The Efficacy of Occupation-Based and Exercise-Based Interventions on Performance Components and Areas of Occupation in Subjects with Chronic Stroke (Clinical Trial)

1. Comparison of the efficacy of occupation-based, exercise-based intervention and traditional interventions on parameters of motor control strategies of upper limb in reach and grasp in people with chronic stroke 2. Comparison of the efficacy of occupation-based, exercise-based intervention and traditional interventions on cognitive function, upper limb function, balance and functional mobility in people with chronic stroke 3. Comparison of the efficacy of occupation-based, exercise-based intervention and traditional interventions on participation in occupational areas in people with chronic stroke

45 chronic stroke patients who have the eligibility criteria will be included in the study and will be randomly assigned to one of the three groups of occupation-based intervention, exercise-based intervention or control group. The sample size is 15 people per group.

In this randomized clinical trial, eligible patients will be recruited and randomly assigned to one of three groups. Interventions will be provided for 3 months in all groups. Interventions and assessmwnts will conduct mainly in school of rehabilitation and Dr. Movafaghiyan research center. The assessment of primary and secondary outcomes will be done by a researcher who is not aware of the patients' assignment.

We will recruit chronic stroke patients who experience the first stroke and have no history of other neurological disorders and depression before stroke onset. Patients who experience another stroke and patients with inappropriate collaboration will be excluded.

In occupation based group, “cognitive orientation to daily occupational performance” will be used. This is a client-centered problem-solving protocol which focuses directly on improving performance in everyday life activity rather than treating the underlying impairments. Intervention in the exercise based group will be a structured exercise protocol including the range of motion and strengthening exercises, balance and endurance training and functional use of the upper extremity. Participants in the routine occupational therapy group will receive traditional occupational therapy including neurodevelopmental methods, stretching and strengthening programs, positioning, training of balance and fine motor skills and functional exercises.

1. Participation in occupational areas 2.Performance components including upper limb function, balance and functional mobility and cognition

Vice Chancellor for Research, Iran University of Medical Sciences

According to "Table of Random Numbers" participants will be randomly assigned to three groups of occupation-based intervention, exercise-based intervention or control group.

The present study is an assessor blind study in which interventions in each group will be delivered by a therapist and outcome measurements will be conducted by another researcher who is not aware of participant's assignment.

Information on the primary and secondary outcome measures

After publishing the articles

Researchers intending to research in this field.

-Obtaining written permission from the research team - Mention the source of information

-Mahnaz Hejazi Shirmard: School of Rehabilitation, Shahid Shahnazari Street, Madar Square, Mirdamad Blvd, Tehran. Email Adress: M.hejazishirmard@yahoo.com -Dr. Laleh Lajevardi: School of Rehabilitation, Shahid Shahnazari Street, Madar Square, Mirdamad Blvd, Tehran. Email Adress: Lajevardi.l@iums.ac.ir

After sending the email to the researcher and requesting the document, the researcher will request the opinion of other members of the research team regarding the provision of this information and, if the members agree, the documents will be sent as soon as possible but sending the documents requires the acceptance of the criteria mentioned above.