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Neurocognitive Robot-assisted Rehabilitation of Hand Function After Stroke

9. juni 2017 opdateret af: Roger Gassert
The aim of this project is to clinically evaluate a novel robot-assisted therapeutic approach to train sensorimotor hand function after stroke. It combines the profound experience of the clinic Hildebrand in neurocognitive therapy - involving brain and mind in the task and training both the motor and the sensory system - with the advanced haptic robotic technology of the Rehabilitation Engineering Lab at the Swiss Federal Institute of Technology Zurich (ETH Zurich), allowing unmet interaction with the hand through the simulation of virtual objects with various mechanical properties. In a randomized controlled clinical trial, 10 sub-acute stroke patients will receive four weeks of robotic therapy sessions, integrated seamlessly into their daily rehabilitation program, while 10 other patients will receive conventional therapy. The investigators will assess baseline performance in an initial clinical and robotic assessment, with another assessment at the end of the four-week period, and in follow-ups four weeks and six months later. The contents of the patient-tailored robotic therapy sessions will match those of the conventional therapy as closely as possible. This study will demonstrate the feasibility of including robotic therapy of hand function into the daily rehabilitation program, and investigate the acceptance from patients and therapists. The investigators expect increased training intensity during the robotic therapy session compared to conventional sessions with similar contents, as well as novel insights into the recovery process of both the motor and the sensory system during the four weeks of therapy, through advanced robotic assessments integrated into the training sessions. This project is a first step towards making such robotic therapy available to patients as integration into the conventional individual therapy program (e.g. for self-training), and towards transferring this technology to the home environment.

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

34

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Ticino
      • Brissago, Ticino, Schweiz, 6614
        • Clinica Hildebrand Centro di riabilitazione Brissago

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 90 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • age between 18-90 years old
  • hemisyndrome (central paralysis of the upper extremity, and all degrees of weakness: M0 - M5 on the paresis scale) as a result of a first stroke
  • sub-acute lesion not more than 6 weeks post ictus

Exclusion Criteria:

  • insufficient state of consciousness
  • severe aphasia
  • severe cognitive deficits
  • severe pathologies of the upper extremity of traumatic or rheumatic nature
  • severe pain in the affected arm
  • Patients with pacemakers and other active implants

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Robot group

Receive robot-assisted neurocognitive therapy instead of conventional neurocognitive therapy.

(4 x 45 min/week)

2 degrees-of-freedom hand rehabilitation robot to train fine motor skills during grasping and forearm rotation.
Andre navne:
  • Rehabilitation robot ReHapticKnob
Aktiv komparator: Control group
Receive dose-matched conventional neurocognitive therapy
Use sensory perception (tactile, proprioception but not vision!) to solve a by the therapist guided (passive) or patient controlled (active) therapy task, e.g. discrimination/identification of different spring resistances, sponges, different sized blocks, etc.
Andre navne:
  • Perfetti-concept

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Motor impairment of the upper limb
Tidsramme: Change from Baseline in motor impairment of the upper limb at 4 weeks
Motor impairment of the upper limb is measured by the means of the Fugl-Meyer Assessment Scale of the upper limb (total of 66 points)
Change from Baseline in motor impairment of the upper limb at 4 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Motor impairment of the upper limb
Tidsramme: Change from Baseline in motor impairment of the upper limb at 8 weeks
Motor impairment of the upper limb is measured by the means of the Fugl-Meyer Assessment Scale of the upper limb (total of 66 points)
Change from Baseline in motor impairment of the upper limb at 8 weeks
Motor impairment of the upper limb
Tidsramme: Change from Baseline in motor impairment of the upper limb at 6 months
Motor impairment of the upper limb is measured by the means of the Fugl-Meyer Assessment Scale of the upper limb (total of 66 points)
Change from Baseline in motor impairment of the upper limb at 6 months
Functional improvement in dexterity
Tidsramme: Change from Baseline in functional improvement of dexterity of the upper limb at 4 weeks
Functional improvement in dexterity is assessed with the Box and Block Test
Change from Baseline in functional improvement of dexterity of the upper limb at 4 weeks
Functional improvement in dexterity
Tidsramme: Change from Baseline in functional improvement of dexterity of the upper limb at 8 weeks
Functional improvement in dexterity is assessed with the Box and Block Test
Change from Baseline in functional improvement of dexterity of the upper limb at 8 weeks
Functional improvement in dexterity
Tidsramme: Change from Baseline in functional improvement of dexterity of the upper limb at 6 months
Functional improvement in dexterity is assessed with the Box and Block Test
Change from Baseline in functional improvement of dexterity of the upper limb at 6 months
Spasticity level of the upper limb
Tidsramme: Change from Baseline in spasticity level of the upper limb at 4 weeks
Spasticity level is measured with the Modified Ashworth Scale
Change from Baseline in spasticity level of the upper limb at 4 weeks
Spasticity level of the upper limb
Tidsramme: Change from Baseline in spasticity level of the upper limb at 8 weeks
Spasticity level is measured with the Modified Ashworth Scale
Change from Baseline in spasticity level of the upper limb at 8 weeks
Spasticity level of the upper limb
Tidsramme: Change from Baseline in spasticity level of the upper limb at 6 months
Spasticity level is measured with the Modified Ashworth Scale
Change from Baseline in spasticity level of the upper limb at 6 months
Tactile and proprioceptive sensory function of the upper limb
Tidsramme: Change from Baseline in Tactile and proprioceptive sensory function of the upper limb at 4 weeks
Tactile and proprioceptive sensory function of the upper limb is assessed with the Erasmus MC (Medical Center) Nottingham Sensory Assessment
Change from Baseline in Tactile and proprioceptive sensory function of the upper limb at 4 weeks
Tactile and proprioceptive sensory function of the upper limb
Tidsramme: Change from Baseline in tactile and proprioceptive sensory function of the upper limb at 8 weeks
Tactile and proprioceptive sensory function of the upper limb is assessed with the Erasmus MC Nottingham Sensory Assessment
Change from Baseline in tactile and proprioceptive sensory function of the upper limb at 8 weeks
Tactile and proprioceptive sensory function of the upper limb
Tidsramme: Change from Baseline in tactile and proprioceptive sensory function of the upper limb at 6 months
Tactile and proprioceptive sensory function of the upper limb is assessed with the Erasmus MC Nottingham Sensory Assessment
Change from Baseline in tactile and proprioceptive sensory function of the upper limb at 6 months
Neglect
Tidsramme: Change from Baseline in neglect at 4 weeks
Neglect is assessed with the Albert's test of neglect
Change from Baseline in neglect at 4 weeks
Neglect
Tidsramme: Change from Baseline in neglect at 8 weeks
Neglect is assessed with the Albert's test of neglect
Change from Baseline in neglect at 8 weeks
Neglect
Tidsramme: Change from Baseline in neglect at 6 months
Neglect is assessed with the Albert's test of neglect
Change from Baseline in neglect at 6 months
Cognitive impairment
Tidsramme: Change from Baseline in cognitive impairment at 4 weeks
Cognitive impairment is assessed with the Mini Mental State Examination
Change from Baseline in cognitive impairment at 4 weeks
Cognitive impairment
Tidsramme: Change from Baseline in cognitive impairment at 8 weeks
Cognitive impairment is assessed with the Mini Mental State Examination
Change from Baseline in cognitive impairment at 8 weeks
Cognitive impairment
Tidsramme: Change from Baseline in cognitive impairment at 6 months
Cognitive impairment is assessed with the Mini Mental State Examination
Change from Baseline in cognitive impairment at 6 months
Frontal lobe function
Tidsramme: Change from Baseline in frontal lobe function at 4 weeks
Frontal lobe function is assessed with the Frontal assessment battery
Change from Baseline in frontal lobe function at 4 weeks
Frontal lobe function
Tidsramme: Change from Baseline in frontal lobe function at 8 weeks
Frontal lobe function is assessed with the Frontal assessment battery
Change from Baseline in frontal lobe function at 8 weeks
Frontal lobe function
Tidsramme: Change from Baseline in frontal lobe function at 6 months
Frontal lobe function is assessed with the Frontal assessment battery
Change from Baseline in frontal lobe function at 6 months
Aphasia
Tidsramme: Change from Baseline in aphasia at 4 weeks
Aphasia is assessed with the Aachener Aphasia Test
Change from Baseline in aphasia at 4 weeks
Aphasia
Tidsramme: Change from Baseline in aphasia at 8 weeks
Aphasia is assessed with the Aachener Aphasia Test
Change from Baseline in aphasia at 8 weeks
Aphasia
Tidsramme: Change from Baseline in aphasia at 6 months
Aphasia is assessed with the Aachener Aphasia Test
Change from Baseline in aphasia at 6 months
Attention
Tidsramme: Change from Baseline in attention at 4 weeks
Attention is assessed with the test to identify attention
Change from Baseline in attention at 4 weeks
Attention
Tidsramme: Change from Baseline in attention at 8 weeks
Attention is assessed with the test to identify attention
Change from Baseline in attention at 8 weeks
Attention
Tidsramme: Change from Baseline in attention at 6 months
Attention is assessed with the test to identify attention
Change from Baseline in attention at 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studieleder: Roger Gassert, Prof. Dr., Rehabilitation Engineering Lab, ETH Zurich

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. april 2013

Primær færdiggørelse (Faktiske)

10. marts 2017

Studieafslutning (Faktiske)

9. juni 2017

Datoer for studieregistrering

Først indsendt

19. marts 2014

Først indsendt, der opfyldte QC-kriterier

21. marts 2014

Først opslået (Skøn)

26. marts 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. juni 2017

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

9. juni 2017

Sidst verificeret

1. juni 2017

Mere information

Begreber relateret til denne undersøgelse

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Kliniske forsøg med robot-assisted neurocognitive therapy of hand function

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