- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02882997
An Interactive Computer Game, Called Duck Duck Punch, for Stroke Rehabilitation at Home and in a Rehabilitation Clinic (DDPHme/Hsp)
August 24, 2016 updated by: Michelle Woodbury, Medical University of South Carolina
A Virtual Environment for Post-Stroke Upper Extremity Rehabilitation
This study will determine the feasibility of using an interactive computer game to elicit repetitive practice of paretic arm movements in the homes of community dwelling stroke survivors and during non-therapy hours at an inpatient stroke rehabilitation hospital.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
More than 75% of the 800,000 people who annually suffer stroke exhibit persistent arm/hand hemiparesis restricting independence thus burdening caregivers.
Arm motor skill can recover if the rehabilitation program provides an adequate "dose" of repetitive movement practice.
However, the vast majority of stroke survivors lack the proper practice-dose because the duration of inpatient stroke rehabilitation is limited by cost, or residence in medically underserved rural settings.
To meet the pressing need for innovative cost-effective rehabilitation options, the investigators developed, tested and licensed a prototype virtual environment (VE) for post-stroke arm rehabilitation.
Its custom built design motivates extended practice of specific arm motor skills known to improve quality of life.
Excitingly, practice sessions do not require direct therapist supervision.
Published pilot data demonstrated improved real-world arm movement after VE training.
These promising initial results led to software upgrades that will now enable installation and testing in the primary markets for this technology; stroke rehabilitation hospitals, and patients' homes.
The overall goal for this small pilot study is to test the feasibility of self-directed VE practice in these settings measured by movement repetitions and motor skill improvement.
To that end, this project will address the following Specific Aims (1) Determine the number of daily movement repetitions and treatment effect achieved by inpatients in a stroke rehabilitation hospital who self-direct VE practice sessions during non-therapy hours (evenings, weekends) compared to standard evening activities; and (2) Determine the number of daily movement repetitions and treatment effect achieved by in-home stroke survivors who self-direct daily VE practice sessions compared to a group of in-home survivors with a standard self-directed exercise program.
Study Type
Interventional
Enrollment (Actual)
40
Phase
- Phase 2
- Phase 1
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
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South Carolina
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Charleston, South Carolina, United States, 29425
- The Medical University of South Carolina
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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
21 years to 90 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- experienced uni-hemispheric ischemic or hemorrhagic stroke
- exhibit voluntarily shoulder flexion (affected UE) ≥20° with simultaneous elbow extension ≥10°. We reason that persons at this motor ability level have enough residual arm activation to engage in VE training
- passive range of motion in affected shoulder and elbow and within 20 degrees of normal values
Additional inclusion criteria for community dwelling stroke survivors
- live at home
- no current rehabilitation therapy
- live within a 60 minute drive of the university
Additional inclusion criteria for inpatient stroke patients
- medically stable
- expected to remain in the hospital for the next 7 days
- able to sit in a chair for 60 minutes without difficulty
Exclusion Criteria:
- lesion in brainstem or cerebellum
- presence of other neurological disease that may impair motor skills (e.g., Parkinson's Disease)
- pain in the paretic arm that would interfere with movement
- unable to understand and follow 3-step directions
- orthopedic condition or impaired corrected vision that would interfere with reaching.
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: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Duck Duck Punch
Community dwelling stroke survivors: Stroke survivors will install an interactive computer game in their home.
Subjects will be instructed to play the computer game "as much as you want to every day for 7 days."
Inpatient stroke patients: The interactive computer game will be installed at a local inpatient stroke rehabilitation hospital.
Subjects will be instructed to "play this game as much as you want to during non-therapy hours (evenings and weekends) over the next 7 days."
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Duck Duck Punch is an interactive computer game designed to elicit repetitive practice of paretic arm movements in stroke patients.
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Active Comparator: Standard activities
Community dwelling stroke survivors: Subjects will receive a hard-copy handout of an arm home exercise program and given the instructions to "do these exercises as many times as you can daily."
Inpatient stroke patients: Subjects will be encouraged to participate in standard evening/weekend recreational activities and to "remember to use the paretic arm as much as you can."
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For community dwelling stroke survivors this is a hard copy, written/illustrated home exercise program for the paretic arm.
For inpatient stroke patients this is standard recreational activities organized by the facility during non therapy hours (evenings and weekends).
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Paretic arm use
Time Frame: 1 year
|
The amount of paretic arm use will be measured by wrist worn accelerometers.
Subjects will be shown how to don/doff wristwatch sized triaxial Actigraph accelerometers (GT3X+ Activity Monitor; ActiGraph LLC) by securing a Velcro band on the dorsal aspect of each wrist proximal to the wrist joint.
Subjects will be instructed to don the accelerometers each time they engaged in either the computer game or standard activity and wear them only for the duration of the activity.
The accelerometers will be stored in a box during other times.
Accelerometry data will be recorded in 1 minute epochs as the number of arm activity counts.
At the final study evaluation session, data will be used to create a ratio of paretic to non-paretic arm activity counts.
A value of 1 will indicate bilateral arm use, a value higher than 1 will indicate that the paretic arm was used more than the non-paretic arm, and a value less than 1 will indicate that the paretic arm was used less than the non-paretic arm.
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1 year
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fugl Meyer Upper Extremity Assessment
Time Frame: up to 7 days
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a 33-item measure of arm impairment testing the subject's ability to achieve various postures with the paretic arm and hand, scored on a 3 point ordinal rating scale with higher scores indicating less motor impairment.
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up to 7 days
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Wolf Motor Function Test
Time Frame: up to 7 days
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A 15-item evaluation of paretic arm motor function, testing the amount of time required for a subject to use the paretic arm to accomplish various functional tasks.
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up to 7 days
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Stroke Impact Scale - Hand subtest
Time Frame: up to 7 days
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A 5-item evaluation of patient self-reported level of difficulty using the paretic hand to perform various functional activities at home.
Items are rated on a 4 point ordinal scale so that higher numbers indicate less difficulty.
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up to 7 days
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Michelle L Woodbury, PhD, OTR/L, Medical University of South Carolina
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.
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
November 1, 2013
Primary Completion (Actual)
August 1, 2016
Study Completion (Actual)
August 1, 2016
Study Registration Dates
First Submitted
August 5, 2016
First Submitted That Met QC Criteria
August 24, 2016
First Posted (Estimate)
August 30, 2016
Study Record Updates
Last Update Posted (Estimate)
August 30, 2016
Last Update Submitted That Met QC Criteria
August 24, 2016
Last Verified
August 1, 2016
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00029185
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
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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