Harnessing Neuroplasticity to Enhance Functional Recovery in Allogeneic Hand Transplant and Heterotopic Hand Replant Recipients

What this Trial Is About

Researchers are evaluating a new rehabilitation approach for people recovering from peripheral nervous system injuries, including hand transplantation, hand replantation, and nerve repairs in the upper extremity. This approach is based on neuroscience discoveries about brain plasticity and aims to improve functional recovery by combining behavioral training with a non-invasive brain stimulation technique called transcranial direct current stimulation (tDCS). The study uses a combination of bi-hemispheric tDCS and modified Constraint Induced Movement Therapy (CIMT), where patients wear a mitt to restrict movement of the unaffected limb while practicing structured tasks and daily activities. The program targets individuals in the chronic stage of recovery, about 12 to 18 months after surgery. In addition, the study collects data on limb use patterns through actigraphy in hand transplant/replant patients and amputees to better understand prosthesis use and limb activity. Participants will undergo assessments including the Dellon Modified Moberg Pick-Up Test and the Action Research Arm Test to measure hand function changes from baseline to two weeks after the intervention. Movement during everyday life will be monitored through actigraphy at multiple time points up to six months after treatment. The study includes randomized assignment to treatment groups and uses double-blinding methods. The total participation time varies by individual, including baseline evaluation, intervention, and follow-up assessments.

Harnessing Neuroplasticity to Enhance Functional Recovery During Chronic Recovery From Upper Extremity Nerve Repair