Integrated Cognitive, Sensory, and Motor Rehabilitation of Hand Functions

NCT ID: NCT03349138

Last Updated: 2017-11-24

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

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-01

Study Completion Date

2017-08-31

Brief Summary

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This study evaulates the addition to the standard theraphy of enriched sensorimotor training by means of robotic glove therapy, or functional electrical stimulation in the treatment of chronic stroke patients with upper limb motor impairments. All the patients receive the conventional physiotherapic treatment. Supplemental to the conventional treatment, patients are evenly split in four groups to provide different treatments for an equivalent amount of time. Patient in the first group receive supplemental conventional therapy; patients in the second group receive robotic glove therapy; patients in the third group receive functional electrical stimulation; patients in the fourth group receive robotic glove treatment and functional electrical stimulation in different sessions.

Detailed Description

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Stroke very frequently impacts on patients' motor function, and particularly on upper limb movements. Limited hand functionality is a major negative outcome after stroke, negatively affecting patients' recovery and independence, with major impact on rehabilitation.However, standard motor rehabilitation outcome is often suboptimal, because insufficient or non-specific treatment is provided. Robotic hand mobilization and functiona electrical stimulation grasp rehabilitation each improve motor capabilities in grasp impaired patients, but they do so by different mechanisms.

Robotic hand mobilization achieves grasp rehabilitation by providing passive mobilization of the affected limb if the subject does not react to the designed task.

Functional electrical stimulation achieves grasp rehabilitation by inducing localized muscle contraction, that is by providing an electrical field able to stimulate both sensory afferent pathways and lower motor neurons in the targeted volume.

Conditions

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Stroke

Keywords

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rehabilitation functional electrical stimulation electrode array upper limb chronic motor relearning

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Conventional treatment allocated to patients in all arms. Supplemental dose matched treatment to each of the four arms (9 weeks, 3 treatments a week) as follows:

* conventional treatment (27 treatments)
* functional electrical stimulation (27 treatments)
* robotic glove ( 27 treatments )
* robotic glove and electrical stimulation ( each session uses one device, half of the sessions uses the robotic glove, half the functional electrical stimulation )
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Conventional Therapy

27 sessions, 3 sessions per week for a total of 9 weeks. Each session lasts about 90 minutes and consists of different standard motor training modalities typically used in the rehabilitation of the arm after stroke. The training session is customized on the patients' need and can be adapted to their improvement during the intervention.

Group Type ACTIVE_COMPARATOR

Conventional Therapy

Intervention Type DEVICE

Robotic Glove

Robotic Glove \& Conventional Therapy 27 sessions, 3 sessions per week for a total of 9 weeks. Each session consists of 30-minute training with the robotic glove system plus 60 minutes of conventional therapy. The training session is customized on the patients' need and can be adapted to their improvement during the intervention.

Group Type EXPERIMENTAL

Robotic Glove

Intervention Type DEVICE

Electrical Stimulation

Electrical Stimulation \& Conventional Therapy 27 sessions, 3 sessions per week for a total of 9 weeks. Each session consists of 30-minute training with the electrical stimulation system plus 60 minutes of conventional therapy. The training session is customized on the patients' need and can be adapted to their improvement during the intervention.

Group Type EXPERIMENTAL

Electrical Stimulation

Intervention Type DEVICE

Electrical Stimulation and Robotic Glove

Electrical Stimulation \& Robotic Glove \& Conventional Therapy 27 sessions, 3 sessions per week for a total of 9 weeks. Each session consists of 30-minute training with the electrical stimulation system plus 60 minutes of conventional therapy or 30-minute training with the robotic glove system plus 60 minutes of conventional therapy. Half of the sessions are allocated to the electrical stimulation system, and half are allocated to the robotic glove system. The training session is customized on the patients' need and can be adapted to their improvement during the intervention.

Group Type EXPERIMENTAL

Robotic Glove

Intervention Type DEVICE

Electrical Stimulation

Intervention Type DEVICE

Interventions

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Conventional Therapy

Intervention Type DEVICE

Robotic Glove

Intervention Type DEVICE

Electrical Stimulation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adults male and/or female, older than 18 years
* Patients who have suffered one or more strokes with major unilateral functional impairment
* Hemiplegic, left and right unilateral lesion
* Chronic phase of stroke at least six months before study enrollment
* Level of impairment: hand and/or arm
* No left handed
* Mini-Mental State Examination \> 20

Exclusion Criteria

* Limitation for using the device due to impairment of Passive Range of Motion and/or
* Pain due to Spasticity evaluated using Modified Ashworth Scale (\>=3)
* Previous history of major neurological or psychiatric disorders
* allergy to electrodes
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ecole Polytechnique Fédérale de Lausanne

OTHER

Sponsor Role collaborator

Villa Beretta Rehabilitation Center

OTHER

Sponsor Role lead

Responsible Party

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Dr. Franco Molteni

Clinical Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Franco Molteni, MD

Role: PRINCIPAL_INVESTIGATOR

Villa Beretta Rehabilitation Center

Locations

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Villa Beretta Rehabilitation Center

Costa Masnaga, Lecco, Italy

Site Status

Countries

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Italy

References

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Crema A, Bassolino M, Guanziroli E, Colombo M, Blanke O, Serino A, Micera S, Molteni F. Neuromuscular electrical stimulation restores upper limb sensory-motor functions and body representations in chronic stroke survivors. Med. 2022 Jan 14;3(1):58-74.e10. doi: 10.1016/j.medj.2021.12.001. Epub 2022 Jan 7.

Reference Type DERIVED
PMID: 35590144 (View on PubMed)

Other Identifiers

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INCOGNITO

Identifier Type: -

Identifier Source: org_study_id