MOvement Control After Stroke (MOCAS)

  • Research type

    Research Study

  • Full title

    Does the upper limb rehabilitation programme lead to a general improvement in motor control processes in chronic stroke patients?

  • IRAS ID

    222832

  • Contact name

    Nick Ward

  • Contact email

    n.ward@ucl.ac.uk

  • Sponsor organisation

    University College London

  • Duration of Study in the UK

    5 years, 0 months, 0 days

  • Research summary

    Current consensus is that chronic stroke patients cannot reduce their level of motor impairment through rehabilitation. However, patients who attend the three-week intensive upper limb (UL) rehabilitation programme at The National Hospital for Neurology and Neurosurgery do reduce their level of motor impairment measured by the Fugyl-Meyer Assessment UL scale (FMA-UL) and this improvement persists six months later.

    The mechanism that underlies this change and whether specific motor control processes are involved is currently unknown. Understanding this is key to improving current knowledge of how movement and motor control processes are affected in chronic stroke patients, the potential for improvement with rehabilitation, possible predictors / biomarkers for this and how best to optimise treatment programmes.

    By exploring various motor control processes in approximately 200 patients recruited from the UL rehabilitation programme over three years, this study will examine change in FMA-UL score and the underlying mechanism. Patients will undergo testing on admission, at discharge and at 6-week and 6-month follow-up appointments. This will involve clinical assessment and FMA-UL scale, performing simple reaching movements with the affected arm to allow recording of kinematic parameters and simple behavioural tasks to assess motor adaptation and motor skill learning ability. Subsequent analysis of these data will reveal how motor impairment and motor control processes change and relate over time following rehabilitation.

    The study will be conducted at University College London and funded by The Wellington Hospital. It will be the first to demonstrate and explore how rehabilitation can lead to a reduction of UL motor impairment in the chronic phase of stroke in such a large patient cohort. It carries important implications for service provision in terms of need for intensive therapy beyond the acute phase of stroke to maximize recovery, reduction of disability and quality of life.

  • REC name

    London - Camden & Kings Cross Research Ethics Committee

  • REC reference

    17/LO/1466

  • Date of REC Opinion

    26 Sep 2017

  • REC opinion

    Favourable Opinion