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NCT05311384

Application of a Reimbursable Form of Constraint-Induced Movement Therapy for Upper Extremity

Completed NA Results posted Last updated 7 March 2025
What this trial tests

NA trial testing Keys Constraint-induced Movement Therapy protocol in CVA (Cerebrovascular Accident) in 10 participants. Completed in 1 February 2024.

Timeline
20 April 2022
Primary endpoint
1 February 2024
1 February 2024

Quick facts

Lead sponsorUniversity of Alabama at Birmingham
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment10
Start date20 April 2022
Primary completion1 February 2024
Estimated completion1 February 2024
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Alabama at Birmingham

Who can join

18 and older, any sex, with CVA (Cerebrovascular Accident) or Stroke. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Motor Activity Log (MAL) Primary · Pre-treatment

The MAL assesses how much and how well the individuals uses the affected upper extremity in 30 different daily activities. It will be used to investigate the change in spontaneous use of the affected upper extremity comparing the scores collected before and in the middle of the treatment. The MAL includes two scales: Amount of use (AOU) and Quality of Movement (QOM) and each one of them is scored from 0-10, and higher scores denote more frequent spontaneous use and better quality of movement of the affected arm.

Amount of Use (AOU) Scale
GroupValue95% CI
Keys Intervention10.3 – 1.6
Quality of Movement (QOM)
GroupValue95% CI
Keys Intervention1.10.3 – 1.5
Motor Activity Log (MAL) Primary · 4 weeks after starting the intervention (middle of the protocol)

The MAL assesses how much and how well the individuals uses the affected upper extremity in 30 different daily activities. It will be used to investigate the change in spontaneous use of the affected upper extremity comparing the scores collected before and in the middle of the treatment. The MAL includes two scales: Amount of use (AOU) and Quality of Movement (QOM) and each one of them is scored from 0-10, and higher scores denote more frequent spontaneous use and better quality of movement of the affected arm.

Amount of Use (AOU) Scale
GroupValue95% CI
Keys Intervention3.51.9 – 4.5
Quality of Movement (QOM)
GroupValue95% CI
Keys Intervention3.32.0 – 4.4
Motor Activity Log (MAL) Primary · after the intervention (8 weeks after starting the protocol)

The MAL assesses how much and how well the individuals uses the affected upper extremity in 30 different daily activities. It will be used to investigate the change in spontaneous use of the affected upper extremity comparing the scores collected before and in the middle of the treatment.The MAL assesses how much and how well the individuals uses the affected upper extremity in 30 different daily activities. It will be used to investigate the change in spontaneous use of the affected upper extremity before and after the treatment. The assessment is scored from 0-10, and higher scores denote mo

Amount of Use (AOU)
GroupValue95% CI
Keys Intervention3.92.5 – 4.8
Quality of Movement (QOM)
GroupValue95% CI
Keys Intervention3.41.7 – 4.7
Motor Activity Log (MAL) Primary · 3 months after the end of the treatment.

The MAL assesses how much and how well the individuals uses the affected upper extremity in 30 different daily activities. It will be used to investigate the change in spontaneous use of the affected upper extremity comparing the scores collected before and in the middle of the treatment. The MAL includes two scales: Amount of use (AOU) and Quality of Movement (QOM) and each one of them is scored from 0-10, and higher scores denote more frequent spontaneous use and better quality of movement of the affected arm.

Amount of Use (AOU)
GroupValue95% CI
Keys Intervention4.02.8 – 4.8
Quality of Movement
GroupValue95% CI
Keys Intervention3.72.1 – 4.8
Canadian Occupational Performance Measure (COPM) Primary · Pre-treatment

The COPM is a self-reported measure regarding the individual's occupational performance in self-care, productivity, and leisure activities. The COPM will be administered to explore the changes in occupational performance comparing the scores collected before, in the middle of the treatment and after the treatment. Five of the activities considered more important to the individuals are scored through two different scales: the performance and the satisfaction scales. Each one is scored from 0-10, and higher scores denote higher satisfaction, and quality of performance.

Performance
GroupValue95% CI
Keys Intervention1.91 – 3
Satisfaction
GroupValue95% CI
Keys Intervention1.31 – 1.4
Canadian Occupational Performance Measure (COPM) Primary · 4 weeks after starting the intervention (middle of the protocol)

The COPM is a self-reported measure regarding the individual's occupational performance in self-care, productivity, and leisure activities. The COPM will be administered to explore the changes in occupational performance comparing the scores collected before, in the middle of the treatment and after the treatment. Five of the activities considered more important to the individuals are scored through two different scales: the performance and the satisfaction scales. Each one is scored from 0-10, and higher scores denote higher satisfaction, and quality of performance.

Performance
GroupValue95% CI
Keys Intervention5.53.8 – 7.6
Satisfaction
GroupValue95% CI
Keys Intervention4.71.6 – 6
Canadian Occupational Performance Measure (COPM) Primary · after the intervention (8 weeks after starting the protocol)

The COPM is a self-reported measure regarding the individual's occupational performance in self-care, productivity, and leisure activities. The COPM will be administered to explore the changes in occupational performance comparing the scores collected before, in the middle of the treatment and after the treatment. Five of the activities considered more important to the individuals are scored through two different scales: the performance and the satisfaction scales. Each one is scored from 0-10, and higher scores denote higher satisfaction, and quality of performance.

Performance
GroupValue95% CI
Keys Intervention6.33.8 – 8.4
Satisfaction
GroupValue95% CI
Keys Intervention6.13.2 – 8.8
Canadian Occupational Performance Measure (COPM) Primary · 3 months after the end of the treatment.

The COPM is a self-reported measure regarding the individual's occupational performance in self-care, productivity, and leisure activities. The COPM will be administered to explore the changes in occupational performance comparing the scores collected before, in the middle of the treatment and after the treatment. Five of the activities considered more important to the individuals are scored through two different scales: the performance and the satisfaction scales. Each one is scored from 0-10, and higher scores denote higher satisfaction, and quality of performance.

Performance
GroupValue95% CI
Keys Intervention6.63 – 9.2
Satisfaction
GroupValue95% CI
Keys Intervention6.11.4 – 9.4
Wolf Motor Function Test (WMFT) - Performance Time Primary · Pre-treatment

The WMFT measures upper extremity motor function in terms of quality of movement and performance time. The WMFT will be administered to investigate changes in motor function of the affected arm comparing the scores collected before and in the middle of the treatment. The WMFT is scored in two different ways: through performance times (in seconds) and quality of performance through the Functional Ability Scale (FAS). The FAS ranges from 0-5, in which 0 represents inability to perform the task, and 5 is given for performances close o before the stroke. The tasks are also timed with a stopwatch a

GroupValue95% CI
Keys Intervention5.323.17 – 10.64
Wolf Motor Function Test (WMFT) - Performance Time Primary · 4 weeks after starting the intervention (middle of the protocol)

The WMFT measures upper extremity motor function in terms of quality of movement and performance time. The WMFT will be administered to investigate changes in motor function of the affected arm comparing the scores collected before and in the middle of the treatment. The WMFT is scored in two different ways: through performance times (in seconds) and quality of performance through the Functional Ability Scale (FAS). The FAS ranges from 0-5, in which 0 represents inability to perform the task, and 5 is given for performances close o before the stroke. The tasks are also timed with a stopwatch a

GroupValue95% CI
Keys Intervention5.323.17 – 10.64
Wolf Motor Function Test (WMFT) - Performance Time Primary · after the intervention (8 weeks after starting the protocol)

The WMFT measures upper extremity motor function in terms of quality of movement and performance time. The WMFT will be administered to investigate changes in motor function of the affected arm comparing the scores collected before and in the middle of the treatment. The WMFT is scored in two different ways: through performance times (in seconds) and quality of performance through the Functional Ability Scale (FAS). The FAS ranges from 0-5, in which 0 represents inability to perform the task, and 5 is given for performances close o before the stroke. The tasks are also timed with a stopwatch a

GroupValue95% CI
Keys Intervention3.822.43 – 31.26
Wolf Motor Function Test (WMFT) - Functional Ability Scale Primary · Pre-treatment

The WMFT measures upper extremity motor function in terms of quality of movement and performance time. The WMFT will be administered to investigate changes in motor function of the affected arm comparing the scores collected before and in the middle of the treatment. The WMFT is scored in two different ways: through performance times (in seconds) and quality of performance through the Functional Ability Scale (FAS). The FAS ranges from 0-5, in which 0 represents inability to perform the task, and 5 is given for performances close o before the stroke. The tasks are also timed with a stopwatch a

GroupValue95% CI
Keys Intervention32 – 3.5

Sponsor's own description

CI therapy is a family of techniques that has systematically applied intensive treatment daily over consecutive days, supervised motor training using a technique called shaping, behavioral strategies to improve the use of the more- affected limb in real life situations called a Transfer Package (TP), and strategies to remind participants to use the more-affected extremity; including restraint of the less-affected arm in the upper extremity (UE) protocol. Numerous studies examining use of CI therapy with UE rehabilitation have demonstrated robust evidence for increasing the amount and the quality of the paretic UE functional use in daily situations of individuals recovering from stroke. Previous studies have explored the barriers for clinical implementation of the approach, including the amount of time needed by therapists, other resources required and lack of payment for the services. With regards to therapists' time/resources, in the signature CI therapy protocol, therapists supervised movement training for 3 hours daily (except for weekends) for a 12 consecutive-day period. This level of supervision in highly unusual for traditional rehabilitation clinical settings. The treatment schedule is also incompatible with most insurance reimbursement policies in the US. As such, most CI therapy clinics require patients to pay privately with little or no insurance reimbursement. Such practices severely limit the number of patients who can afford to receive CI therapy. Two lines of evidence have suggested that an alternative CI therapy protocol may allow for the essential (or "Key") CI therapy elements to be delivered in a schedule that better utilizes therapist time/resources and is compatible with payment policies of many US insurance companies. One line of evidence comes from findings that indicate that the original 6-hour supervised training schedule could be shortened to as little as 2-hours/daily without a reduction in outcomes. Additional evidence comes from a study exploring the systematic addition and deletion of the signature CI therapy protocol elements indicated that when the transfer package was omitted, outcomes related to functional use were reduced by 50%. These findings were also verified by brain imaging studies conducted concurrently that revealed a much-reduced level of brain remodeling in those not receiving the transfer package. These findings highlight the potential effectiveness of the transfer package and continued movement training by the patient while away from clinical supervision. The hypothesis of this study is that the amount of supervised training could be reduced further and delivered in a distributed schedule (1 to 4 times/ week over an 8-week period) instead of consecutively over a 12-day treatment period. This modification could be possible by adapting and strengthening the transfer package component of the protocol. In order to investigate if all of the Keys intervention protocol is necessary for producing optimal outcomes, the delivery of specific protocol elements will be also explored. Additionally, another round of testing at the 4-week point of the 8-week intervention will be administered to investigate the need for the final 4 weeks of the intervention.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Effects of a Distributed Form of Constraint-Induced Movement Therapy for Clinical Application: The Keys Treatment Protocol.
    Dos Anjos S, Bowman M, Morris D. · · 2025 · cited 1× · PMID 39851454 · DOI 10.3390/brainsci15010087

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Other recruiting trials for CVA (Cerebrovascular Accident)

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT05311384.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing