Unimanual Versus Bimanual Motor Skill Learning in Acute and Chronic Stroke (MLAS6)

September 14, 2026 updated by: Pr Yves Vandermeeren, MD, PhD, University Hospital of Mont-Godinne

Comparison of Unimanual Versus Bimanual Motor Skill Learning (Proximal and Distal) After Stroke by Means of Robotics (REA²Plan® and Dextrain®) and Multimodal Brain Imaging (VLSM, DTI, NODDI, DIAMOND)

To test the capacity of healthy individuals, chronic and acute stroke patients to learn and retain a complex unimanual or bimanual motor skill, trained on the neurorehabiliation robot REAplan® et the Dextrain® device. The goals are (1) to compare head-to-head bimanual versus unimanual motor learning (in the proximal and distal upper limb, UL) during the acute - early subactue stage of stroke with robotics and (2) to identify the neural substrates associated with (and deficits in) unimanual versus bimanual motor control (proximal and distal) after stroke by means of multimodal brain imaging.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Over 3 consecutive days, healthy individuals, acute and chronic stroke patients (1) will be evaluated and (2) will train on the neurorehabiliation robot REAplan® and Dextrain® device.

They will practice a task on the robot REAplan® (unimanual or bimanual version), requiring movements with the affected arm (unimanual version) and complex, coordinated movements with both arms (bimanual version). They will practice another task on the Dextrain® device, also in unimanual and bimanual version.

In addition, several standardized clinical scales and tests will be used to evaluate overall motor-sensory-cognitive functions (clinical tests, questionnaires, ...)

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • 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 Contact

Study Contact Backup

Study Locations

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

STROKE PATIENTS

Inclusion Criteria:

  • acute stroke (between day 2 and day 21 post-stroke) or chronic stroke (>6 mois)
  • aged 40-90 years
  • with a single demonstrated stroke (ischemic or hemorrhagic) lesion on brain imaging

Exclusion Criteria:

  • [for acute paitents] "classical" contre-indication to MRI (non-MR-compatible pacemaker, pregnancy, non-MR-compatible implanted devices, claustrophobia, etc ...)
  • difficulty in understanding or executing commands
  • drug/alcohol abuse
  • severe aphasia/cognitive deficits interfering with study
  • inability to complete the tasks (i.e. full paralysis of the arm)
  • multiple stroke/dementia/psychiatric condition

HEALTHY INDIVIDUALS

Inclusion Criteria:

  • 40-90 years

Exclusion Criteria:

  • "classical" contre-indication to MRI (non-MR-compatible pacemaker, pregnancy, non-MR-compatible implanted devices, claustrophobia, etc ...)
  • medical history with a previous stroke/relevant neurological deficit
  • drug/alcohol abuse
  • psychiatric condition/dementia
  • having already used the robotic devices

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: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Bimanual tasks
Training on the REAplan® robot with a serious game based on proximal motor skill learning (MSkL) with the bimanual version of the Circuit task and training on the Dextrain® Manipulandum with a serious game based on the distal MSkL with a bimanual version of the Targeting task.
motor skill learning with the REAplan® rehabilitation robot, to be performed with one or two arms
motor skill learning with the Dextrain® Manipulandum dexterity tool to be performed with on or two hands
Experimental: Unimanual tasks
Training on the REAplan® robot with a serious game based on proximal motor skill learning (MSkL) with the unimanual version of the Circuit task and training on the Dextrain® Manipulandum with a serious game based on the distal MSkL with a unimanual version of the Targeting task.
motor skill learning with the REAplan® rehabilitation robot, to be performed with one or two arms
motor skill learning with the Dextrain® Manipulandum dexterity tool to be performed with on or two hands

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
bi-Force, bimanual force measured by the REAplan® robot
Time Frame: change between baseline (Day 1) and after training (Day 3)
bimanual forces, forces exerted in the wrong direction by each arm (Newtons)
change between baseline (Day 1) and after training (Day 3)
Unimanual/bimanual Speed/Accuracy Trade-off (SAT/bi-SAT) measured by the REAplan® robot
Time Frame: Change between baseline (Day 1) and after training (Day 3) and transfer from Day 3 to Day 1 on the untrained mode
Unimanual/bimanual Speed/Accuracy Trade-off: mathematical computation of the relationship between speed and accuracy, in arbitrary units (SAT = speed (cm/s)/error (cm²).C, where C=1cm.s)
Change between baseline (Day 1) and after training (Day 3) and transfer from Day 3 to Day 1 on the untrained mode
bimanual Coordination factor (bi-CO) measured by the REAplan® robot
Time Frame: change between baseline (Day 1) and after training (Day 3)
bimanual Coordination factor, mathematical measure of the phase coherence between speeds of both arms
change between baseline (Day 1) and after training (Day 3)
Root Mean Square Error (RMSE), bimanual root mean square error measured by the Dextrain® Manipulandum
Time Frame: change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode
tracking error between the optimal trajectory between 2 targets and the actual trajectory
change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode
bimanual Coordination factor (bi-CO) measured by the Dextrain(R) Manipulandum
Time Frame: change between baseline (Day 1) and after training (Day 3)
bimanual Coordination factor, mathematical measure of the phase coherence between speeds of both hands
change between baseline (Day 1) and after training (Day 3)
Hold time measured by the Dextrain® Manipulandum
Time Frame: change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode
The amount of time the cursor remains inside the target zone
change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Voxel-based Lesion Symptom Mapping (VLSM)
Time Frame: Baseline
Diffusion Weighted Imaging (DWI)
Baseline
Shoulder Abduction Finger Extension (SAFE) test
Time Frame: Day 1
A prognostic determinant of the function of the hemiparetic upper limb (UL) after a stroke. For each of the 2 subitems, the range is 0-5. A score of 5 means normal power. A score of 0 means no contraction possible.
Day 1
Modified Ashworth Scale (mAS)
Time Frame: Day 1
clinical measure of spasticity. For each of the 8 subitems, the range is 0-4. A higher score means a higher level of spasticity
Day 1
Coactivation measured by the Dextrain Manipulandum
Time Frame: change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode
binary measure of unasked fingers activated above the force threshold
change between baseline (Day 1) and after training (Day 3) and transfer between Day 3 and Day 1 on the untrained mode
Diffusion Tensor Imaging (DTI)
Time Frame: Baseline
Fractional Anisotrophy, Mean/Axial/Radial Diffusivity
Baseline
Fugl Meyer Upper Extremity (FMA-UE)
Time Frame: Day1
Tests impairments of the upper limb after stroke. Range: 0-66. A higher score means less impairment
Day1
Box and Block test
Time Frame: Day1
Measures unilateral gross dexterity by moving as many small wooden blocks as possible from one side to the other side of the box within 60 seconds. The task is performed seperately with each hand. Score range: 0-150 for each hand. The score corresponds to the number of blocks successfully transferred in one minute. A higher score indicates better gross manual dexterity and upper-limb function.
Day1
Purdue Pegboard Test
Time Frame: Day1
Measures the fingertip dexterity and gross movement of the hand, fingers and arm. 4 different subtasks
Day1
Oxford Cognitive Screen
Time Frame: Day2
A first-line, stroke-specific and domain-specific cognitive screening tool, inclusive for patients with aphasia and neglect. Domains assessed: Language, Praxis, Number, Memory, Spatial and Controlled Attention. It provides a cognitive profile showing both preserved and impaired abilities
Day2
Key WAIS IV
Time Frame: Day2
A paper-pen test to asses processing speed and working memory.
Day2
Fatigue Visual Analog Scale
Time Frame: Every days, mean of the three days
A psychometric response scale which can be used in questionnaires. It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. When responding to a VAS item, respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end-points. Range : 0- 10. A higher score means a higher level of fatigue.
Every days, mean of the three days
Intrinsic Motivation Inventory
Time Frame: Day 3
The Intrinsic Motivation Inventory (IMI) is a multidimensional measurement device intended to assess participants' subjective experience related to a target activity in laboratory experiments
Day 3

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Yves Vandermeeren, MD, PhD, UCLouvain IoNS

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)

May 18, 2026

Primary Completion (Estimated)

December 31, 2028

Study Completion (Estimated)

December 31, 2031

Study Registration Dates

First Submitted

September 8, 2026

First Submitted That Met QC Criteria

September 14, 2026

First Posted (Actual)

September 17, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 14, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • B039201938990 - part 6

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Data Management Plan REDCap

IPD Sharing Time Frame

The data will become available during the beginning of the study and for 10 years.

IPD Sharing Access Criteria

Login user of the Hospital of CHU UCL Namur - Site Godinne

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

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.