-38), and therapeutic alliance (CAF-P) will be evaluated. The intervention includes 10 sessions (120 minutes each), delivered daily over a two-week period. The experimental group (EG) will receive CIMT combined with C-tDCS, while the control group (CG) will receive CIMT plus sham C-tDCS (using the standard safety sham protocol commonly known as "FISSFO" [Fade In of Stimulation, Brief Real Stimulation, Fade Out]). In both groups, C-tDCS will be applied during the first 20 minutes of the session simultaneously with the practice of specific upper-limb motor tasks, followed by 100 minutes of CIMT. The CG will receive the same intervention but with sham stimulation, applying current for one minute to generate the initial sensation without producing a physiological effect. Sessions will be conducted in mixed subgroups (two participants from the EG and two from the CG) sharing the same therapeutic space. A proposed sample size of N = 26 (13 patients per group) was calculated considering a statistical power of 80%, assuming a medium effect size of f = 0.25, an error probability α = 0.05, a power (1 - error probability β) = 0.95, and correlations among repeated measures = 0.50. An additional 10% was included to compensate for potential losses during follow-up. Simple random allocation of the sample will be performed using SPSS Statistics 27. Proposed Analysis Plan SPSS Statistics 27 software will be used. Initially, descriptive statistics will be employed to analyze the sample according to sociodemographic and clinical characteristics. Subsequently, Cronbach's alpha reliability coefficient will be calculated to examine the internal consistency of the motor function and quality-of-life variables, both within and between groups and across evaluation time points. The effects of the intervention will be assessed using unifactorial intragroup and intergroup analyses of covariance (ANCOVA). In each ANCOVA, treatment will be considered the independent variable, each motor function and quality-of-life score will be considered the dependent variable, and control variables will be included as covariates. All results with p-values less than or equal to 0.05 in one-tailed tests will be considered statistically significant. Expected Results It is expected that the combination of CIMT and C-tDCS will significantly enhance motor recovery in post-stroke women. The intervention may improve upper-limb function recovery, promote better quality of life, and optimize the therapeutic alliance, resulting in greater participation in daily activities. By modulating cerebellar activity, C-tDCS may facilitate neuronal plasticity and accelerate the response to intensive training. If confirmed, the study will provide evidence for a safe, accessible, and effective neurorehabilitation strategy, opening future low-cost avenues for current rehabilitation practices.

A vizsgálat 2 csoportja

• CIMTm y ctDCSA vizsgált kezelés

  c-tDCS will be applied during the first 20 minutes of the session simultaneously with the practice of motor tasks of specific movements aimed at the upper extremity, continuing the session with 100 minutes of CIMTm.

  Kezelés: tDCS

• CIMTm y ctDCS shamSzínlelt kezelés, összehasonlításként

  c-tDCS (sham) will be used, which will consist of the application of an initial current that will be maintained for one minute with a 30-second ramp until reaching 1.5 mA and a 30-second descending ramp, after which the device will turn off (program available on the device).

  Kezelés: tDCS