Virtual Reality Assessment of Control Interfaces for the Use a Neuroprosthesis in Individuals With Tetraplegia (I-GRIP)

June 8, 2026 updated by: Centre Bouffard Vercelli - USSAP

Relevance of Virtual Reality Assessment of Control Interfaces for a Neuroprosthesis That Stimulates the Upper Limbs of Quadriplegic Individuals

With a view to implanting a neuroprosthesis for the upper limb in individuals with complete tetraplegia, this study aims to validate virtual reality as a simulation tool for evaluating and optimizing the piloting interfaces of these type of assistive devices. The operating principle of the device we are interested in is to provide a set of predefined functional electrical stimulation (FES) configurations that activate specific hand movements (hand opening, palmar grasp, key grip, etc.), from which the user selects the one that is suitable for performing a task. The user control is usually based on commands from the contralateral limb (pressing a button, shoulder movement, or voluntary muscle contractions). These stereotypical and unintuitive commands hinder any possibility of bimanual tasks. Hands-free voice interfaces have been tested but have contextual limitations, particularly in terms of discretion or usability for certain activities such as eating. Furthermore, it is difficult to evaluate the performance of control interfaces and adjust them prior to the implantation of the stimulation neuroprosthesis. The aim of the I-GRIP project is to establish a methodology that is sufficiently realistic to enable people to envision their future use of a neuroprosthesis. Such a tool would also enable future candidates for implantation to better understand the device's potential. This approach would also make it possible to customize the technology prior to implantation (choice and adjustment of control interfaces, training, configuration of algorithms for analyzing movements evoked by stimulation, etc.).

Our main hypothesis is that two control interfaces (HMI1 and HMI2) will allow the user to control the completion of a grasping task (approach, grasp, hold) for each target object in the virtual environment simulating electrical stimulation of the forearm muscles.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Immersive, semi-immersive, or non-immersive VR has mainly been used for therapeutic rehabilitation purposes in patients with spinal cord injuries who have motor impairments in their upper limbs. A recent literature review in 2024 highlights a strong trend emerging from the analysis of all publications on the subject, namely an analytical gain in strength with no impact on manual dexterity, this gain being all the more significant the longer the training lasted (> 15 hours in total). In the field of functional electrical muscle stimulation, which is of interest to us here, Ajiboye et al. 2017 proposed post-implantation training of an upper limb (UL) stimulation neuroprosthesis in a quadriplegic patient under the control of a Brain Computer Interface (BCI) and compared object grasping performance in immersive VR and non-VR. Given that VR training was longer than non-VR training, movements were found to be smoother and more precise in VR. The uniqueness of this experiment lies in having established proof of concept around a subject's ability to control single and multi-coordinated movements with 80 to 100% accuracy using their thoughts, first using a virtual upper limb (UL) and then their own UL activated by FES to drink a cup of coffee and bring food to their mouth. It also highlighted the real value of immersive virtual reality in learning movements.

A recent publication of a clinical case study focused on the use of a Leap Motion optical hand tracking controller in a semi-immersive environment [Ahmed Al Nattah 2024]. Leap Motion, which is mainly used in kinematic assessments, is introduced in this publication for the purpose of rehabilitating the hand of an incomplete quadriplegic participant equipped with sensors and invited to perform exercises of increasing difficulty in custom-built video games offering both visual and auditory feedback. Beyond the promising therapeutic benefits observed in this single case study, this semi-immersive experience can be transposed into full immersion in applications such as the optimization and customization of neuroprosthesis control interfaces. VR is playing an increasingly decisive role in movement rehabilitation. It is part of the therapeutic arsenal that now aims to offer a fun, meaningful, and motivating approach to encourage the repetition of gestures and movements and, in fact, learning. However, its use as a tool for designing and evaluating the performance of assistive technology control interfaces has been little explored in studies, which justifies the approach adopted in this project.

With a view to implanting a neuroprosthesis for the upper limb in individuals with complete tetraplegia, this study aims to validate virtual reality as a simulation tool for evaluating and optimizing the piloting interfaces of these type of assistive devices. Such an environment would ultimately enable future users to prepare for the use of these devices and to project themselves into their use. This approach would also make it possible to customize the technology prior to implantation (choice and adjustment of control interfaces, training, configuration of algorithms for analyzing movements evoked by stimulation, etc.). In general, it is important to advance control interfaces to improve their ergonomics and usability. Here, we wish to show that virtual reality allows participants to realistically project themselves into an experience of using a neuroprosthesis that controls wrist extension and finger flexion/extension movements.

Participants will be equipped with a virtual reality headset that will project a virtual scene with various everyday objects and a representation of their hand. They will have to move their arm towards one of the objects in the scene, then trigger hand movements using one of the available control interfaces to grasp the object and manipulate it. Two methods of controlling the opening and closing movements of the fingers will be tested: HMI1: two physical buttons activated by pressing with the opposite hand to send commands, and HMI2 - shared control: the reaching movement of the arm towards the object is tracked using a video camera and automatically select the appropriate opening and gripping movements. HMI1 therefore requires a stereotypical action (pressing a button), while HMI2 allows automatic selection of grasping movements by observing the natural movements of approaching the object, which are observed by a camera and interpreted by an algorithm.

The experimental aspects of the study will be conducted over 2 sessions:

  • (V1) Selection Visit: The selection visit will be conducted by the coordinating investigator, who will monitor the participant throughout the trial.
  • (V2) Inclusion Visit: This visit will include: Clinical examination Collection of the signed consent form
  • (V3 to V4) Experimental Visits: V3 (session 1): Taking measurements of the user to customize the models used for the virtual environment (2 hours max) V4 (session 2): Virtual immersion experiment (2 hours max)
  • (V5) End-of-Study Visit: This final visit will consist of a clinical and psychological follow-up consultation to ensure the absence of any adverse effects.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
10

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Perpignan, France, 66000
        • Rehabilitation Center Bouffard-Vercelli USSAP

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Spinal cord injury defined by an AIS A, B or score (AIS A, B): complete or incomplete motor deficit below the lesion. This is a standard for describing spinalcord injuries that has been internationally agreed upon.
  • Spinal cord injury at the neurological level > C7
  • Age greater than or equal to 18 and less than or equal to 80 years
  • A history of more than 3 months of neurological stability, with no changes in muscle testing.
  • Participants capable of following instructions for testing and providing feedback on the use of the device.
  • Participants who have signed the informed consent form to participate in the study after being fully informed.
  • Participants affiliated with a social security system (either as a beneficiary or a dependent), excluding those covered by State Medical Aid (AME).

Exclusion Criteria:

  • • Participant deprived of liberty (by judicial or administrative decision).

    • Adult participants are under legal protection or unable to provide informed consent.
    • Participation in another ongoing clinical trial.
    • Unstable psychiatric condition.
    • Severe cognitive impairment.
    • Unstable acute medical condition
    • Insufficient proficiency in spoken and written French.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Patients with complete tetraplegia AIS A or B, with a neurological level ≥ C7
Device: Virtual reality used as a simulation tool to evaluate and optimize the use of control interfaces
With a view to implanting a neuroprosthesis for the upper limb in individuals with complete tetraplegia, this study aims to validate virtual reality as a simulation tool for evaluating and optimizing the piloting interfaces of these type of assistive devices.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Efficacy indicators
Time Frame: At Day 1
Success rate (%) of the task (approach the object, grasp it with the dedicated grip, hold it for 5 seconds) over 10 repetitions for the each control modality. The expected success rate is at least 90% over all 10 repetitions for each control modality after a short learning phase.
At Day 1

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Time workload indicators
Time Frame: At day 1
Task execution time (seconds) for each of the HMIs
At day 1
Indicators of satisfaction, comfort, pleasure of use and subjective workload
Time Frame: At day 1

Enjoyability of the control interface, reflecting the user's mood, motivation, or frustration.

Evaluation criterion: For each HMI, after 10 repetitions, appropriate section of the questionnaire National Aeronautics and Space Administration Task Load Index (NASA-TLX). For each item, the score min is 0 and max 100.
At day 1
Indicators of satisfaction, comfort, pleasure of use and subjective workload
Time Frame: At day 1
Measuring the patient experience Evaluation criterion: For each HMI, after 10 repetitions, appropriate section of the questionnaire PREMs.
At day 1
Indicator of appropriation: quality of the embodiement in the VR environment Appropriation
Time Frame: At day 1
Appropriation indicator - Virtual Embodiment Questionnaire (VEQ) (French version) before and after personalization of the environment
At day 1
Indicator of tolerance: cyberkinetosis
Time Frame: At day 1
SSQ - Simulator Sickness Questionnaire (French version) at the end of the experiment
At day 1

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Centre Bouffard Vercelli - USSAP

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Institut National de Recherche en Informatique et en Automatique

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: CHARLES FATTAL, MD, PhD, Centre Bouffard Vercelli - USSAP
  • Study Director: CHRISTINE AZEVEDO, PhD, Institut National de Recherche en Informatique et en Automatique

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
April 10, 2026

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 7, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 27, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 8, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 11, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 8, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2025-A01444-45
  • 101099916 (Other Grant/Funding Number: HORIZON-EIC-2022-PATHFINDEROPEN-01-01)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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