- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04494685
Effects of Robotic Rehabilitation in Post-Stroke Patients
July 28, 2020 updated by: Rodrigo Della Méa Plentz, Federal University of Health Science of Porto Alegre
Effects of Robotic Rehabilitation in Post-Stroke Patients: A Randomized Controlled Trial
This study aims to evaluate the effect of robotic rehabilitation through training on a robot-assisted orthostatic board and neuromuscular electrical stimulation (NMES) on functionality in post-stroke patients.
In this randomized controlled trial the patients will be allocated to a control group (which will receive conventional physiotherapy) or or to intervention group (which will receive conventional physiotherapy and robotic rehabilitation).
Interventions will occur every day in the hospital phase and three times/week after discharge, totaling 18 sessions.The groups will be evaluated prior to any physiotherapy intervention, in the 10h session and at the end of six weeks of treatment (or 18 sessions).The following outcomes will be measured: functionality, peripheral muscle strength, muscle architecture and echogenicity, spasticity, cardiorespiratory repercussions, mobility, disability and dependence, quality of life and time of hospital stay.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
40
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
- Name: Rodrigo DM Plentz, PhD
- Phone Number: +555191131651
- Email: roplentz@yahoo.com.br
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
18 years to 85 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Medical diagnosis of ischemic stroke, in the subacute phase (after 48 hours);
- To present hemiparesis or muscle weakness defined by the Medical Research Council (MRC) score;
- To understand simple commands and being able to report signs of discomfort.
Exclusion Criteria:
- Severe psychomotor agitation;
- Recent acute myocardial infarction (24 hours) and/or uncontrolled arrhythmias;
- Intracranial hypertension (PIC> 20mmHg);
- Uncontrolled hypertension (PAS> 230 mmHg and PAD> 120 mmHg) or PAM <60 mmHg;
- Decompensated heart failure;
- To present important hemodynamic changes during training;
- Peripheral vascular disease in the lower limb such as untreated deep vein thrombosis;
- Unconsolidated fractures or severe joint pain;
- Feverish state;
- Smokers;
- Epidermal lesions on the thighs that make it impossible to place self-adhesive electrodes for electrical stimulation;
- Pre-existing neuromuscular disease;
- Signs of rhabdomyolysis;
- Pregnancy.
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: Robotic rehabilitation
Robotic rehabilitation with Erigo® equipment (Hocoma, Volketswil, Switzerland).
|
Robotic rehabilitation with Erigo® equipment (Hocoma, Volketswil, Switzerland).
The training protocol has a progression of the board inclination up to 90º associated with flexion/extension movements of the knees and hips, with time evolution of up to 40 minutes.
Such equipment is associated with electrostimulation of the quadriceps, hamstrings, sural triceps and anterior tibialis.
Other Names:
|
Active Comparator: Conventional physiotherapy
The protocol will be based on lower limb exercises, aiming at maintaining and gaining muscle strength through passive, assisted or active mobilization, when possible, on the affected side.
|
Knee and hip flexion and extension movements, hip adduction, and abduction, respecting the articular physiology of each joint.
Weight transfer will also be performed in the sitting and standing position, mini squat, and gait training.
All exercises will have a total of 10 repetitions in three sets.
In the end, stretching of the upper and lower limbs will be performed.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Functionality
Time Frame: Baseline, after 3 weeks and after 6 weeks
|
The change in functionality will be assessed using the Fugl-Meyer Scale.
This scale consists of six domains: range of motion, pain, sensitivity, motor function of the upper and lower extremities, balance, coordination and speed.
The score for each item ranges from 0 to 2, where 0 = cannot be performed; 1 = partially accomplished; 2 = completely accomplished.
The total score ranges from 0 to 266 points and the higher the score the better the functionality.
|
Baseline, after 3 weeks and after 6 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Muscle strength
Time Frame: Baseline, after 3 weeks and after 6 weeks.
|
The change in muscle strength will be assessed by the Medical Research Council (MRC) scale and by test of maximum repetition (1RM)
|
Baseline, after 3 weeks and after 6 weeks.
|
Quadriceps muscle thickness
Time Frame: Baseline and after 6 weeks
|
The change in quadriceps muscle thickness will be evaluated for the acquisition of ultrasound images using a high resolution ultrasound device (Vivid-i, GE, USA).
In order to verify the thickness of the muscle, the distance between the superficial and deep aponeurosis is measured.The thickness is given in centimeters.
|
Baseline and after 6 weeks
|
Echogenicity of the rectus femoris muscle
Time Frame: Baseline and after 6 weeks
|
The change in echogenicity will be evaluated for the acquisition of ultrasound images of the rectus femoris muscle using a high resolution ultrasound device (Vivid-i, GE, USA).
To check the echogenicity of the rectus femoris an image of the cross-sectional area of the muscle will be taken.
The echogenicity measurement is given in an arbitrary unit.
|
Baseline and after 6 weeks
|
Spasticity
Time Frame: Baseline, after after 3 weeks and after 6 weeks
|
The change in spasticity will be assessed by the Modified Ashworth Scale.
This scale consists of an ordinal classification of 5 points for grading the resistance found during passive stretching, with 0 indicating normal muscle tone and 4 severe increase in tone.
The higher the score, the greater the spasticity.
|
Baseline, after after 3 weeks and after 6 weeks
|
Mobility
Time Frame: After 3 weeks and after 6 weeks
|
The change in mobility will be assessed using the Timed Up and Go test (TUG), which will be associated with an inertial sensor
|
After 3 weeks and after 6 weeks
|
Disability and dependence
Time Frame: Baseline and after 6 weeks
|
The change in disability and dependency will be assessed using the Modified Rankin Scale.
This instrument has 6 scores, where: 0 = asymptomatic; 1 = symptoms without disabilities; 2 = mild disability; 3 = moderate disability; 4 = moderate to severe disability; 5 = severe disability and 6 = death.
The higher the score, the greater the degree of disability and dependence.
|
Baseline and after 6 weeks
|
Quality of life indicator
Time Frame: Baseline and after 6 weeks
|
The change in quality of life will be assessed using the EuroQol-5D questionnaire.
This is a generic instrument that assesses mobility, personal care, usual activities, pain and anxiety/depression.
It allows to generate a global index of the value of an individual's health status.
The number 1 indicates the best state of health (perfect health) and 0 the worst state of health (death).
|
Baseline and after 6 weeks
|
Heart rate
Time Frame: From the 1st to the 18th day/session
|
Heart rate will be assessed by pulse oximetry
|
From the 1st to the 18th day/session
|
Peripheral arterial oxygen saturation
Time Frame: From the 1st to the 18th day/session
|
Peripheral arterial oxygen saturation will be assessed by pulse oximetry
|
From the 1st to the 18th day/session
|
Systolic blood pressure
Time Frame: From the 1st to the 18th day/session
|
Systolic blood pressure will be assessed through sphygmomanometer
|
From the 1st to the 18th day/session
|
Diastolic blood pressure
Time Frame: From the 1st to the 18th day/session
|
Diastolic blood pressure will be assessed through sphygmomanometer
|
From the 1st to the 18th day/session
|
Muscle pain
Time Frame: From the 1st to the 18th day/session
|
Pain perception will be assessed using the Visual Analog Scale.
This scale ranges from 0 to 10, where 0 indicates no pain and 10 maximum pain.
|
From the 1st to the 18th day/session
|
Lower limb fatigue
Time Frame: From the 1st to the 18th day/session
|
Lower limb fatigue will be assessed by Borg effort subjective perception scale.
This scale ranges from 0 to 10, where 0 indicates no effort or fatigue and 10 indicates maximum effort.
|
From the 1st to the 18th day/session
|
Time of hospital stay
Time Frame: From the 1st to the last day of hospitalization
|
The days between admission and hospital discharge will be counted
|
From the 1st to the last day of hospitalization
|
Collaborators and Investigators
This is where you will find people and organizations involved with this 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 (Anticipated)
August 1, 2020
Primary Completion (Anticipated)
February 1, 2021
Study Completion (Anticipated)
December 31, 2021
Study Registration Dates
First Submitted
May 29, 2020
First Submitted That Met QC Criteria
July 28, 2020
First Posted (Actual)
July 31, 2020
Study Record Updates
Last Update Posted (Actual)
July 31, 2020
Last Update Submitted That Met QC Criteria
July 28, 2020
Last Verified
July 1, 2020
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- Stroke_ERIGO
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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