| Approved on: | 2026-04-15 |
| Brief purpose of the study: | An ischemic stroke occurs when a blood vessel to the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. This stroke may cause paralysis or weakness of muscles in the arm. The arm weakness is present in the majority of patients immediately after the stroke. Arm weakness may be hard to treat after stroke because the treatments that are normally used do not treat the brain problem. We think that people who have had an ischemic stroke have higher levels of inhibition of the neurons in the brain areas that control the weak arm. These brain changes may cause poor recovery of arm weakness.
This project will test whether inhibition of these areas is high at the beginning of the rehabilitation regime and if this alteration is recovering over the entire course of rehabilitation. This project will also study the relationships between these brain changes and the changes in arm weakness to see if we can predict which person will recover the best with rehabilitation.
This project will also test the effects of a repeated motor practice performed with the intact arm on the neurological recovery of those with more severe stroke, that respond little to the current rehabilitation. |
| Brief summary of what participants will be asked to do: | Longitudinal observational study: Sixty-one patients with stroke will be asked to complete a brain MRI (similar to a clinical MRI but longer) at the CNS Core Facility. For this, the participant will be transported by the Rusk van (or assisted transportation service after discharge from Rusk Rehabilitation Hospital) and scheduled with therapy services to maintain the same therapy amount on that day. The participants will also be evaluated on how he/she can move their weak arm (paretic) and the intact arm; these evaluations will take place at the Rusk Rehabilitation Hospital. The brain MRI, arms measures, as well as general health questionnaires will will be performed 3 times during the first 3 months after the stroke.
Forty-six healthy controls will be asked to complete a brain MRI (similar to that obtained from patients; the MRI will take place at the CNS Core Facility) and undergo testing of their arms movements (this evaluation will take place at the Rusk Rehabilitation Hospital), as well as general health questionnaires.
Interventional study: Thirty additional patients will participate, during their stay in our ward, to 10 sessions of motor training with the intact arm. All participants will also be evaluated on how they can move their weak (paretic) and intact arms; these evaluations as well as general health questionnaires will take place at the Rusk Rehabilitation Hospital, before and after the training. Only half of the patients will be asked to complete a brain MRI (similar to a clinical MRI but longer) at the CNS Core Facility. For this, the participant will be transported by the Rusk van and scheduled with therapy services to maintain the same therapy amount on that day. The brain MRI will be performed 2 times, before and after training, while the participant is in inpatient rehab.
Twenty-five healthy neurological controls will be asked to complete a brain MRI (similar to that obtained from patients; the MRI will take place at the CNS Core Facility) and undergo testing of their arms movements (this evaluation will take place at the Rusk Rehabilitation Hospital), as well as general health questionnaires. |
| Basic eligibility criteria: | Adult (18 to 80 years) patients who have arm weakness after a stroke and are undergoing inpatient rehabilitation at Rusk Rehabilitation Hospital.
Adult (18 to 80 years) neurological healthy controls who have no major neurological, psychiatric, or hand/arm orthopedic issues. |
| Study contact for more information: | Please contact Dr. Cirstea's lab at (573) 884-8792 or cirstealab@umsystem.edu. |
| IRB Number: | 2004508 MU |
