The National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, is looking for individuals to participate in clinical studies. Participating in clinical trials allows you to play an active role in research on the nature and causes of many disorders of the brain and nervous system, and to possibly help physician-scientists develop future treatments. The information below is designed to help you quickly learn about actively recruiting research studies for which you or someone you know may be eligible.

Description:

Of the 700,000 individuals who experience a new or recurrent stroke each year, a majority have considerable residual disability. Sixty-five percent (65%) of patients at 6 months are unable to incorporate the paretic hand effectively into daily activities. In turn, this degree of functional deficit contributes to a reduced quality of life after stroke. The extent of disability has been underplayed by the use of the Barthel Index that captures only basic activities of daily living such as self-care and does not extend to activities and participation at higher levels of functioning that are most affected by a residual upper extremity disability. The past decade has witnessed an explosion of different therapy interventions designed to capitalize on the brain's inherent capability to rewire and learn well into old age and more importantly for rehabilitation, after injury. The most effective arm-focused interventions with the strongest evidence and potentially the most immediate and cost-effective appeal for the current health-care environment share a common emphasis on focused task-specific training applied with an intensity higher than usual care. Therefore, our primary aim is to compare the efficacy of a fully defined, hybrid combination of the most effective interventions (forced-use/constraint-induced therapy and skill-based/impairment-mitigating motor learning training), the Accelerated Skill Acquisition Program (ASAP), to an equivalent dose of usual and customary outpatient therapy.

Eligibility Criteria:

INCLUSION Ischemic or hemorrhagic stroke. Hemiparesis in an upper extremity. Age 21+. Able to communicate in English (or Spanish,Rancho Los Amigos site only). Willing to attend outpatient therapy & f/u evaluations for 1 yr. Some active finger extension. EXCLUSION Traumatic or non-vascular brain injury, subarachnoid hemorrhage, AV malformation. History of psychiatric illness requiring hospitalization within past 24 mos. Active drug treatment for dementia. Neurologic condition that may affect motor response (e.g. Parkinson's, ALS, MS). History of head trauma requiring >48 hours of hospitalization within past 12 mos. Amputation of all fingers or thumb of hemiparetic (weak) arm. Treated with Botox in affected arm within last 3 months.

Study Design:

Study Location:

Multiple U.S. Locations