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
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Giada Devittori, Dr.
- Telefonnummer: +41 44 510 72 31
- E-Mail: giada.devittori@hest.ethz.ch
Studienorte
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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
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Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-Mail: giada.devittori@hest.ethz.ch
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Valens, Schweiz, 7317
- Rehaklinik Valens
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Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-Mail: giada.devittori@hest.ethz.ch
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Zihlschlacht, Schweiz, 8588
- Rehaklinik Zihlschlacht AG
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Kontakt:
- Study coordinator
- Telefonnummer: +41 44 510 72 31
- E-Mail: giada.devittori@hest.ethz.ch
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-
Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
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).
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Sonstiges
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Experimental: 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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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Dosis der unbeaufsichtigten Therapie – Minuten
Zeitfenster: Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Tägliche Dosis in Minuten selbst verabreichter robotergestützter Therapie, die von Probanden zu Hause ohne Aufsicht durchgeführt wird.
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Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Dosis einer unbeaufsichtigten Therapie – Wiederholungen
Zeitfenster: Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Tägliche Dosis in Anzahl der Aufgabenwiederholungen einer selbst verabreichten robotergestützten Therapie, die von Probanden zu Hause ohne Aufsicht durchgeführt wird.
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Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Dosis der unbeaufsichtigten Therapie – Prozentuale Änderung der Therapiezeit
Zeitfenster: Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Prozentualer Anstieg der Therapiezeit aufgrund der unbeaufsichtigten Robotertherapie im Vergleich zu dem Fall, in dem die Teilnehmer nur eine konventionelle (d. h. normalerweise verordnete) Therapie durchführen würden.
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Dies wird während des Eingriffs (d. h. während der sechswöchigen unbeaufsichtigten Therapie zu Hause) gemessen.
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Machbarkeit – Unerwünschte Ereignisse
Zeitfenster: Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Durchführbarkeit einer Therapie mit dem ReHandyBot anhand der Anzahl der während dieser Studie aufgetretenen unerwünschten Ereignisse.
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Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Machbarkeit – Gerätemängel
Zeitfenster: Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Durchführbarkeit einer Therapie mit dem ReHandyBot anhand der Anzahl der während dieser Studie aufgetretenen Gerätemängel.
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Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Änderung des aktiven Bewegungsbereichs (aROM) für das Greifen, gemessen in Millimetern, bewertet durch die benutzerdefinierte Roboterbewertung „aROM – Hand“
Zeitfenster: Dieser wird am Ende der Studie berechnet, nachdem die letzten Messungen durchgeführt wurden (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Wechsel zwischen Grundlinie (d. h.
Beginn des Studiums) und Abschluss (d. h.
Ende der Studie) aROM zum Greifen, also zum Öffnen und Schließen der Hand.
Dies wird vom Roboter mit einer benutzerdefinierten Bewertung gemessen.
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Dieser wird am Ende der Studie berechnet, nachdem die letzten Messungen durchgeführt wurden (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Änderung der haptischen Wahrnehmung, bewertet durch die benutzerdefinierte Roboterbewertung „Weber-Fraktion“, die den minimalen Unterschied in der Steifheit misst, den ein Patient in Prozent wahrnehmen kann
Zeitfenster: Dieser wird am Ende der Studie berechnet, nachdem die letzten Messungen durchgeführt wurden (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Wechsel zwischen Grundlinie (d. h.
Beginn des Studiums) und Abschluss (d. h.
Ende der Studie) haptische Wahrnehmung, definiert als der minimale Unterschied in der Steifheit, den ein Patient gemäß dem Weber-Bruchgesetz in Prozent ausgedrückt wahrnehmen kann.
Dies wird vom Roboter mit einer benutzerdefinierten Bewertung namens „Weber-Fraktion“ gemessen.
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Dieser wird am Ende der Studie berechnet, nachdem die letzten Messungen durchgeführt wurden (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Inhalt der Robotertherapie – Leistung
Zeitfenster: Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Aufgabenleistung (d. h. korrekte Versuche im Vergleich zur Gesamtzahl der Versuche) während der Robotertherapie während der gesamten Studie.
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Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Inhalt der Robotertherapie – Effektives Zeitverhältnis
Zeitfenster: Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Verhältnis der effektiven (d. h. Netto-Gesamttherapiezeit ohne Pausen) zur Gesamtdauer der Therapiesitzung während der Robotertherapie während der gesamten Studie.
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Dies wird über die gesamte Protokolldauer überwacht (d. h. vom Beginn der ersten Woche bis zum Ende der sechs Wochen unbeaufsichtigter Therapie zu Hause).
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Parameter, die die unbeaufsichtigte robotergestützte Therapie beeinflussen
Zeitfenster: Dieser wird am Ende der Studie berechnet (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Korrelation zwischen der erreichten unbeaufsichtigten robotergestützten Therapiedosis und verschiedenen Parametern (d. h. kognitiven Beurteilungen (Goodglass-Kaplan-Skala, LCF-R, Montreal Cognitive Assessment (MoCA)), die während des Screening-Besuchs durchgeführt wurden, den klinischen Beurteilungen, den robotergestützten Beurteilungen, demografischen Merkmalen usw die erhobenen medizinischen Daten).
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Dieser wird am Ende der Studie berechnet (d. h. am Ende der sechswöchigen unbeaufsichtigten Therapie zu Hause).
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Feasibility - Subjects performing unsupervised robot-assisted training
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Bertrand Léger, Dr., Responsible for research at the SUVA clinics (Bellikon and Sion)
- Hauptermittler: Roman Gonzenbach, Dr. med. Dr. sc. nat., Rehaklinik Valens
- Hauptermittler: René Müri, Prof. Dr. med., Rehaklinik Zihlschlacht AG
- Hauptermittler: Mauro Silva, Dr. med., University Hospital, Geneva
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- RHB Home SNR
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