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Neurocognitive Robot-assisted Rehabilitation of Hand Function After Stroke

9 juni 2017 uppdaterad av: 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.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

34

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

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

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 90 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

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

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: 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.
Andra namn:
  • 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.
Andra namn:
  • Perfetti-concept

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Motor impairment of the upper limb
Tidsram: 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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Motor impairment of the upper limb
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

1 april 2013

Primärt slutförande (Faktisk)

10 mars 2017

Avslutad studie (Faktisk)

9 juni 2017

Studieregistreringsdatum

Först inskickad

19 mars 2014

Först inskickad som uppfyllde QC-kriterierna

21 mars 2014

Första postat (Uppskatta)

26 mars 2014

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

12 juni 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

9 juni 2017

Senast verifierad

1 juni 2017

Mer information

Termer relaterade till denna studie

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