Virtual Reality Training for Upper Extremity After Stroke

NCT ID: NCT02079103

Last Updated: 2016-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2016-08-31

Brief Summary

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Background: High intensity training of challenging tasks with many repetitions is a key factor for regaining motor function after stroke. Novel virtual reality (VR) rehabilitation systems provide the potential to increase intensity and offer challenging and motivating tasks. The efficacy of VR systems has not been demonstrated yet in sufficiently powered studies.

Methods: In 5 participating rehabilitation centers patients in the subacute phase after stroke will be randomized to either a group receiving 4 weeks of VR training in addition to conventional arm training or a group receiving dose-matched and therapist attention-matched conventional arm-training.

Hypothesis: VR training is more effective in improving arm motor function than conventional arm training in the subacute phase after stroke.

Detailed Description

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Background: Approximately two thirds of patients with stroke experience impaired arm motor function, which compromises independence in activities of daily living, occupational areas and quality of life. High intensity training of challenging tasks with many repetitions are key factors for regaining motor function after stroke. Novel virtual reality (VR) rehabilitation systems provide the potential to increase intensity and offer challenging and motivating tasks. The efficacy of VR systems has not been demonstrated yet in sufficiently powered studies.

Methods: In this study 120 patients in 5 participating Norwegian, Danish and Belgian rehabilitation institutions will be randomized to either a group receiving VR training in addition to conventional arm training or a group receiving dose-matched and therapist attention-matched conventional arm-training. During a period of 4 weeks the patients will be offered additional 4-5 training sessions weekly of 45-60 minutes duration by a physiotherapist or an occupational therapist. Arm motor function, dexterity and independence in daily life activities will be evaluated at baseline, post and 3 months follow-up assessments with the Action Research Arm Test, Box and Blocks Test and the Functional Independence Measure. Patient satisfaction and therapist satisfaction with the implementation of a new technology based rehabilitation system will also be assessed with questionnaires and interviews.

Objective: The objective of the VIRTUES trial is to study the effectiveness and acceptance of a novel VR training approach. The study will provide evidence-based knowledge of new virtual reality based treatment strategies to clinicians, patients and health economists.

Conditions

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Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Virtual reality

Virtual reality training using the YouGrabber® for patients with impaired arm motor function after stroke. The YouGrabber exercises focus on intensity, repetitions and motivating tasks and are adapted to the patient's motor abilities.

Group Type EXPERIMENTAL

Virtual Reality

Intervention Type DEVICE

During a 4 weeks period the patients will be offered 4-5 Virtual reality training sessions weekly of 45-60 minutes duration in addition to other rehabilitation. The Virtual reality training will be supervised by a physical or an occupational therapist. Virtual reality gaming parameters are adapted according to improving arm motor function.

Conventional arm training

The patients receive supervised self-training exercises with focus on functional tasks adapted to their motor abilities.

Group Type ACTIVE_COMPARATOR

Conventional arm training

Intervention Type BEHAVIORAL

During a 4 weeks period the patients will be offered 4-5 supervised self-training sessions weekly of 45-60 minutes duration in addition to other rehabilitation. The training will be task-related and supervised by a physical or an occupational therapist. Exercises increase in difficulty according to improving arm motor function.

Interventions

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Virtual Reality

During a 4 weeks period the patients will be offered 4-5 Virtual reality training sessions weekly of 45-60 minutes duration in addition to other rehabilitation. The Virtual reality training will be supervised by a physical or an occupational therapist. Virtual reality gaming parameters are adapted according to improving arm motor function.

Intervention Type DEVICE

Conventional arm training

During a 4 weeks period the patients will be offered 4-5 supervised self-training sessions weekly of 45-60 minutes duration in addition to other rehabilitation. The training will be task-related and supervised by a physical or an occupational therapist. Exercises increase in difficulty according to improving arm motor function.

Intervention Type BEHAVIORAL

Other Intervention Names

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YouGrabber®

Eligibility Criteria

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Inclusion Criteria

* First ever ischemic or hemorrhagic stroke or former stroke without any residual motor impairment
* 1 - 12 weeks post stroke
* Impaired arm motor function but some residual arm motor activity as defined by a score of less than 52 on Action Research Arm Test (ARAT), and the ability to execute at least 20 degrees of active shoulder extension and abduction against gravity.

Exclusion Criteria

* Severe cognitive impairment defined as \< 20 on Mini Mental Status Examination
* Orthopedic impairment, limiting mobility substantially or causing pain
* Visual disorders limiting the ability to comply with treatment regimen - \< 18 years
* Unable to give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Haukeland University Hospital

OTHER

Sponsor Role collaborator

Sunnaas Rehabilitation Hospital

OTHER

Sponsor Role collaborator

Regionshospitalet Hammel Neurocenter

OTHER

Sponsor Role collaborator

Regionshospitalet Viborg, Skive

OTHER

Sponsor Role collaborator

KU Leuven

OTHER

Sponsor Role collaborator

Jessa Hospital

OTHER

Sponsor Role collaborator

The Research Council of Norway

OTHER

Sponsor Role collaborator

Helse Vest

OTHER

Sponsor Role collaborator

Norwegian Fund for Postgraduate Training in Physiotherapy

OTHER

Sponsor Role collaborator

University of Bergen

OTHER

Sponsor Role lead

Responsible Party

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Iris Ch. Brunner

PhD, PT

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jan Sture Skouen, MD, PhD

Role: STUDY_DIRECTOR

University of Bergen, Helse Vest

Iris Brunner, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Bergen, Helse Vest

Locations

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Rehabilitation Campus Sint-Ursula

Herk-de-Stad, , Belgium

Site Status

Hammel Neurocenter

Hammel, , Denmark

Site Status

Skive Neurorehabilitation

Skive, , Denmark

Site Status

Haukeland University Hospital

Bergen, , Norway

Site Status

Sunnaas Rehabilitation Hospital

Nesoddtangen, , Norway

Site Status

Countries

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Belgium Denmark Norway

References

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Brunner I, Skouen JS, Hofstad H, Assmus J, Becker F, Sanders AM, Pallesen H, Qvist Kristensen L, Michielsen M, Thijs L, Verheyden G. Virtual Reality Training for Upper Extremity in Subacute Stroke (VIRTUES): A multicenter RCT. Neurology. 2017 Dec 12;89(24):2413-2421. doi: 10.1212/WNL.0000000000004744. Epub 2017 Nov 15.

Reference Type DERIVED
PMID: 29142090 (View on PubMed)

Brunner I, Skouen JS, Hofstad H, Assmuss J, Becker F, Pallesen H, Thijs L, Verheyden G. Is upper limb virtual reality training more intensive than conventional training for patients in the subacute phase after stroke? An analysis of treatment intensity and content. BMC Neurol. 2016 Nov 11;16(1):219. doi: 10.1186/s12883-016-0740-y.

Reference Type DERIVED
PMID: 27835977 (View on PubMed)

Brunner I, Skouen JS, Hofstad H, Strand LI, Becker F, Sanders AM, Pallesen H, Kristensen T, Michielsen M, Verheyden G. Virtual reality training for upper extremity in subacute stroke (VIRTUES): study protocol for a randomized controlled multicenter trial. BMC Neurol. 2014 Sep 28;14:186. doi: 10.1186/s12883-014-0186-z.

Reference Type DERIVED
PMID: 25261187 (View on PubMed)

Other Identifiers

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UiB-228792

Identifier Type: -

Identifier Source: org_study_id

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