Home » Trials » SLCTR/2017/031

Effectiveness of first-person and third-person motor imagery in relearning daily hand tasks for people with chronic stroke: A randomised controlled trial -

SLCTR Registration Number


Date of Registration

22 Sep 2017

The date of last modification

Sep 22, 2017

Application Summary

Scientific Title of Trial

Effectiveness of first-person and third-person motor imagery in relearning daily hand tasks for people with chronic stroke: A randomised controlled trial

Public Title of Trial

Relearning daily hand tasks for people with chronic stroke

Disease or Health Condition(s) Studied


Scientific Acronym


Public Acronym


Brief title

Motor imagery for people with stroke

Universal Trial Number


Any other number(s) assigned to the trial and issuing authority

P/154/06/2017 (ERC: Kelaniya) AAJ/ETH/COM/2017-08 (ERC: NHSL, Colombo) AA/04/2017/596 (ERC: CSTH, Kalubowila)

Trial Details

What is the research question being addressed?

What is the effectiveness of first-person and third-person motor imagery in relearning daily hand tasks for people with chronic stroke?

Type of study


Study design


Randomized controlled trial


Double blinded


Standard therapy




Supportive care


Intervention(s) planned

Study settings Occupational Therapy Unit at: 1. Colombo North Teaching Hospital, Ragama 2. Rheumatology and Rehabilitation Hospital,Ragama 3. The National Hospital of Si Lanka, Colombo 10 4. Colombo South Teaching Hospital, Kalubowila

Method of randomisation
Simple randomisation using a computer-generated randomization table by an independent research person.

Details of the intervention
There will be three study arms:
1. First-person imagery group
2. Third-person imagery group
3. Conventional occupational therapy (control) group

All participants will receive individual training on daily hand tasks such as turning pages of a newspaper, eating a biscuit, using comb etc. The program will be conducted 45 minutes a day, two times a week for 6 weeks. The intervention will be conducted in the occupational therapy unit or in a quiet area free of distraction.

Arm 1 (First-person imagery group): Participants will imagine themselves doing the task and then actually perform the task in the first-person imagery group.

Arm 2 (Third-person imagery group): Participants will imagine a person doing the task and then actually perform the task in the third-person imagery group.

Arm 3 (Control group): Participants will receive conventional occupational therapy which encompasses actual practice of the daily hand tasks for 45 minutes. The frequency, duration, number of sessions, and the sequence and training schedule will be the same as for the intervention groups.

Details on blinding
• An independent research person will conduct the randomisation.
• The participants are blinded to which group they are assigned.
• Two occupational therapists not involved in treatment will conduct the assessment for blinding purpose
• The investigators (including the PI) who are involved in data analysis will be blinded to the conditions and group allocation of the participants during analysis of data.
• One investigator who will not be involved in data analysis will rename the groups for data analysis

Inclusion criteria

  1. Age between 18 and 80 years
  2. A diagnosis of hemiplegia due to stroke (infarct or hemorrhage)
  3. Stroke experienced more than 3 months prior to enrollment (Summers et al., 2007)
  4. Able to complete Advanced Hand Activities 1, 2 and 3 of Motor Assessment Scale (Carr, et al.,1985)
  5. Score of more than 24 points on the Mini-Mental State Exam (dictates no cognitive deficits) (Folstein, et al., 1975)
  6. Able to give voluntary consent to participate in the study.

Exclusion criteria

  1. Visual and perceptual problems including hemianopia and unilateral neglect
  2. Excessive pain in the affected arm as measured by score of more than 4 on a 10-point Visual Analog Scale (Scott & Huskisson, 1976)
  3. Spasticity of more than 3 on Modified Ashworth Scale (Bohannon & Smith, 1987)
  4. Pre-existing musculoskeletal, neurological (apart from stroke) or other conditions that may affect upper limb function.

Primary outcome(s)

    1. Hand function: assessed by Jebsen-Taylor Hand Function Test (JTHFT) (Jebsen, Taylor, Trieschmann, Trotter, & Howard, 1969)

    2. Perceived hand function: assessed by Motor Activity Log (MAL) (Duncan, Propst, & Nelson, 1983].


    At baseline, six weeks (end of intervention) and 10 weeks after the end of intervention.


Secondary outcome(s)

    1. Vividness of imagery: assessed by Vividness of Movement Imagery Questionnaire-2 (VMIQ-2) (Roberts, Callow, Hardy, Markland, & Bringer, 2008)

    2. Upper extremity impairment: assessed by Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA) (Sanford, Moreland, Swanson, Stratford, & Gowland, 1993)

    3. Finger dexterity: assessed by Nine Hole Peg Test (NHPT) (Mathiowetz et al., 1985)

    4. In-hand manipulation: assessed by In-Hand Manipulation Assessment (IHMA) (Klymenko et al., under review)

    5. Independent living skills: assessed by Lawton Instrumental Activities of Daily Living Scale (IADL) (Lawton & Brody, 1988)

    6. Self-perception of performance: assessed by Canadian Occupational Performance Measure (COPM) (Law et al., 1998)

    7. Health-related quality of life specific to stroke survivors: assessed by Stroke Specific quality of life scale (SS-QOL) (Williams, Weinberger, Harris, Clark, & Biller, 1999)


    At baseline, six weeks (end of intervention) and 10 weeks after the end of intervention.


Target number/sample size

60 (20 in each arm)

Countries of recruitment

Sri Lanka

Anticipated start date


Anticipated end date


Date of first enrollment

Date of study completion

Recruitment status


Funding source

PhD scholarship at Western Sydney University

State of Ethics Review Approval


Date of Approval

Approval number

Details of Ethics Review Committee

Institutional Address:

Contact & Sponsor Information

Contact person for Scientific Queries/Principal Investigator

Nandana Welage
PhD candidate
Western Sydney University, Locked Bag 1797 Penrith NSW 2751, Australia n.welage@westernsydney.edu.au Karen Liu (Supervisor), Associate Professor Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
Tel: +61 2 4620 3432


Contact Person for Public Queries

Dr. Padma S. Gunaratne
Consultant Neurologist
Department of Neurology, The National Hospital of Sri Lanka, Regent Street, Colombo 10, Sri Lanka
Tel: +94 11 2584325

E-mail: pagunara@gmail.com

Primary study sponsor/organization

Western Sydney University

Western Sydney University Locked Bag 1797 Penrith NSW 2751


Secondary study sponsor (If any)


Trial Completion details

Do the investigators plan to share identified individual clinical trial participant-level data (IPD)?

IPD sharing plan description

Study protocol available

Protocol version and date

Protocol URL

Results summary available

Date of study completion

Final sample size

Date of first publication

Link to results

Brief summary of results