Therapy to Improve Body Awareness after Stroke

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Contact us

Contact us with no obligation to participate.

Ann Van de Winckel
Principal Investigator
Study Coordinator

612-625-1191
avdwlab@umn.edu

Mia Larson, BSN, RN, HN-BC
PhD Student

University of Minnesota
Divisioin of Physical Therapy
420 Delaware Street SE
MMC 388
Minneapolis, MN  55455

Therapy to Improve Body Awareness after Stroke

For this study, we will recruit 8 healthy adults and 12 adults who are at least six months post-stroke and, as a result, have weakness on one side of the body (hemiparesis). The focus of this study is geared toward the recovery of function and quality of movement of the weaker arm and hand. The objectives of this study are to:

  • Identify connections between brain areas among healthy persons
  • Identify connections between brain areas among persons with stroke
  • Evaluate in persons with stroke if and how these brain connections change after they receive a specific therapy, aimed at improving proprioception (body awareness)
  • Evaluate how this specific therapy aids in recovery of function and quality of movement of the arm and hand

This research study will investigate the process of recovery of the arm and hand and plasticity in the brain, using neurocognitive therapy, as well as identify how these important brain areas are connected to each other.

Want to participate? 

Download one of the following:

 

Therapy to Improve Body Awareness After Stroke

The Brain Plasticity Lab at the University of Minnesota

Neurocognitive therapy

How does it work?

Neurocognitive therapy consists of exercises that help give you a better awareness of your body, by feeling movements of the arm and hand with eyes closed. The neurocognitive therapy is given by certified and qualified physical therapists with years of experience in this type of therapy.

An example of this therapy would be to have the therapist move a subject’s hand two different times from position A to B and then from position A to C. Then the therapist would ask the patient which of the two established positions is the hand furthest away from the body. By doing this, neurocognitive therapy uses movement and touch to improve body awareness.

Subjects thus solve a “cognitive problem” (e.g. how far, how large, what shape, how heavy, which texture) through the use of their body and focus on both movements and interaction between their body and the environment. They explore and feel the object’s texture, length, shape, and weight in order to improve the flow of information between the hand and the brain. Through interactions with these objects, the person becomes more aware of their own body movements.

Visits will occur at University of Minnesota Children's Rehabilitation Centerand at the Center for Magnetic Resonance Research. You will receive compensation for travel.

Visual Explanation of Neurocognitive Therapy, MRI Compatible Robot, and Brain Activity

Frequently asked questions

What do researchers hope to learn?

Researchers hope to better identify connections between brain areas among people with stroke and healthy persons and how training through proprioception can better improve motor recovery after stroke.

How will participating in this study help?

This research helps us explore ways to offer stroke therapies that can increase hand and arm strength and function, which in turn could improve their quality of life by making everyday tasks more manageable.

What type of therapy will I receive?

Patients with stroke will receive neurocognitive therapy. The neurocognitive therapy consists of exercises that help give you a better awareness of your body, by feeling movements of the arm and hand with eyes closed. The neurocognitive therapy is given by certified and qualified physical therapists with years of experience in this type of therapy.

An example of this therapy would be to have the therapist move a subject’s hand two different times from position A to B and then from position A to C. Then the therapist would ask the patient which of the two established positions is the hand furthest away from the body.  By doing this, neurocognitive therapy uses movement and touch to improve body awareness.

Subjects thus solve a “cognitive problem” (e.g. how far, how large, what shape, how heavy, which texture) through the use of their body and focus on both movements and interaction between their body and the environment. They explore and feel the object’s texture, length, shape, and weight in order to improve the flow of information between the hand and the brain. Through interactions with these objects, the person becomes more aware of their own body movements.

What do I need to bring to therapy? How do I need to be dressed?

You do not need to bring anything to therapy. Loose fitting clothing would be fine. We recommend you wear clothing in which you are comfortable.

Do I have to take a break from other activities/therapies in order to participate?

We only recruit patients who do not receive therapy anymore, or at least during the full period of the study, because we need to demonstrate that the changes that are seen in the brain (with MRI scanning) are due to the therapy that is given in this study, and not due to other therapies that are happening at the same time.

What are the characteristics of stroke patients you are working with on this study?

People with stroke with various levels of movement impairment can participate. Participants will need to be able to feel movement of their index finger, in order to do the tasks with the robot in the scanner. Patients also need to have sufficient hearing to hear the music through the headphones, when the MRI is making loud noises. Participants who have cognitive problems, are unable to speak or understand instructions, have neglect or apraxia will not be recruited. Neglect, apraxia, cognitive assessment, and sensation will be tested during the screening, so if you are not sure feel free to contact us.

How will I benefit from participating?

For participants with stroke:

You may benefit from the 6 weeks of Physical Therapy; however there is no way to know for sure.  There may be no direct benefit to participating in this study.  However, information from this study may help other people in the future.

For healthy participants:

There is no direct benefit to participating in this study. However, information from this study may help other people in the future.

What is MRI?

MRIs use powerful magnets to make images of your body tissues, like your brain.

What are the risks for MRI?

  • There is no radiation risk associated with MRI.  However, long term effects of exposure to high magnetic fields are unknown.

  • Persons with metal implants, such as surgical clips, or pacemakers should not have an MRI. All credit cards and other items with magnetic strips should also be kept out of the MRI.  Similarly, glasses with metal will be taken off. Regular lenses usually pose no problem.

  • People who feel uncomfortable in confined spaces (claustrophobia) may feel uncomfortable in the narrow cylinder. If you have previously experienced claustrophobia, tell the principal investigator researchers (study staff) before you start the study.

Does MRI hurt?

No. The MRI makes loud banging noises as it takes images. Headphones will be used to reduce the noises and for listening to the audio guidance.

How long is the actual MRI?

The scanning in itself will take about 1.5 hour. If you wish, you can ask for a break in-between. We account for count two hours in order to give you information beforehand, time to ask questions, get you comfortably in and out of the scanner.

Why do I have to come back in one year?

We want to see whether our therapy had long lasting effects on arm and arm-and-hand function even after the therapy was stopped. This would give us stronger evidence for if this therapy can help patients long-term.

Does this cost money to participate?

There is no charge to participate. You will receive $25 for travel reimbursement for each test visit. Therapy will be free. Other personal expenses will not be covered.

I'm working full-time/in shifts, can I come before/after my work?

While we cannot always promise a perfect match, we will do our best to plan our visits around your working schedule. Visits early in the morning, after 5pm or during the weekend can be discussed.

Meet the research team

Investigators

Ann L. Van de Winckel, PhD, MSc, PT
Assistant Professor

612-625-1191
avandewi@umn.edu

Ann Van de Winckel, PhD, MSc, PT is an Assistant Professor in Physical Therapy, co-Director of the Brain Plasticity Laboratory and physical therapist. She is the principal investigator (PI) on this project. Her research interests are to understand the neural mechanisms of neuroplasticity and recovery after stroke through the use of brain imaging, and the determine its impact on sensory and motor recovery. Further, to translate these findings to therapeutic interventions aimed at sensory and motor recovery.

Full bio

Teresa J. Kimberley, PhD, PT
Associate Professor

612-626-4096
tjk@umn.edu

Teresa Jacobson Kimberley, PhD, PT is an Associate Professor and co-Director of the Brain Plasticity Laboratory. She is Co-Investigator (Co-I) on this project. Dr. Kimberley's overall research goal is to understand and influence the extent of plastic changes in the cortex that occur during recovery from a movement impairment such as hemiparesis secondary to stroke or focal hand dystonia. Tools used in her lab include functional magnetic resonance imaging (fMRI), kinematic analysis, and transcranial magnetic stimulation (TMS).

Full bio

James R. Carey, PhD, PT, FAPTA
Professor

612-626-2746
carey007@umn.edu

James R. Carey, PhD, PT, FAPTA is a Full Professor and co-Director of the Brain Plasticity Laboratory. He is Co-Investigator (Co-I) on this project. Dr. Carey's research focuses on promoting recovery of motor function following stroke through up-regulation of function in surviving but dormant neural centers or through transference of function to new neural centers. Investigative and interventional techniques include motor learning (joint tracking) training, telerehabilitation, repetitive (r)TMS, and fMRI.

Full bio

Study Staff

Teresa A. Bisson, PT, DPT, NCS, ATP
Assistant Professor

612-624-2364
tbisson@umn.edu

Teresa Bisson, PT, DPT, NCS, ATP is Assistant Professor at the University of Minnesota, and Board-Certified Neurology Certified Specialist (NCS). Her research interest is related to dosing of physical therapy for optimal outcomes in patients with chronic neurologic conditions. Provision of physical therapy services and education internationally.

Full bio

Mia Larson, BSN, RN, HN-BC

Mia began her career as a registered nurse in the neuroscience ICU at Mayo Clinic in Rochester. During this time, she realized the benefit of a holistic wellness approach to healthcare and started training in integrative therapies. She earned a certification as a Mayo Clinic wellness coach in 2015 and a certificate in Integrative Therapies from the Center for Spirituality and Healing at UMN in 2016. After training as a yoga instructor, Mia became interested in how body awareness can be used in rehabilitation from neurologic injury. Her career goals include studying how body awareness and other aspects of holistic health can be utilized to both rehabilitate and maintain health throughout the lifespan.

Full bio

Daniele De Patre, PT

depat002@umn.edu

Daniele DePatre, PT. After graduating from the Physical Therapy Program in Italy, Daniele also pursued a Bachelor degree in Movement Science, went to the Philippines for one year of humanitarian work, and spent two years of intensive training in the Center in Italy where neurocognitive rehabilitation is given to stroke patients.

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Study locations

Center for Magnetic Resonance Research (CMRR)

University of MinnesotaCMRR exterior
2021 Sixth Street SE
Minneapolis, MN 55455
612-625-2874
Click here for map

From Highway I-94 take the Huron Boulevard exit and go north:

  • Proceed ~3 blocks down Huron Boulevard to Washington Avenue.
  • Continue straight across Washington Avenue.
  • Continue straight across University Avenue onto SE 23rd Avenue.
  • Proceed ~3 blocks to SE 6th Street.
  • Turn left on 6th St SE.
  • The CMRR is the second building on the right (2021)

On street parking is located on the east side of the CMRR building. Enter from 6th St SE, under skyway. Parking permits are available at the front desk.

Children's Rehabilitation Center (wheelchair accessible entrance)

426 Church Street SEChildren's Rehab Clinic
Minneapolis, MN 55455
612-625-1191
Click here for map

From Highway I-94 take the Huron Boulevard exit and go north:

  • Left on Fulton Street SE
  • Continue straight ahead onto East River Parkway

The East River Road Garage Parking Ramp will be on your right. After parking, take the elevator to the first floor to go outside. The Coffman Memorial Union Building is in front of you, the road is Delaware Street SE. Turn right to walk on Delaware St SE and take another Right on Church St SE.  We will meet you at the front entrance of the Children's Rehabilitation Building. We will then go to Room 302.

If stairs are not an obstacle, you can also walk out of the East River Road Garage (Level C) and walk to the back entrance of the adjacent building on your left, which is the Children's Rehabilitation Center. We will wait for you at this door. Alternatively, if you prefer to come in by yourself, once inside, go through two red fire doors and walk down the hallway to the elevators. Room 302 is immediately to your left on the 3rd floor. 

Room 302 Children's Rehabilitation Center

302 Entrance Door 302 Interior302 Interior 2

 

 

 

 

The Brain Plasticity Lab - Clinical Assessment Lab