StrokeNCT06604143
Stroke Motor Recovery for the Hand and Fingers
A study testing Quality Training and Goal Training in people with Stroke, run by University of Toronto at 5 sites in Canada.
Trial summary
The goal of this clinical trial is to compare two rehabilitation methods to improve finger movements in people who have had a stroke. The main question it aims to answer is which of these two training methods leads to the most improvement: 1. Read more about this study
- Who is it for?
- Ages 19 to 80 years
- Conditions the study is for
- Stroke
- What is being tested?
- Quality Training and Goal Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 5 sitesCanada
- Study dates
- 7 May 2026to 31 Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Over 18 years of age
- Diagnosis of first time unilateral ischemic or hemorrhagic
- Stroke occurrence: > 6 months and < 2 years
- Able to perform active finger movements (Chedoke-McMaster (CM) Impairment Inventory of the Hand, Stage ≥ 3)
Who cannot join
- History of developmental, neurological, or major psychiatric disorders
- Cognitive deficits (< 23/30 Montreal Cognitive Assessment)
- Apraxia (<2SD mean Waterloo Apraxia test)
- Neglect (> 40/100, Sunnybrook Neglect Assessment Procedure)
- Cerebellar stroke
- Musculoskeletal injury affecting motor performance
- Inability to sit in a chair and perform exercises for sustained periods
- Contraindications to MRI
Trial locations and contacts
5 sites in 1 country. Contact the study team or a site near you to ask about taking part.
5 sites in 1 country
Canada5 sites, 5 recruiting
- Recruiting
Jewish Rehabilitation Hospital
Laval, Quebec, H7V 1R2
Marie-Helene Boudrias, PhD, 514-398-5457, mh.boudrias@mcgill.ca
Mindy Levin, PhD, 514-398-3994, mindy.levin@mcgill.ca
- Recruiting
University Institute for Physical Impairment Rehabilitation of Montreal (IURDPM)
Montreal, Quebec, H3S 2J4
Marie-Helene Boudrias, PhD, 514-398-5457, mh.boudrias@mcgill.ca
Marie-Helene Boudrias, PhD
- Recruiting
Lethbridge-Layton-Mackay Rehabilitation Center
Montreal, Quebec, H4B 1T3
Marie-Helene Boudrias, PhD, 514-398-5457, mh.boudrias@mcgill.ca
Marie-Helene Boudrias, PhD
- Recruiting
Jewish General Hopsital
Montreal, Quebec, H7V 1R2
Alexander Thiel, MD, 514 340 8222 ext. 22094, alexander.thiel@mcgill.ca
- Recruiting
University of Toronto
Toronto, Ontario, M5S 2W6
Joyce L Chen, PhD, 416-946-5394, JOYCELYNN.CHEN@UTORONTO.CA
Joyce Chen, PhD
About this study
Official title: Discovering the Potential for Motor Recovery in People Living With Stroke
The goal of this clinical trial is to compare two rehabilitation methods to improve finger movements in people who have had a stroke. The main question it aims to answer is which of these two training methods leads to the most improvement:
- Teaching people to reach their movement goals using any strategies they like.
- Teaching people to improve their movement technique and avoid compensatory strategies.
Read more
There is no one-size-fits-all approach. The second goal is to find out who might benefit more from each method. Some people with stroke may rely on compensatory strategies due to severe impairment, while others with milder strokes might benefit more from techniques that enhance movement quality.
The third goal is to take pictures of the brain to see how it changes with each method. This will help researchers understand how the brain adapts after a stroke and could lead to treatments that target the brain directly.
Participants will:
- Visit the lab for clinical and research assessments on weeks 1, 4, 5, and 15.
- Complete 10 days of piano training.
- Undergo magnetic resonance imaging (MRI) scans twice, once in week 1 and once in week 4.
Read the detailed description
Forty participants with sub-acute (6 months - 2 years) stroke will be recruited in this multi-site trial taking place in Toronto and Montreal. Participants will need to be able to perform active finger movements. Each site will recruit and randomize participants into one of two training groups. Training will consist of:
- One group will focus on improving the quality of their movements while playing music on a digital piano.
- The other group will focus on achieving their movement goals while playing playing music on a digital piano.
Participation in this study will involve 14 visits, each taking place on a separate day.
Piano training consists of 20 hours total, spread over 2 hours per day for 5 days across 2 weeks. Each participant will receive one-on-one and/or group instruction from a Music Therapist with expertise in Neurologic Music Therapy and piano instruction. Exercises will include pressing single keys and multiple keys with different fingers, holding down certain keys while pressing others, and playing melodies and chords with all five fingers, involving various coordination patterns, rhythms, and speeds.
Assessments will be conducted at four timepoints: Baseline, Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months). Participants will undergo validated clinical assessments to evaluate their ability to move and feel their arm, hand, and fingers, as well as for assessor to understand how the stroke has affected them overall. Some of these tests are routinely used by physical therapists and other rehabilitation professionals who work with people living with stroke. For other types of tests, sensors will be placed on their arm, hand, and fingers. These sensors do not emit anything; they will simply record their movements.
Kinetic and kinematic measures will assess finger forces, grip strength, and pinch strength. Magnetic resonance imaging (MRI) scans at Baseline and Post-training-1 will be taken to quantify structure and function of the brain.
- Conditions
- Stroke
- Being tested
- Quality Training, Goal Training
- Keywords
- Motor system, Stroke rehabilitation, Magnetic resonance imaging, Kinematics, Music
- Medical subject headings
- Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Quality TrainingBehavioural
Participants will engage in piano playing tasks using their affected hand and fingers. The training focuses on specific aspects of finger movement, and participants will receive feedback related to their playing. They will wear a wrist brace for support, and their hand and arm positions will be monitored to ensure proper technique.
Goal TrainingBehavioural
Participants will engage in piano playing tasks using their affected hand and fingers. The training emphasizes learning to play and producing music. Feedback will be provided on various aspects of performance such as speed and accuracy, but specific details about finger movement or technique will not be given. The use of a wrist brace and monitoring of hand and arm positions will be consistent with standard practice.
| Study group | Role | What they receive |
|---|---|---|
| Quality Training Group | Active comparator | Not described Receives: Behavioral: Quality Training |
| Goal Training Group | Active comparator | Not described Receives: Behavioral: Goal Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Finger Individuation: Force
The Finger Individuation - Force is a measure of how well a finger is able to exert force without the other fingers exerting force. This measure has been used to study finger movements in healthy individuals, pianists, and stroke survivors. This task will use a custom device to measure finger movements in all digits of both hands. The forearm will be placed on a table with the wrist in a neutral position and secured to prevent other movements. The device will support the palm and measure the force each finger produces using sensors under each fingertip. The investigators will determine participants' maximum finger force. Then, participants will practice producing forces at 20%, 40%, 60%, and 80% of this maximum for each finger while keeping the others still. They will see a visual target for the required force and get feedback on their performance.
Measured: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months)
Finger Individuation: Joint Angular Excursion
The Finger Individuation - Joint Angular Excursion is a measure of how well a finger is able to bend or straighten while the other fingers remain stationary. The angle being measured in this task is the degree of flexion and extension at the finger joints. Specifically, it tracks the movement at the metacarpophalangeal (MCP) joint (i.e., the joint where the finger meets the hand), and proximal interphalangeal (PIP) joint (i.e., joint between the first and second finger bones). Infrared markers will be placed on the metacarpal MCP and PIP joints to track finger movement using two 3-camera Optotrak Certus motion capture systems.
Measured: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
Secondary outcomes (5)
Fugl Meyer Upper Limb assessment (FM-UL)
The FM-UL assessment assesses the sensorimotor impairment in individuals who have had stroke. It assesses movements, coordination, and reflexes.
Measured: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
Action Research Arm Test (ARAT)
The ARAT is a 19-item assessment designed to evaluate upper extremity motor activity. It measures how well individuals can perform specific arm and hand tasks, focusing on four main areas: grasp, grip, pinch, and gross movement.
Measured: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
Nine-Hole Peg Test (9-HPT)
The 9-HPT is a standardized, quantitative assessment designed to evaluate finger dexterity. In this test, participants are required to pick up pegs from a container one at a time and place them into holes on a pegboard as quickly as possible.
Measured: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
MRI: Neural activation and connectivity in ipsilesional and contralesional motor cortex
The investigators will examine how various areas of the brain function and interact, with a focus on the regions that control movement. They will specifically assess both the injured side of the brain (ipsilesional) and the uninjured side (contralesional) to observe how each responds during tasks.
Measured: Baseline and Post-training-1 (day 3)
MRI: White matter integrity in corticospinal, reticulospinal and rubrospinal tracts
The investigators will evaluate the condition of specific brain pathways involved in transmitting signals to participants' muscles, including the corticospinal, reticulospinal, and rubrospinal tracts.
Measured: Baseline and Post-training-1 (day 3)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Sep 2024
- Study start7 May 2026
- Primary completionAug 2027 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for StrokeStudies of the same condition, open and under way.
- More trials run by University of TorontoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Toronto
- Sponsor type
- University, hospital or other
- Collaborators
- Heart and Stroke Foundation of Canada, McGill University
- Responsible party
- Principal investigator, Joyce Chen, University of Toronto
- Investigators
- Joyce L Chen, PhD, Principal investigator, University of Toronto: Faculty of Kinesiology & Physical Education
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06604143
- Sponsor's protocol ID
- 46065
- Other IDs
- G-23-0034937
- Status last verified
- May 2026
- First submitted
- 17 Sep 2024
- Last updated
- 8 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: IPD used in the results publication
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Discovering the Potential for Motor Recovery in People Living With Stroke
- ClinicalTrials.gov ID
- NCT06604143
- Acronym / sponsor ID
- 46065
- Conditions
- Stroke
- Keywords
- Motor system, Stroke rehabilitation, Magnetic resonance imaging, Kinematics, Music
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- University of TorontoUniversity, hospital or other
- Collaborators
- Heart and Stroke Foundation of Canada, McGill University
- Study start
- 7 May 2026 (actual)
- Primary completion
- Aug 2027 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 19 Sep 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to compare two rehabilitation methods to improve finger movements in people who have had a stroke. The main question it aims to answer is which of these two training methods leads to the most improvement:
- Teaching people to reach their movement goals using any strategies they like.
- Teaching people to improve their movement technique and avoid compensatory strategies.
There is no one-size-fits-all approach. The second goal is to find out who might benefit more from each method. Some people with stroke may rely on compensatory strategies due to severe impairment, while others with milder strokes might benefit more from techniques that enhance movement quality.
The third goal is to take pictures of the brain to see how it changes with each method. This will help researchers understand how the brain adapts after a stroke and could lead to treatments that target the brain directly.
Participants will:
- Visit the lab for clinical and research assessments on weeks 1, 4, 5, and 15.
- Complete 10 days of piano training.
- Undergo magnetic resonance imaging (MRI) scans twice, once in week 1 and once in week 4.
Detailed description
Forty participants with sub-acute (6 months - 2 years) stroke will be recruited in this multi-site trial taking place in Toronto and Montreal. Participants will need to be able to perform active finger movements. Each site will recruit and randomize participants into one of two training groups. Training will consist of:
- One group will focus on improving the quality of their movements while playing music on a digital piano.
- The other group will focus on achieving their movement goals while playing playing music on a digital piano.
Participation in this study will involve 14 visits, each taking place on a separate day.
Piano training consists of 20 hours total, spread over 2 hours per day for 5 days across 2 weeks. Each participant will receive one-on-one and/or group instruction from a Music Therapist with expertise in Neurologic Music Therapy and piano instruction. Exercises will include pressing single keys and multiple keys with different fingers, holding down certain keys while pressing others, and playing melodies and chords with all five fingers, involving various coordination patterns, rhythms, and speeds.
Assessments will be conducted at four timepoints: Baseline, Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months). Participants will undergo validated clinical assessments to evaluate their ability to move and feel their arm, hand, and fingers, as well as for assessor to understand how the stroke has affected them overall. Some of these tests are routinely used by physical therapists and other rehabilitation professionals who work with people living with stroke. For other types of tests, sensors will be placed on their arm, hand, and fingers. These sensors do not emit anything; they will simply record their movements.
Kinetic and kinematic measures will assess finger forces, grip strength, and pinch strength. Magnetic resonance imaging (MRI) scans at Baseline and Post-training-1 will be taken to quantify structure and function of the brain.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Quality Training Group | Active comparator | Behavioral: Quality Training |
| Goal Training Group | Active comparator | Behavioral: Goal Training |
Who may qualify
- Ages
- 19 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Over 18 years of age
- Diagnosis of first time unilateral ischemic or hemorrhagic
- Stroke occurrence: > 6 months and < 2 years
- Able to perform active finger movements (Chedoke-McMaster (CM) Impairment Inventory of the Hand, Stage ≥ 3)
Key exclusion criteria (8 listed)
- History of developmental, neurological, or major psychiatric disorders
- Cognitive deficits (< 23/30 Montreal Cognitive Assessment)
- Apraxia (<2SD mean Waterloo Apraxia test)
- Neglect (> 40/100, Sunnybrook Neglect Assessment Procedure)
- Cerebellar stroke
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Quality TrainingParticipants will engage in piano playing tasks using their affected hand and fingers. The training focuses on specific aspects of finger movement, and participants will receive feedback related to their playing. They will wear a wrist brace for support, and their hand and arm positions will be monitored to ensure proper technique. | Behavioural | Quality Training Group |
| Goal TrainingParticipants will engage in piano playing tasks using their affected hand and fingers. The training emphasizes learning to play and producing music. Feedback will be provided on various aspects of performance such as speed and accuracy, but specific details about finger movement or technique will not be given. The use of a wrist brace and monitoring of hand and arm positions will be consistent with standard practice. | Behavioural | Goal Training Group |
Primary outcome
Finger Individuation: Force
Time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months)
The Finger Individuation - Force is a measure of how well a finger is able to exert force without the other fingers exerting force. This measure has been used to study finger movements in healthy individuals, pianists, and stroke survivors. This task will use a custom device to measure finger movements in all digits of both hands. The forearm will be placed on a table with the wrist in a neutral position and secured to prevent other movements. The device will support the palm and measure the force each finger produces using sensors under each fingertip. The investigators will determine participants' maximum finger force. Then, participants will practice producing forces at 20%, 40%, 60%, and 80% of this maximum for each finger while keeping the others still. They will see a visual target for the required force and get feedback on their performance.
Finger Individuation: Joint Angular Excursion
Time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
The Finger Individuation - Joint Angular Excursion is a measure of how well a finger is able to bend or straighten while the other fingers remain stationary. The angle being measured in this task is the degree of flexion and extension at the finger joints. Specifically, it tracks the movement at the metacarpophalangeal (MCP) joint (i.e., the joint where the finger meets the hand), and proximal interphalangeal (PIP) joint (i.e., joint between the first and second finger bones). Infrared markers will be placed on the metacarpal MCP and PIP joints to track finger movement using two 3-camera Optotrak Certus motion capture systems.
5 secondary outcomes
Fugl Meyer Upper Limb assessment (FM-UL)
Time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
Action Research Arm Test (ARAT)
Time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
Nine-Hole Peg Test (9-HPT)
Time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months).
MRI: Neural activation and connectivity in ipsilesional and contralesional motor cortex
Time frame: Baseline and Post-training-1 (day 3)
MRI: White matter integrity in corticospinal, reticulospinal and rubrospinal tracts
Time frame: Baseline and Post-training-1 (day 3)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2026.
- Individual participant dataSharing planned: Yes. IPD used in the results publication
Related trials for Stroke
Not yet recruiting
Temporal Interference Stimulation for Upper-Limb Motor Recovery in Early Subacute Stroke
Acute Ischemic Stroke
RecruitingObservational study
ELATE Study: Evaluating Large-vessel Acute Thrombectomy in Extended Time Window
Acute Ichemic Stroke
Recruiting
Web-Based Tele-Rehabilitation Using Action Observation and Mirror Therapy for Subacute Stroke: A Randomized Controlled Trial
Stroke, Upper Extremity Paresis
Recruiting
Early Motor-Cognitive Integrative Training on Cognitive and Motor Performance in Patients With Aneurysmal Subarachnoid Hemorrhage
Subarachnoid Aneurysm Hemorrhage
Not yet recruiting
Selective Intra-Arterial Hypothermia After Endovascular Treatment for Acute Basilar Artery Occlusion
Acute Ischemic Stroke, Basilar Artery Occlusion
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Joyce L Chen, PhD principal investigator
University of Toronto: Faculty of Kinesiology & Physical Education
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Quality Training and Goal Training in people with Stroke, run by University of Toronto at 5 sites in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 8 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Joyce L Chen, PhD (416-946-5394, JOYCELYNN.CHEN@UTORONTO.CA), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Finger Individuation: Force (time frame: Pre-training (baseline), Post-training-1 (day 3), Post-training-2 (day 7), and Follow-up (3 months)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2026.