Generalizability of Unsupervised Therapy After Stroke in the Home Setting With a Hand Rehabilitation Device (ReHandyBot) (RHB Home SNR)
Generalizability of Unsupervised Therapy After Stroke in the Home Setting With a Hand Rehabilitation Device (ReHandyBot): a Multicentric, Exploratory Study
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Giada Devittori, Dr.
- Telefonnummer: +41 44 510 72 31
- E-mail: giada.devittori@hest.ethz.ch
Studiesteder
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-
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Bellikon, Schweiz, 5454
- Rehaklinik Bellikon
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Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-mail: giada.devittori@hest.ethz.ch
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Geneva, Schweiz, 1211
- University Hospital, Geneva
-
Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-mail: giada.devittori@hest.ethz.ch
-
Valens, Schweiz, 7317
- Rehaklinik Valens
-
Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-mail: giada.devittori@hest.ethz.ch
-
Zihlschlacht, Schweiz, 8588
- Rehaklinik Zihlschlacht AG
-
Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-mail: giada.devittori@hest.ethz.ch
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Informed Consent signed by the subject;
- female and male patients between 18 and 90 years old;
- acute/subacute stroke (recruitment within 12 weeks from stroke onset);
- pre-stroke modified Rankin score ≤ 1;
- National Institutes of Health Stroke Scale (NIHSS) ≥ 1 in at least one of the items regarding motor functions, sensory functions and ataxia;
- possibility (e.g., enough space) to set up the ReHandyBot at home.
Exclusion Criteria:
- modified Ashworth Scale > 2 for one or more of the following muscles: shoulder adductors, forearm pronator and supinator, flexors and extensors of elbow, wrist and fingers;
- moderate to severe aphasia: Goodglass-Kaplan's scale < 3;
- moderate to severe cognitive deficits: levels of cognitive functioning-revised (LCF-R) < 9;
- functional impairment of the upper limb due to other pathologies;
- severe pain in the affected arm: visual analogue scale for pain (VASp) ≥ 5;
- other pathologies which may interfere with the study;
- after discharge the patient will go to an assisted living facility (e.g., care home).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Unsupervised therapy
This group will perform therapy with the ReHandyBot first with the supervision of a therapist at the rehabilitation clinic.
Then, after discharge, if the participant has learned how to safely train with the device, they can bring the device home and train with it unsupervised.
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During the familiarization phase at the rehabilitation clinics, participants perform one week of supervised and one week of minimally supervised therapy with the ReHandyBot under the supervision of a supervisor (i.e., therapist or researcher).
Minimally supervised therapy means that participants try to perform therapy with the device themselves, while the supervisor is still present but helps only if participants encounter problems or have questions.
During the supervised and minimally supervised phases (first 2 weeks), the intervention consists of 5 sessions of approximately 30 minutes each per week.
These sessions are performed in addition to the conventional therapy plan.
During each session, the robot proposes a set of different exercises targeting the upper limb.
After the familiarization phase, participants train without supervision at the clinic until discharge and then at home for six weeks.
If the therapist thinks that the participant has properly learned how to use the device and can train with it safely, the participant can keep training with the device unsupervised (both at the clinic and at home).
If participants are not ready for unsupervised therapy with the device, they stop the study at the end of the familiarization phase.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Dosis af uovervåget terapi - minutter
Tidsramme: Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Daglig dosis i minutter af selvadministreret robot-assisteret terapi udført af forsøgspersoner i hjemmet uden opsyn.
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Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Dosis af uovervåget terapi - Gentagelser
Tidsramme: Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Daglig dosis i antal opgavegentagelser af selvadministreret robot-assisteret terapi udført af forsøgspersoner i hjemmet uden supervision.
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Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Dosis af uovervåget terapi - Procentvis ændring i behandlingstid
Tidsramme: Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Procentvis stigning i terapitid på grund af den uovervågede robotterapi sammenlignet med det tilfælde, hvor deltagerne kun ville udføre konventionel (dvs. normalt ordineret) terapi.
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Dette måles under interventionen (dvs. under de seks ugers uovervåget behandling i hjemmet).
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Feasibility - Uønskede hændelser
Tidsramme: Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Gennemførligheden af terapi med ReHandyBot vurderet ud fra antallet af uønskede hændelser, der opstår under denne undersøgelse.
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Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Gennemførlighed - Enhedsmangler
Tidsramme: Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Gennemførligheden af terapi med ReHandyBot vurderet ud fra antallet af enhedsmangler, der opstår under denne undersøgelse.
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Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Ændring i det aktive bevægelsesområde (aROM) til greb målt i millimeter som vurderet af den tilpassede robotvurdering "aROM - Hånd"
Tidsramme: Dette beregnes ved afslutningen af undersøgelsen efter udførelse af de endelige målinger (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Skift mellem baseline (dvs.
begyndelsen af studiet) og afsluttende (dvs.
slutningen af undersøgelsen) aROM til at gribe, dvs. til håndåbning og lukning.
Dette måles af robotten med en tilpasset vurdering.
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Dette beregnes ved afslutningen af undersøgelsen efter udførelse af de endelige målinger (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Ændring i haptisk perception vurderet af den tilpassede robotvurdering "Weber Fraction", der måler den mindste forskel i stivhed, som en patient kan opfatte i procent
Tidsramme: Dette beregnes ved afslutningen af undersøgelsen efter udførelse af de endelige målinger (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Skift mellem baseline (dvs.
begyndelsen af studiet) og afsluttende (dvs.
slutningen af undersøgelsen) haptisk perception, defineret som den mindste forskel i stivhed, som en patient kan opfatte udtrykt i procent i henhold til Weber-fraktionsloven.
Dette måles af robotten med en brugerdefineret vurdering kaldet "Weber fraktion".
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Dette beregnes ved afslutningen af undersøgelsen efter udførelse af de endelige målinger (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Indhold af robotterapi - Performance
Tidsramme: Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Opgaveudførelse (dvs. korrekte forsøg i forhold til samlede forsøg) under robotterapi gennem hele undersøgelsen.
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Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Indhold af robotterapi - Effektivt tidsforhold
Tidsramme: Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Forholdet mellem effektiv (dvs. netto total terapitid uden pauser) over den samlede varighed af terapisessionen under robotterapi gennem hele undersøgelsen.
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Dette overvåges over hele protokollens varighed (dvs. fra begyndelsen af den første uge til slutningen af de seks ugers uovervåget behandling i hjemmet).
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Parametre, der påvirker uovervåget robot-assisteret terapi
Tidsramme: Dette beregnes ved afslutningen af undersøgelsen (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Korrelation mellem opnået uovervåget robotassisteret terapidosis og forskellige parametre (dvs. kognitive vurderinger (Goodglass-Kaplan Scale, LCF-R, Montreal Cognitive Assessment (MoCA)) udført under screeningsbesøget, de kliniske vurderinger, robotvurderingerne, demografi og de indsamlede medicinske data).
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Dette beregnes ved afslutningen af undersøgelsen (dvs. ved afslutningen af de seks ugers uovervåget behandling i hjemmet).
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Feasibility - Subjects performing unsupervised robot-assisted training
Tidsramme: This is calculated on completion of the study (i.e., in 2 years, right after last subject - last visit).
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Feasibility of unsupervised therapy with the ReHandyBot as assessed by the number of subjects who can transition to unsupervised robot-assisted therapy at home out of the total number of tested subjects.
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This is calculated on completion of the study (i.e., in 2 years, right after last subject - last visit).
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Feasibility - Attendance
Tidsramme: This is calculated on completion of the study protocol, i.e., at the end of the six weeks of unsupervised therapy at home.
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Feasibility of unsupervised therapy with the ReHandyBot as assessed by attendance during the unsupervised phase at home.
Attendance is measured as the percentage of days where the subject trains at least once without supervision out of the 42 days offered for unsupervised training at home.
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This is calculated on completion of the study protocol, i.e., at the end of the six weeks of unsupervised therapy at home.
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Generalizability of unsupervised therapy with the ReHandyBot
Tidsramme: This is calculated on completion of the study (i.e., in 2 years, right after last subject - last visit).
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Generalizability is assessed by comparing the feasibility of the intervention across the four sites.
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This is calculated on completion of the study (i.e., in 2 years, right after last subject - last visit).
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Usability as assessed by the System Usability Scale (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability of the ReHandyBot measured with the System Usability Scale.
The possible response options vary between 1 (strongly disagree) and 5 (strongly agree).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability as assessed by the System Usability Scale (2)
Tidsramme: Usability is measured again after 8 weeks of intervention.
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Usability of the ReHandyBot measured with the System Usability Scale.
The possible response options vary between 1 (strongly disagree) and 5 (strongly agree).
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Usability is measured again after 8 weeks of intervention.
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Usability as assessed by the raw NASA Task Load Index (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability of the ReHandyBot measured with the raw NASA (National Aeronautics and Space Administration) Task Load Index.
Answers range from 0 (low task load) to 100 (high task load).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability as assessed by the raw NASA Task Load Index (2)
Tidsramme: Usability is measured again after 8 weeks of intervention.
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Usability of the ReHandyBot measured with the raw NASA (National Aeronautics and Space Administration) Task Load Index.
Answers range from 0 (low task load) to 100 (high task load).
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Usability is measured again after 8 weeks of intervention.
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Usability as assessed by the Post-Study System Usability Questionnaire (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability of the ReHandyBot measured with the Post-Study System Usability Questionnaire (version 3).
This questionnaire consists of 16 questions and the possible response options vary between 1 (strongly agree) and 7 (strongly disagree).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability as assessed by the Post-Study System Usability Questionnaire (2)
Tidsramme: Usability is measured again after 8 weeks of intervention.
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Usability of the ReHandyBot measured with the Post-Study System Usability Questionnaire (version 3).
This questionnaire consists of 16 questions and the possible response options vary between 1 (strongly agree) and 7 (strongly disagree).
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Usability is measured again after 8 weeks of intervention.
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Evolution of patient's satisfaction with robot-assisted therapy as assessed by a 5-point scale
Tidsramme: This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).
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A 5-point scale is presented by the robot at the end of each therapy session to measure patient's satisfaction with robot-assisted therapy.
The scale ranges from 1 (low satisfaction) to 5 (high satisfaction).
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This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).
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Usability - Intrinsic Motivation Inventory (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability of the gaming environment is measured with the Intrinsic Motivation Inventory (items: Interest/Enjoyment).
The possible response options vary between 1 (not true at all) and 7 (completely true).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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Usability - Intrinsic Motivation Inventory (2)
Tidsramme: User experience is measured again after 8 weeks of intervention.
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Usability of the gaming environment is measured with the Intrinsic Motivation Inventory (items: Interest/Enjoyment).
The possible response options vary between 1 (not true at all) and 7 (completely true).
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User experience is measured again after 8 weeks of intervention.
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Change in usability
Tidsramme: This is calculated at the end of the study (i.e., after 8 weeks of intervention).
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Change in usability between the first and second time when it is measured.
This change is used to define how the absence of the therapist during robot-assisted therapy impacts the perceived usability of the device.
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This is calculated at the end of the study (i.e., after 8 weeks of intervention).
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User experience - Customer Satisfaction Score (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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The Customer Satisfaction Score consists of the question "Overall, how satisfied are you with the therapy with ReHandyBot?".
The possible response options vary between 1 (extremely dissatisfied) and 5 (extremely satisfied).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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User experience - Customer Satisfaction Score (2)
Tidsramme: User experience is measured again after 8 weeks of intervention.
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The Customer Satisfaction Score consists of the question "Overall, how satisfied are you with the therapy with ReHandyBot?".
The possible response options vary between 1 (extremely dissatisfied) and 5 (extremely satisfied).
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User experience is measured again after 8 weeks of intervention.
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User experience - Net Promoter Score (1)
Tidsramme: This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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The Net Promoter Score consists of the question "How likely would you be to recommend therapy with ReHandyBot to another patient?".
The possible response options vary between 1 (extremely unlikely) and 10 (extremely likely).
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This is measured at the end of the second week of intervention (at the end of the familiarization phase).
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User experience - Net Promoter Score (2)
Tidsramme: User experience is measured again after 8 weeks of intervention.
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The Net Promoter Score consists of the question "How likely would you be to recommend therapy with ReHandyBot to another patient?".
The possible response options vary between 1 (extremely unlikely) and 10 (extremely likely).
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User experience is measured again after 8 weeks of intervention.
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Change in the user experience
Tidsramme: This is calculated at the end of the study (i.e., after 8 weeks of intervention).
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Change in user experience between the first and second time when it is measured.
This change is used to define how the absence of the therapist during robot assisted therapy impacts user experience when training with the device.
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This is calculated at the end of the study (i.e., after 8 weeks of intervention).
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Change in upper limb functions as assessed by the Fugl-Meyer Assessment of Upper Extremities (FMA-UE)
Tidsramme: This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change between midterm (i.e., at discharge from the clinic) and final (i.e., end of the study) upper limb functions as assessed by the FMA-UE.
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This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change in upper limb functions as assessed by the ABILHAND
Tidsramme: This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change between midterm (i.e., at discharge from the clinic) and final (i.e.
end of the study) upper limb functions as assessed by the ABILHAND scale.
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This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change in upper limb functions as assessed by the Box and Block (BBT) test
Tidsramme: This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change between midterm (i.e., at discharge from the clinic) and final (i.e.
end of the study) upper limb functions as assessed by the BBT test.
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This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change in upper limb functions as assessed by the modified Ashworth Scale (mAS)
Tidsramme: This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change between midterm (i.e., at discharge from the clinic) and final (i.e., end of the study) upper limb functions as assessed by the mAS.
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This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).
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Change in proprioception as assessed by the custom robotic assessment "JND" measuring the minimum difference in hand positioning that a patient can perceive
Tidsramme: This is calculated at the end of the study, after performing the final measurements (i.e., after 8 weeks of intervention).
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Change between baseline (i.e.
beginning of the study) and final (i.e.
end of the study) proprioception, defined as the minimum difference in the hand position that a patient can perceive (i.e.
just noticeable difference).
This is measured by the robot with a custom assessment.
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This is calculated at the end of the study, after performing the final measurements (i.e., after 8 weeks of intervention).
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Content of robotic therapy - Intensity (repetitions of a therapy task over time)
Tidsramme: This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).
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Intensity (i.e., repetitions of a therapy task over time) of the robotic therapy throughout the study.
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This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Bertrand Léger, Dr., Responsible for research at the SUVA clinics (Bellikon and Sion)
- Ledende efterforsker: Roman Gonzenbach, Dr. med. Dr. sc. nat., Rehaklinik Valens
- Ledende efterforsker: René Müri, Prof. Dr. med., Rehaklinik Zihlschlacht AG
- Ledende efterforsker: Mauro Silva, Dr. med., University Hospital, Geneva
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
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