Evaluation of a Haptic Glove for Assessing Tactile Perception in Post-Stroke Patients (SCORES-glove)
A Multicenter Randomized Controlled Trial on the Effects of Upper Limb Robotic Rehabilitation on Sensory and Cognitive Impairments in Subjects With Stroke. The SCORES (Sensory and Cognitive Outcomes of Robotic Exercises in Stroke) Study. Evaluation of a Haptic Glove.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Sensory and proprioceptive deficits in the upper limbs affect about 50-85% of stroke survivors. These deficits can impact single sensations (such as primary tactile senses like light touch, pressure, and localization) and the ability to discriminate between different materials or temperatures, as well as proprioception and multiple somatosensory modalities. Furthermore, somatosensory deficits have been strongly correlated with variations in treatment responses among patients. However, in clinical practice, the use of appropriate quantitative tools to measure these deficits is not widespread, and evidence for active sensory training remains limited.
In recent years, robotic therapy has been proposed as an effective approach for upper limb rehabilitation. Nevertheless, recent studies with large samples have failed to demonstrate the superiority of robotic treatment over traditional methods regarding the recovery of upper limb motor functions. These studies primarily focus on motor aspects of stroke recovery, often neglecting sensory and cognitive aspects of rehabilitation, whether robotic or conventional.
Actually, there is limited evidence supporting the superiority of robotic approaches over conventional rehabilitation in recovering cognitive deficits and sensitivity. Additionally, it remains unclear whether cognitive and/or sensory deficits impact motor outcomes differently when using robotic versus conventional approaches.
To address this, the SCORES (Sensory and Cognitive Outcomes of Robotic Exercises in Stroke) study is a multicenter randomized controlled study investigating the effects of robotic rehabilitation on cognitive and sensory deficits in stroke survivors. It aims to compare robotic and conventional rehabilitation approaches regarding cognitive recovery and tactile sensitivity in subacute stroke patients. While some quantitative methods exist to assess absolute perception levels of tactile stimuli, standardized, repeatable, and objectively quantitative methods for assessing localization ability are lacking. Therefore, this study will evaluate how the tactile perceptual abilities of recruited patients evolve during and after a rehabilitation course-whether robotic or conventional-using a specifically developed haptic device that includes a glove with integrated vibrotactile elements. This system aims to objectively define patients' tactile sensitivity through psychophysical evaluations involving the identification and localization of randomized vibrations delivered to the surface of the hand affected by sensorimotor alterations. Specifically, this study will investigate the test-retest reliability, discriminant ability, responsiveness, and clinical validity of the metrics obtained from the haptic glove.
During each experimental session, randomized vibrotactile stimuli will be administered to the recruited patient at different sites on the hand. The patient will be asked to identify and verbally communicate the site of each perceived vibration, as well as the intensity of the vibration itself between the two possible levels.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Chiara Fanciullacci, PhD
- Email: ctu@dongnocchi.it
Study Contact Backup
- Name: Marco Germanotta, PhD
- Phone Number: 3805464652
- Email: mgermanotta@dongnocchi.it
Study Locations
-
-
Italy
-
Florence, Italy, Italy, 50143
- Recruiting
- IRCCS Fondazione Don Carlo Gnocchi
-
Messina, Italy, Italy, 98123
- Recruiting
- IRCCS Centro Neurolesi Bonino Pulejo
-
Roma, Italy, Italy, 00166
- Recruiting
- Fondazione Don Carlo Gnocchi - Centro Santa Maria della Provvidenza
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- a single event, verified by MRI or CT;
- age between 18 and 85 years;
- time since stroke within six months;
- a demographically adjusted total score of the Montreal Cognitive Assessment (MoCA) between 15.5 and 22.23
Exclusion Criteria:
- behavioural and cognitive disorders and/or reduced compliance that would interfere with active therapy;
- fixed contraction deformity in the affected limb that would interfere with active therapy (ankylosis, Modified Ashworth Scale = 4);
- severe deficits in visual acuity.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Robotic Rehabilitation
Robotic Rehabilitation of the upper limb
|
Upper limb rehabilitation using a set of 4 devices. A set of motor/cognitive exercises will be selected to train also attention, memory, executive function, speed of processing, and visuospatial abilities.The following devices will be used: (a) a robotic device that allows passive, active, and active-assistive planar movements of the shoulder and elbow joints (Motore, Humanware); (b) a robotic device that allows passive, active, and active-assistive finger flexion and extension movements (Amadeo, Tyromotion); (c) a sensor-based system that allows unsupported 3-dimensional movements of shoulder, elbow, and wrist joint, both unimanual and bimanual (Pablo, Tyromotion); and (d) a robotic system that allows 3-dimensional, unimanual and bimanual, movements of the shoulder joint, with arm weight support (Diego, Tyromotion). The rehabilitation treatment will be performed daily for 45 minutes, 5 days/week, for a total of 30 sessions. |
|
Active Comparator: Conventional Rehabilitation
Conventional Rehabilitation of the upper limb
|
Upper limb rehabilitation using conventional techniques, focused on upper limb reprogramming sensorimotor function, hypertonus, inhibition and functional improvement. The rehabilitation treatment will be performed daily for 45 minutes, 5 days/week, for a total of 30 sessions. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number and types of the haptic glove malfunctions that occurred during the study, along with their descriptions (Feasibility evaluation)
Time Frame: Baseline; within 2 days after the end of rehabilitation treatment; within 2 days after the end of rehabilitation treatment; 6 months after the end of treatment.
|
Number and types of the haptic glove malfunctions that occurred during the study, along with their descriptions.
|
Baseline; within 2 days after the end of rehabilitation treatment; within 2 days after the end of rehabilitation treatment; 6 months after the end of treatment.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of stimulations provided by the haptic glove and correctly identified in terms of intensity and localization (test-retest reliability)
Time Frame: Baseline; within two day after baseline
|
The number of stimulations provided by the haptic glove and correctly identified by the patient in terms of intensity and localization at baseline and within two days after baseline will be assessed to evaluate the measure's test-retest reliability
|
Baseline; within two day after baseline
|
|
Number of stimulations correctly identified in terms of intensity and localization (responsiveness)
Time Frame: Baseline; within 2 days after the end of rehabilitation treatment; 6 months after the end of treatment.
|
The number of stimulations provided by the haptic glove and correctly identified by the patient in terms of intensity and localization before and after the intervention will be assessed to evaluate the measure's responsiveness
|
Baseline; within 2 days after the end of rehabilitation treatment; 6 months after the end of treatment.
|
|
Number of stimulations correctly identified in terms of intensity and localization (clinical validity)
Time Frame: Baseline; within 2 days after the end of rehabilitation treatment.
|
The number of stimulations provided by the haptic glove and correctly identified by the patient in terms of intensity and localization before and after the intervention will be correlated with the Semmes-Weinstein monofilament test at the same timepoint to assess measure's clinical validity
|
Baseline; within 2 days after the end of rehabilitation treatment.
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SCORES-haptic glove
- GR-2021-12374896 (Other Grant/Funding Number: Italian Ministry of Health)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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