Robots passifs pour la rééducation après un AVC : une étude de faisabilité
Robots passifs pour la rééducation après un AVC
The purpose of this study is to examine the feasibility and effectiveness of a novel, multimodal approach that combines passive devices with noninvasive neuromuscular stimulation for upper extremity rehabilitation after stroke.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
About 800,000 individuals suffer from a stroke every year in the United States. The majority of stroke survivors often experience lingering deficits in upper extremity function. High-end robotic devices can improve outcomes and clinical productivity; however, these devices are expensive and bulky, making them not practical for many clinical or home environments. This study aims to evaluate the feasibility of low-cost non-motorized devices for stroke rehabilitation in a long-term intervention. The intervention will involve training with a table-top, semi-passive (i.e., no motors) exercise equipment called SepaRRo and commonly-used neuromuscular stimulation. The stimulation will be provided during functional activities using a custom controller (NeuRRoFES) to trigger stimulation. These instruments are designed to provide flexible, compliant assistance/resistance to improve upper extremity function and can be used in a home setting. The study will measure technical feasibility (e.g., qualitative survey, adherence, time on task, retention, ability to perform tasks) as well as clinical feasibility (i.e., changes in biomechanical, neurophysiological, and functional measures) of an intervention with these devices in stroke survivors. The findings aim to support the development of affordable, home-use rehabilitation systems for stroke patients.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Chandramouli Krishnan, PT, PhD
- Numéro de téléphone: 7349364031
- E-mail: mouli@umich.edu
Sauvegarde des contacts de l'étude
- Nom: Thomas E Augenstein, PhD
- Numéro de téléphone: 7342320898
- E-mail: tomaugen@umich.edu
Lieux d'étude
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Michigan
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Ann Arbor, Michigan, États-Unis, 48108
- Recrutement
- University of Michigan - NeuRRo Lab
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Chercheur principal:
- Chandramouli Krishnan, PT PhD
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Contact:
- Thomas E. Augenstein, PhD
- Numéro de téléphone: (734) 936-4031
- E-mail: tomaugen@umich.edu
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Age 18 to 75 years;
- Ischemic or hemorrhagic stroke confirmed by CT, MRI, or clinical criteria;
- No major deficits of sensation or proprioception;
Exclusion Criteria:
- Bilateral stroke
- Unable to think clearly and remember (Mini-Mental State Exam score < 22 and miniMOCA < 8);
- Uncontrolled Diabetes or Hypertension;
- Severe limitations of joint range of motion that will lead to inability of testing
- Severe spasticity and joint contractures that will lead to inability of testing
- Complete paresis with no possible movements
- Severe aphasia
- Any other medical condition that will significantly impact the study results
- Unable to obtain reliable motor evoked potentials
- Are pregnant or are actively trying to conceive
- Have a recent history of repeated fainting spells or syncope.
- Have a recent history of seizure (epilepsy) while on anti-seizure medication
- Have a recent history of skull fracture/head injury
- Have metal implants in the skull
- Have cardiac pacemakers
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Faisabilité de l'appareil
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Robotic Intervention
Participants will receive upper extremity rehabilitation using SepaRRo and NeuRRoFES 2-5 times per week for 2-6 weeks |
Participants will perform functional movements (e.g., reach for targets) with their extremities. During movements, the devices will be used to assist or resist their motion. Participants may receive biofeedback of their movements to better engage them in training. Participants may receive assistance from the devices (including neuromuscular stimulation) and/or their less-impaired limb. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Device Survey For Feasibility
Délai: Post-intervention (immediately following last session of intervention)
|
Subjective feedback regarding feasibility of the device for training |
Post-intervention (immediately following last session of intervention)
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Retention
Délai: Post-intervention (immediately following last session of intervention)
|
Measure of how many participants completed intervention |
Post-intervention (immediately following last session of intervention)
|
|
Adherence
Délai: Post-intervention (immediately following last session of intervention)
|
Measure of percentage of sessions completed |
Post-intervention (immediately following last session of intervention)
|
|
Upper extremity Fugl-Meyer Score
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively.
|
Changes in upper extremity Fugl-Meyer score from before the intervention (from baseline) to after its completion using publicly available scoring sheets. The Fugl-Meyer score is a measure of functional impairment and runs from 0 to 66 points, with higher numbers reflecting better outcome. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively.
|
|
Reachable workspace
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in reachable workspace from before the intervention (from baseline) to after its completion). The reachable workspace area will be measured with SepaRRo obtained from optical encoders mounted in the device. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Voluntary hand opening
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in voluntary ability to open the hand from before the intervention (from baseline to after its completion). Voluntary hand opening will be measured with motion capture equipment. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Action Research Arm Test Score
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in the Action Research Arm Test Score from before the intervention (from baseline) to after its completion using publicly available scoring sheets. The Action Research Arm Test is a measure of arm functional ability and runs from 0 to 57 points, with higher numbers reflecting better outcome. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Box and Block (BBT)
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in functional measure of arm disability (BBT) from before the intervention (from baseline) to after its completion using publicly available scoring sheets. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Hand Strength
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in force produced by the hand from before the intervention (from baseline) to after its completion as measured by force production recorded with a dynamometer |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Arm strength
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in force produced by the arm from before the intervention (from baseline) to after its completion as measured by force production recorded with a dynamometer |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Muscle coordination
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in muscle coordination of the upper extremity muscles as measured using surface electromyography between before the intervention (from baseline) to after its completion. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Joint coordination
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in coordination of the upper extremity joints as measured motion capture between before the intervention (from baseline) to after its completion. |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
|
Corticospinal excitability
Délai: Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Changes in corticospinal excitability of the upper extremity muscles as measured using surface electromyography and transcranial magnetic stimulation between before the intervention (from baseline) to after its completion |
Baseline and post-intervention measurements will be taken on separate days, within a week of the first and last sessions of the intervention, respectively
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Chandramouli Krishnan, PT, PhD, University of Michigan
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Manifestations neurologiques
- Troubles cérébrovasculaires
- Maladies du cerveau
- Maladies du système nerveux central
- Maladies du système nerveux
- Maladies vasculaires
- Maladies cardiovasculaires
- Conditions pathologiques, signes et symptômes
- Signes et symptômes
- Accident vasculaire cérébral
- Parésie
- Asthénie
Autres numéros d'identification d'étude
- HUM00087962
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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