Trial Summary
What is the purpose of this trial?The iCOSMO study investigates the feasibility and beneficial effects of an intervention combining sensation, motor and cognition to improve arm and hand function after chronic stroke.
What data supports the idea that Cognitive-Somatosensory-Motor Training for Stroke is an effective treatment?The available research shows that Cognitive-Somatosensory-Motor Training can improve motor function in stroke patients. For example, one study found that somatosensory stimulation, which is part of this training, led to better hand motor function in patients with chronic strokes. This improvement was greater than in sessions without this stimulation, and the benefits lasted for at least 30 days. This suggests that the treatment can be a helpful tool in stroke rehabilitation, especially for those with certain types of brain injuries.13478
What safety data exists for Cognitive-Somatosensory-Motor Training for stroke?The provided research does not directly address safety data for Cognitive-Somatosensory-Motor Training or its variants like iCOSMO. The studies focus on the effectiveness of somatosensory retraining and stimulation in improving motor function after stroke, but they do not specifically mention safety outcomes or adverse effects related to these interventions.12368
Is the treatment Cognitive-Somatosensory-Motor Training for Stroke promising?Yes, Cognitive-Somatosensory-Motor Training for Stroke is promising because it combines physical and sensory training to improve motor and sensory functions in stroke patients. Studies show that somatosensory stimulation can enhance motor function and help maintain training benefits, making it a valuable tool for stroke rehabilitation.35678
Do I have to stop taking my current medications for the trial?The trial protocol does not specify whether you need to stop taking your current medications.
Eligibility Criteria
The iCOSMO trial is for individuals who have had a stroke and are looking to improve the function of their arm and hand. Specific eligibility criteria details were not provided.Inclusion Criteria
I have weakness or sensory loss in my arms.
I have been diagnosed with a stroke.
I am over 18 years old.
Exclusion Criteria
I have had a brain disorder other than a stroke.
I have arm or hand issues not caused by a stroke.
I can follow instructions and provide consent for treatment.
Treatment Details
This study tests two types of training programs: GRASP, which patients do at home, and iCOSMO, which integrates sensory, motor, and cognitive exercises to aid recovery after a chronic stroke.
2Treatment groups
Experimental Treatment
Active Control
Group I: iCOSMOExperimental Treatment1 Intervention
20 participants will receive the iCOSMO intervention. iCOSMO consists of two training approaches that will include active touch and movement exploratory procedures during goal-oriented tasks as well as robotic training using the Kinarm Exoskeleton device.
Group II: Home GRASPActive Control1 Intervention
20 participants will receive the control intervention. The control group will receive a matched dose of a home-based exercise programme. The home-based exercise programme will be based on the Home Graded Repetitive Arm Supplementary Program.
Find a clinic near you
Research locations nearbySelect from list below to view details:
Urvashy GopaulToronto, Canada
Toronto Rehabilitation InstituteToronto, Canada
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Who is running the clinical trial?
University Health Network, TorontoLead Sponsor
StrokeCog clinical training platformCollaborator
References
Improved function of hemiplegic upper extremity after cognitive sensory motor training therapy in chronic stroke patients: preliminary report of a case series. [2007]Recovery of upper extremity functions after a severe stroke and traumatic brain injuries (TBI) have generally been less than satisfactory. The "cognitive sensory motor training therapy" is a relatively new method claimed to improve motor control using a specific type of repetitive sensory and motor re-learning protocol. There has been no previous study demonstrating the effectiveness of this method.
Translational studies in neurorehabilitation: from bench to bedside. [2019]Stroke is the leading cause of adult disability in the western world. Consensus has built over the last few years regarding the usefulness of training to improve motor disability resulting from stroke. Until recently, there were no accepted strategies to enhance the beneficial effects of training. However, the combination of basic and clinical science data over the last few years is changing this picture, and is highly relevant to the field of neurorehabilitation. Human studies in both healthy individuals and patients after brain damage demonstrate as a proof of principle that somatosensory input, cortical stimulation, interhemispheric interactions, and pharmacologic interventions can modulate cortical plasticity in neurorehabilitation after stroke. These findings strongly suggest directions in the development of novel strategies to enhance training effects on motor recovery. The intent of this review is to describe these strategies, the basic science principles on which they are based, and the clinical applications that have emerged so far.
Effects of somatosensory stimulation on motor function in chronic cortico-subcortical strokes. [2018]Somatosensory stimulation enhances aspects of motor function in patients with chronic, predominantly subcortical infarcts. We investigated the effects of somatosensory stimulation on motor function in stroke patients with predominantly cortical involvement in the middle cerebral artery territory in a double-blind, pseudorandomized crossover trial. Motor performance was evaluated with the Jebsen-Taylor test before, after 2-hour somatosensory stimulation, and after subsequent motor training (n=11). In one experimental session, patients were submitted to median nerve stimulation (MNS) and in the other session, to control stimulation (CS). The order of the sessions was counterbalanced across patients. Improvement in performance in the Jebsen-Taylor test after somatosensory stimulation and after motor training was significantly greater in the MNS session than in the CS session. Additionally, patients who received MNS in the second session maintained the beneficial effects of training 30 days later. A single MNS session improves hand motor function in patients with chronic cortico-subcortical strokes and appears to favor consolidation of training effects. Somatosensory stimulation may be an adjuvant tool for stroke rehabilitation in patients with cortical lesions.
Motor Imagery Training on Muscle Strength and Gait Performance in Ambulant Stroke Subjects-A Randomized Clinical Trial. [2020]The ultimate goal of physiotherapy in stroke rehabilitation is focused towards physical independence and to restore their functional ability during activities of daily living (ADLs). Motor imagery (MI) is an active process during which a specific action is reproduced within working memory without any actual movements. MI training enhances motor learning, neural reorganization and cortical activation in stroke. The efficacy of MI training involving lower extremity mobility tasks need to be assessed.
The State-of-the-Science on Somatosensory Function and Its Impact on Daily Life in Adults and Older Adults, and Following Stroke: A Scoping Review. [2017]The aim was to identify and synthesize research evidence about how adults and older adults process somatosensory information in daily activities, and the interventions available to regain somatosensory function following stroke. We developed two interacting concept maps to address the research questions. The scoping review was conducted from 2005 to 2015 across Web of Science, AMED, CINAHL, Embase, Medline, and PsychInfo databases. Search terms included somatosensory, perception, performance, participation, older adult, stroke, intervention, discrimination, learning, and neuroplasticity. Contributions from 103 articles for Concept 1 and 14 articles for Concept 2 are reported. Measures of somatosensory processing, performance, and participation used are identified. Interventions available to treat somatosensory loss are summarized in relation to approach, outcome measures, and theory/mechanisms underlying. A gap exists in the current understanding of how somatosensory function affects the daily lives of adults. A multidisciplinary approach that includes performance and participation outcomes is recommended to advance the field.
Nerve Stimulation Enhances Task-Oriented Training for Moderate-to-Severe Hemiparesis 3-12 Months After Stroke: A Randomized Trial. [2019]The aim of the study was to determine whether somatosensory stimulation affects outcomes of motor training for moderate-to-severe upper limb hemiparesis less than 12 mos before stroke.
COMbined Physical and somatoSEnsory training after stroke: Development and description of a novel intervention to improve upper limb function. [2019]After stroke, reach-to-grasp goal-directed movements are disrupted as a result of both residual motor and somatosensory impairments. This report describes the rationale and development of a new upper limb stroke rehabilitation intervention known as COMPoSE: "COMbined Physical and somatoSEnsory training," designed to improve somatosensory and motor deficits in the upper limb after stroke. A standardized training matrix has been developed to facilitate intervention delivery.
The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review. [2022]The aim of this study was to evaluate if somatosensory retraining programmes assist people to improve somatosensory discrimination skills and arm functioning after stroke.