Mirror Therapy Rehabilitation of the Upper Limb After Stroke (NEURO-MIROIR 2)

Summary

Hemiparesis is a common motor disorder after a stroke. The majority of patients do not recover functional use of their paretic upper limb.

The use of mirror therapy allows the activation of the mirror neurons involved to stimulate brain plasticity after brain damage.The IVS (Intensive Visual Stimulation) device allows an easy implementation of mirror therapy by filming the valid upper limb and projecting the inverted image onto a screen placed above the parietal arm thus producing the illusion of movement of the parietal arm.

The main hypothesis of this study is that the structured practice of a large number of upper limb targeted movement repetitions using an intensive visual numerical simulation device as a partial replacement for routine care (conventional occupational therapy) in the sub-acute phase of stroke will increase the active function (motor function and functional abilities) of the distal end of the upper limb compared to conventional rehabilitation.

Objectives: This randomized controlled trial will evaluate the effects of partial substitution of routine care (occupational therapy) by structured movement repetition programs by Intensive Visual Simulation using an IVS3 device, on the distal motor control of the upper hemiparesis limb, between 4 and 10 weeks after the stroke, compared to a program with conventional care alone.

Conditions

• Stroke

Interventions

OTHER

Conventional rehabilitation

upper limb rehabilitation involving submaximal passive amplitude stretching movements, inhibition postures, active efforts assisted of varying difficulty, target approach exercises with or without elbow support and gripping tasks, adapted to the upper limb's paresis abilities. The patient will be encouraged to gradually dispense with the assistance provided by the therapist or any technical assistance (suspension...) and thus to carry out the exercises in free active as soon as possible.

DEVICE

Intensive Visual Simulation

* First week: observation, mentalization and then attempt to perform the movements on the screen. * Second and third weeks: production of analytical movements of wrist flexion/extension, pronation/supination, finger flexion/extension, thumb opposition. * From the 4th week until the end: depending on the patient's motor capacities, continuation of the work of the previous 2 weeks or introduction of more functional work with object manipulation, gripping work. Conventional rehabilitation upper limb rehabilitation involving submaximal passive amplitude stretching movements, inhibition postures, active efforts assisted of varying difficulty, target approach exercises with or without elbow support and gripping tasks, adapted to the upper limb's paresis abilities. The patient will be encouraged to gradually dispense with the assistance provided by the therapist or any technical assistance (suspension...) and thus to carry out the exercises in free active as soon as possible.

Sponsors & Collaborators

• Clinalliance Villiers-sur-Orge

  collaborator UNKNOWN

• Centre de Rééducation Fonctionnelle Pasori

  collaborator UNKNOWN

• CHU de Reims

  collaborator OTHER

• Clinique Les Grands Chênes

  collaborator UNKNOWN

• Clinique Napoléon

  collaborator UNKNOWN

• Clinique Mariénia

  collaborator UNKNOWN

• Clinique Verdaich

  collaborator UNKNOWN

• Clinique Les Trois Soleils

  lead OTHER

Principal Investigators

• Christophe DURET, MD · Clinique Les Trois Soleils

• Manuel Wiese, MD · Clinalliance Villiers-sur-Orge

• Nikolay DOBREV, MD · CRF PASORI

• François BOYER, Professor · Hôpital Sébastopol, CHU de Reims

• Caroline TERRACOL, MD · Clinique Marienia Inicea

• Jean-Marc GUEBLE, MD · Clinique Verdaich

• Adrien PETIT, MD · Clinique Les Grands Chênes Inicea

• Magali CAPLANNE, MD · Clinique Napoléon Inicea

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

100 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-12-10

Primary Completion

2027-07-31

Completion

2028-07-31

Countries

• France

Study Locations