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Upper Limb Mirror Therapy With Bilateral Transcutaneous Electrical Nerve Stimulation to Improve Upper Limb Functions in Patients With Stroke

Sponsor: The Hong Kong Polytechnic University • ClinicalTrials.gov ID: NCT03631628

Registry updated: 2026-10-15

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Description

This study compare the effectiveness of 2 rehabilitation programmes that use (1) MT with Bilateral TENS (Bi-TENS), (2) sham-MT with Bi-TENS (Bi-TENS), respectively, in addition to conventional rehabilitation of standardized upper limb training, in improving upper limb motor functions, activities of daily living, community integration, and quality of life in patients with stroke.

Interventions

Bilateral Transcutaneous electrical nerve stimulation (Bi-TENS) (Device)
The stimulator is a 120z Dual-Channel TENS Unit (ITO Physiotherapy \& Rehabilittaion, Co, Ltd, Tokyo, Japan). The TENS stimulation will be at 100 Hz, with 0.2 ms square pulses at an intensity of twice the sensory threshold (defined as the minimum intensity at which subject reported feeling a tingling sensation and below the motor threshold as indicated by the absence of muscle twitching, to provide sensory stimulation to both paretic and intact arms. Two pairs of disposable surface electrodes will be applied over the median nerve from the carpal tunnel to the flexor digitorum superficialis and the superficial radial nerve from the extensor pollicis longus to the extensor digitorum communis, with the cathode on the proximal site, and the anode on the distal site.
Mirror Therapy (MT) (Behavioral)
A customised angle-adjustable frame with a mirror board will be used. All subjects are instructed to perform 1. Elbow flexion and extension exercise 2. Forearm pronation and supination exercise 3. Wrist flexion and extension exercise 4. Wrist radial and ulnar deviation exercise 5. Fingers opposition exercise 6. Gripping exercise The subject will complete bilaterally upper limb exercises during the 30 minutes period. Intact arm will be placed in front of mirror, and paretic arm will be placed behind the mirror. Joints involved will be flexed and extended in full available range in sitting positon, in order to improve the active control of elbow joint, wrist joint and all fingers joint respectively. Participants will be encouraged to focus on the image of intact arm when performing upper limb exercises bilaterally.
sham-Mirror Therapy (sham-MT) (Behavioral)
A customised angle-adjustable frame with a mirror board will be used while the reflecting surface of the mirror was covered with paper. All subjects are instructed to perform 1. Elbow flexion and extension exercise 2. Forearm pronation and supination exercise 3. Wrist flexion and extension exercise 4. Wrist radial and ulnar deviation exercise 5. Fingers opposition exercise 6. Gripping exercise The subject will complete bilaterally upper limb exercises during the 30 minutes period. Intact arm will be placed in front of covered mirror, and paretic arm will be placed behind the covered mirror. Joints involved will be flexed and extended in full available range in sitting positon, in order to improve the active control of elbow joint, wrist joint and all fingers joint respectively.
Conventional Rehabilitation Program (Behavioral)
Standardized upper limb training

Eligibility criteria

Inclusion Criteria: 1. have been diagnosed with ischemic brain injury or intracerebral hemorrhage by MRI or computed tomography within three weeks to 10 years after the first onset of stroke; 2. have volitional control of the non-paretic arm, and at least minimal antigravity movement in the shoulder of the paretic arm; 3. have at least 5 degrees in wrist extension of the paretic arm in the antigravity position 4. are able to score \> 6 of 10 of abbreviated Mental Test; 5. are able to follow instruction and give informed consent of the study. Exclusion Criteria: 1. Have any additional medical, cardiovascular and orthopedic condition that would hinder the proper assessment and treatment; 2. Use cardiac pacemakers; 3. Have receptive dysphasia; 4. Have a significant upper limb peripheral neuropathy (e.g., diabetic polyneuropathy); 5. Have severe shoulder, elbow, wrist or finger contractures that would preclude a passive range of motions of the arm; 6. Have skin allergy that would prevent electrical stimulation; 7. Are involved in drug studies or other clinical trials.

Conditions

Stroke

Locations

The Hong Kong Polytechnic University — Hong Kong, Hong Kong, Hong Kong
Shatin Hospital — Hong Kong, Hong Kong, Hong Kong

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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