Increased practice of affected Upper Limb (UL) during early post-stroke period influences neuroplasticity and optimises UL functional recovery. Translation of increased UL practice from research to real clinical settings is lacking because there are still knowledge gaps on neuroplasticity and effective mode of early UL practice.

Aims:

To investigate the effectiveness of a Self-empowered Upper limb Repetitive Engagement (SURE) program to increase UL practice and improve UL functional outcomes early post-stroke.

To investigate early post-stroke neuroplasticity through multiple neuro-imaging analysis with the goal to develop imaging biomarkers for image-guided neuro-rehabilitation framework so as to optimize early UL practice after stroke.

To correlate the imaging biomarkers with neuro-recovery outcomes.

Hypothesis:

Imaging biomarkers are associated with rehab-methods and recovery of UL post-stroke. Increased UL practice in early post-stroke period influences neuroplasticity positively to optimize UL recovery. SURE-program increases UL practice in the ward and improves UL functional outcomes post-stroke.

Methodology:

An exploratory pilot trial on 24 stroke inpatients with severe and moderate UL paresis within 3-weeks post-stroke onset. Subjects were randomised into 2 groups. The experimental-group underwent 4 weeks of SURE program in the ward. The control-group underwent 4 weeks of education program. Pre- intervention, post-intervention, and 3-month post-intervention UL functional and multimodal-MRI assessments were performed and will be compared for UL recovery and neuroplasticity between the two groups.