Self-Administered Gaming and Exercise at Home (SAGEH)

Description

This study aims at comparing manual function outcomes between the standard of care and additional self-administered hand therapy after stroke. Strokes are common neurological injuries, and although rates of survival have increased in recent decades, survivors often continue to experience deficiencies in hand dexterity and bimanual function. Most motor recovery takes place within the first 3 months after a stroke. This initial period is necessary for stabilizing the patient but also provides different opportunities to foster motor recovery. Functional gains, including instances after the post-acute period, have been observed after regular and frequent (high dosage) therapy, suggesting that recovery is likely influenced by practice-driven sensorimotor learning. These findings motivate the implementation of daily therapeutic regimes beyond post-stroke hospitalization and basic motor function, aiming instead at addressing overlooked deficiencies in manipulation and bimanual coordination. While some hand therapy is often provided during outpatient therapy visits (the standard of care), self-administered sessions play a large role in implementing additional daily therapy. As a result, the investigators are interested in both the implementation of self-administered regimes and measuring clinical outcomes with and without self-administered therapy.

Conditions

Stroke, Hand Weakness

Study Overview

Study Details

Study overview

This study aims at comparing manual function outcomes between the standard of care and additional self-administered hand therapy after stroke. Strokes are common neurological injuries, and although rates of survival have increased in recent decades, survivors often continue to experience deficiencies in hand dexterity and bimanual function. Most motor recovery takes place within the first 3 months after a stroke. This initial period is necessary for stabilizing the patient but also provides different opportunities to foster motor recovery. Functional gains, including instances after the post-acute period, have been observed after regular and frequent (high dosage) therapy, suggesting that recovery is likely influenced by practice-driven sensorimotor learning. These findings motivate the implementation of daily therapeutic regimes beyond post-stroke hospitalization and basic motor function, aiming instead at addressing overlooked deficiencies in manipulation and bimanual coordination. While some hand therapy is often provided during outpatient therapy visits (the standard of care), self-administered sessions play a large role in implementing additional daily therapy. As a result, the investigators are interested in both the implementation of self-administered regimes and measuring clinical outcomes with and without self-administered therapy.

Self-Administered Gaming and Exercise at Home (SAGEH)

Self-Administered Gaming and Exercise at Home (SAGEH)

Condition
Stroke
Intervention / Treatment

-

Contacts and Locations

Baltimore

Johns Hopkin, Baltimore, Maryland, United States, 21287-6953

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. Age 21 years and over
  • 2. Stroke confirmed by CT or MRI within the previous 6 weeks.
  • 3. Arm and/or hand impairment induced by the stroke.
  • 4. Meet JSTTEP criteria and are enrolled in JSTTEP.
  • 5. Admitted to the Johns Hopkins Hospital (JHH) inpatient stroke service.
  • 6. Proficient in speaking and reading English.
  • 7. Willing and capable to contacted remotely for all necessary telemedicine contacts.
  • 8. No history of prior ischemic or hemorrhagic stroke with associated motor deficits (prior stroke with no upper limb motor symptoms is allowed)
  • 9. Ability to give informed consent.
  • 1. Arm impairment that is too severe (FM-UE \< 40) on day of baseline testing prior to beginning of the study.
  • 2. Recent Botox injection to upper limb (since stroke onset).
  • 3. History of physical or neurological condition that interferes with study procedures or assessment of motor function (e.g. severe arthritis, severe neuropathy, Parkinson's disease).
  • 4. Terminal illness with life expectancy \< 6 months.
  • 5. Inability to sit in a chair and perform hand exercises for 20 minutes at the time.
  • 6. Cognitive impairment, with score on Montreal Cognitive Assessment (MoCA) ≤ 20.
  • 7. Social and/or personal circumstances that prevent telemedicine follow-up.

Ages Eligible for Study

21 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Johns Hopkins University,

Steven R Zeiler, M.D, Ph.D., PRINCIPAL_INVESTIGATOR, Johns Hopkins University

Study Record Dates

2025-12