Combined Effects of Soft Robotic Hand and Electrical Stimulation on Hand Function in Stroke Survivors
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Aruba Saeed, PhD
- Phone Number: +923344399403
- Email: arubasaeedpt@gmail.com
Study Contact Backup
- Name: Amna Naveed, DPT
- Phone Number: +923178731632
- Email: amnanaveed14082000@gmail.com
Study Locations
-
-
Punjab Province
-
Lahore, Punjab Province, Pakistan, 54660
- Recruiting
- Shadman Medical Center, Stroke Rehabilitation
-
Lahore, Punjab Province, Pakistan, 54660
- Recruiting
- Pakistan Society for the Rehabilitation of the Disabled (PSRD)
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosed with their first episode of stroke.
- Participants with 3-6 months post stroke.
- Participants with normal cognition on Montreal Cognitive Assessment (MOCA) ≥24.
- Participants with the ability to extend Metacarpophalangeal (MCP) and Proximal Interphalangeal (PIP) joint to 180 degree passively
- Modified Ashworth Scale < 2.
- Participants with the score of 10 to 16 on National Institute of Health Stroke Scale Score (NIHSS Score).
Exclusion Criteria:
- Presence of other neurological, neuromuscular, orthopedic diseases, or
- conditions that may interfere with task performance.
- Participants with sensory disturbances in the fingers
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: Experimental: Group-1 (Soft Robotic Hand + Neuromuscular Electrical Stimulation)
The experimental group will follow a rehabilitation program that combines soft robotic hand support along with electrical muscle stimulation (EMS), and perform task oriented training.
Syrebo Hand rehabilitation robotic glove will be used which help the patient to flex and extend the fingers as in open or close a fist and for the stimulation of muscles ComfyStim EMS device will be used, By placing EMS electrodes on the important muscle groups used for gripping, moving the wrist, and making small movements, adjusting the intensity to what each person can handle.
After the careful set up of both devices patient will perform task training such as grip-release cycles, reaching to grab objects, pinching small items, and mimicking daily activities like lifting a cup or stacking blocks.
|
Group-1, will follow a rehabilitation program that combines soft robotic hand support, electrical muscle stimulation (EMS), and task oriented training.
After the adjustment of soft robotic hand, EMS electrodes will be placed on specific muscles, with set FITT principal as, A pulse frequency of 20 to 50 Hz and a pulse duration of 400 μs will be set with the intensity as per tolerated by the participant.
Participants will perform task oriented activities that will include, Reaching to grasp objects, Picking up and releasing things at different heights using active finger and wrist extension.
Opening a jar, or bottle, Turning a key or doorknob, Holding and lifting a tray or flat object, Pushing objects forward (like sliding a book across) with the assistance of soft robotic hand while electrical simulations are being delivered through the EMS for 40 min/day, 03 days/week, for 08 week.
Measurements will be taken prior to the treatment, after 4 weeks of treatment and 8 weeks post-treatment.
Other Names:
|
|
Other: Control: Group-2 ( Neuromuscular Electrical Stimulation)
The control group will follow a rehabilitation program that combines support of electrical stimulation, and task oriented training.
For the stimulation of muscles ComfyStim EMS device will be used, by placing EMS electrodes on the important muscle groups used for gripping, moving the wrist, and making small movements, adjusting the intensity to what each person can handle.
After the careful set up of EMS device patient will perform task training such as grip-release cycles, reaching to grab objects, pinching small items, and mimicking daily activities like lifting a cup or stacking blocks.
|
The control group will follow a rehabilitation program that combines support of electrical stimulation, and task oriented training.
For the stimulation of muscles ComfyStim EMS device will be used.
The FITT principal used for EMS will be as, A pulse frequency of 20 to 50 Hz and a pulse duration of 400 μs will be set with the intensity as per tolerated by the participant.
Participants will perform task oriented activities that will include, Reaching to grasp objects, Picking up and releasing things at different heights using active finger and wrist extension.
Opening a jar or bottle, Turning a key or doorknob, Holding and lifting a tray or flat object, Pushing objects forward (like sliding a book across) while electrical simulations are being delivered through the EMS for 40 min/day, 03 days/week, for 08 week.
Measurements will be taken prior to the treatment, after 4 weeks of treatment and 8 weeks post-treatment.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Wolf Motor Function Test
Time Frame: Measurements will be taken before the treatment as baseline, after 4 weeks of treatment, and 8 weeks post-treatment
|
Motor hand function will be assessed using the Wolf Motor Function Test (WMFT).
The WMFT evaluates functional ability and movement speed through 17 tasks, including 15 timed functional tasks and 2 strength-based tasks.
Each task is scored on a 6-point scale (0-5), with higher scores indicating better performance; total scores range from 0 to 85.
|
Measurements will be taken before the treatment as baseline, after 4 weeks of treatment, and 8 weeks post-treatment
|
|
Fugl-meyer assessment of upper limb (FMA-UE)
Time Frame: Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
Motor hand function will be assessed using the Fugl-Meyer Assessment of Upper Extremity (FMA-UE).
The FMA-UE has demonstrated excellent test-retest and inter- and intra-rater reliability, and evidence for its content validity.
The FMA assesses motor recovery in the upper extremity using a 33-item scale scored from 0 to 2 per item, with a maximum score of 66.
|
Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
|
Nine-Peg Hole Test
Time Frame: Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
Dexterity of the affected hand will be assessed using the Nine-Hole Peg Test (NHPT), a standardized and widely used tool for measuring fine motor coordination.
Participants are instructed to place nine pegs into nine holes on a board and then remove them as quickly as possible, using one hand at a time.
The total time taken to complete the task is recorded in seconds.
Shorter completion times indicate better manual dexterity.
|
Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
|
Dynamometer
Time Frame: Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
Grip strength will be assessed using a hand-held dynamometer, a reliable tool for measuring isometric muscle force.
Participants will be instructed to squeeze the device with maximum effort while seated, with the elbow flexed at 90 degrees and the forearm in a neutral position.
Each hand will be tested three times, and the highest value will be recorded.
This method provides an objective measure of hand strength and is commonly used in stroke rehabilitation to monitor functional recovery and response to intervention.
|
Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment
|
|
Modified Ashworth Scale
Time Frame: Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment.
|
The Modified Ashworth Scale (MAS) will be used to evaluate muscle spasticity in the affected upper limb.
This scale grades resistance during passive soft-tissue stretching on a 6-point ordinal scale (0 to 4, with an additional 1+ grade), where higher scores indicate increased muscle tone.
MAS is widely used in stroke rehabilitation to monitor changes in spasticity and assess the effectiveness of interventions aimed at promoting motor recovery.
|
Measurements will be taken before the treatment, after 4 weeks of treatment, and 8 weeks post-treatment.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Aruba Saeed, PhD, Lahore University of Biological and Applied sciences, UBAS
Publications and helpful links
General Publications
- Murphy SJ, Werring DJ. Stroke: causes and clinical features. Medicine (Abingdon). 2020 Sep;48(9):561-566. doi: 10.1016/j.mpmed.2020.06.002. Epub 2020 Aug 6.
- Chien WT, Chong YY, Tse MK, Chien CW, Cheng HY. Robot-assisted therapy for upper-limb rehabilitation in subacute stroke patients: A systematic review and meta-analysis. Brain Behav. 2020 Aug;10(8):e01742. doi: 10.1002/brb3.1742. Epub 2020 Jun 26.
- Kristensen MGH, Busk H, Wienecke T. Neuromuscular Electrical Stimulation Improves Activities of Daily Living Post Stroke: A Systematic Review and Meta-analysis. Arch Rehabil Res Clin Transl. 2021 Nov 12;4(1):100167. doi: 10.1016/j.arrct.2021.100167. eCollection 2022 Mar.
- Ko MJ, Chuang YC, Ou-Yang LJ, Cheng YY, Tsai YL, Lee YC. The Application of Soft Robotic Gloves in Stroke Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Brain Sci. 2023 Jun 2;13(6):900. doi: 10.3390/brainsci13060900.
- Bayindir O, Akyuz G, Sekban N. The effect of adding robot-assisted hand rehabilitation to conventional rehabilitation program following stroke: A randomized-controlled study. Turk J Phys Med Rehabil. 2022 Jun 1;68(2):254-261. doi: 10.5606/tftrd.2022.8705. eCollection 2022 Jun.
- Chen P, Liu TW, Tse MMY, Lai CKY, Tsoh J, Ng SSM. The Predictive Role of Hand Section of Fugl-Meyer Assessment and Motor Activity Log in Action Research Arm Test in People With Stroke. Front Neurol. 2022 Jul 7;13:926130. doi: 10.3389/fneur.2022.926130. eCollection 2022.
- Lindsay LR, Thompson DA, O'Dell MW. Updated Approach to Stroke Rehabilitation. Med Clin North Am. 2020 Mar;104(2):199-211. doi: 10.1016/j.mcna.2019.11.002.
- Mosconi MG, Paciaroni M. Treatments in Ischemic Stroke: Current and Future. Eur Neurol. 2022;85(5):349-366. doi: 10.1159/000525822. Epub 2022 Aug 2.
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 (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- UBAS/ERB/FoRS/25/040 Amna
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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