New Technologies in the Rehabilitation of Chronic Stroke

NCT ID: NCT03641651

Last Updated: 2022-09-27

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-08-31

Study Completion Date

2020-05-31

Brief Summary

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The objective of the current study is to develop and investigate training concepts involving rehabilitation technology, which aim at exploiting the potential for regaining the ability to perform skilled movements by maximizing training intensity and keeping the motivation of patients high.

The evaluation focuses on feasibility and cost-benefit analyses

Detailed Description

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This feasibility project aims to establish an efficient setting for intensive rehabilitation with new technology in four trailblazer clinics. This will enable them to provide intensive therapy to the patients in accordance with the study protocol. If this setting is integrated into the clinical routine, the investigators will be able to collect data to get some first insight into economic and functional data required to calculate changes in socioeconomic costs

Conditions

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Stroke Hemiplegia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Technology arm

4 Weeks intervention of intensive rehabilitation using rehabilitation technology, 3-5 h per day, within a 5d week in-or outpatient setting.

Group Type EXPERIMENTAL

Rehabilitation technology

Intervention Type OTHER

* Series of tailored rehabilitative training with the use of new technology which provide feedback and allow for a targeted and intensive and dense training.
* With supervision based on patients preconditions and therapy device (e.g. patient/ therapist ratio= 3/1).
* A training series lasts four weeks and comprises 3-5 training-days per week. Maximum training break of 7 days.

Five sessions of training with duration of 45 min per session, and up to four hours each day are foreseen.

* The training can take place in an outpatient or inpatient setting.
* Training will be organized in individual one-to-one or group session

Interventions

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Rehabilitation technology

* Series of tailored rehabilitative training with the use of new technology which provide feedback and allow for a targeted and intensive and dense training.
* With supervision based on patients preconditions and therapy device (e.g. patient/ therapist ratio= 3/1).
* A training series lasts four weeks and comprises 3-5 training-days per week. Maximum training break of 7 days.

Five sessions of training with duration of 45 min per session, and up to four hours each day are foreseen.

* The training can take place in an outpatient or inpatient setting.
* Training will be organized in individual one-to-one or group session

Intervention Type OTHER

Other Intervention Names

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Lokomat Erigo Andago Armeo (Boom, Senseo, Spring, Power) Valedo motion Amadeo Myro NuStep Bi-Manu Trainer EksoGT The Float MOTOmed Allegro

Eligibility Criteria

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Inclusion Criteria

* Adult patients with residual hemiparesis after cerebrovascular accident
* Up to 12 months after the event
* Primary rehabilitation terminated
* Able to cognitively comprehend the aim of the project with at least 22 points in the Montreal Cognitive Assessment (MoCA)
* General health condition allows for intensive rehabilitative training with limited supervision i.e. clearance and prescription of responsible physician
* Understand written and spoken German language

Exclusion Criteria

Patients with any signs and symptoms showing that the participant is unwilling to participate in the study will result in the patient being excluded from participation Any medical condition preventing participation such as Severe respiratory disease Severe OR unstable cardio-circulatory conditions Orthopaedic conditions, especially in extremities targeted for rehabilitation such as

* fixed joint contractures limiting range of motion
* non-consolidated fractures Neuro-psychological conditions including cognitive deficits limiting communication or non-cooperation like (self-) aggressive behaviour Infections or inflammatory diseases, like osteomyelitis

Specific absolute contraindication for the training with any of the respective devices:

* Improper fit of the device, including its harness to relevant extremity(ies)
* Contraindicated training position (standing, sitting)

Device specific contraindications will be respected and will lead to the exclusion of the device for that patient.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Klinik Lengg, Zurich

OTHER

Sponsor Role collaborator

Reha Rheinfelden

OTHER

Sponsor Role collaborator

Klinik Valens

OTHER

Sponsor Role collaborator

Rehaklinik Zihlschlacht AG

OTHER

Sponsor Role collaborator

Markus Wirz

OTHER

Sponsor Role lead

Responsible Party

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Markus Wirz

Head of Physiotherapy R&D

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Reha Rheinfelden

Rheinfelden, , Switzerland

Site Status

Kliniken Valens

Valens, , Switzerland

Site Status

Rehakliniken Zihlschlacht

Zihlschlacht, , Switzerland

Site Status

Klinik Lengg AG

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, Pomeroy VM, Langhorne P. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst Rev. 2014 Apr 22;2014(4):CD001920. doi: 10.1002/14651858.CD001920.pub3.

Reference Type BACKGROUND
PMID: 24756870 (View on PubMed)

Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, Kwakkel G. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014 Feb 4;9(2):e87987. doi: 10.1371/journal.pone.0087987. eCollection 2014.

Reference Type BACKGROUND
PMID: 24505342 (View on PubMed)

Langhorne P, Wagenaar R, Partridge C. Physiotherapy after stroke: more is better? Physiother Res Int. 1996;1(2):75-88. doi: 10.1002/pri.6120010204.

Reference Type BACKGROUND
PMID: 9238725 (View on PubMed)

Hornby TG, Holleran CL, Hennessy PW, Leddy AL, Connolly M, Camardo J, Woodward J, Mahtani G, Lovell L, Roth EJ. Variable Intensive Early Walking Poststroke (VIEWS): A Randomized Controlled Trial. Neurorehabil Neural Repair. 2016 Jun;30(5):440-50. doi: 10.1177/1545968315604396. Epub 2015 Sep 3.

Reference Type BACKGROUND
PMID: 26338433 (View on PubMed)

Knecht S, Rossmuller J, Unrath M, Stephan KM, Berger K, Studer B. Old benefit as much as young patients with stroke from high-intensity neurorehabilitation: cohort analysis. J Neurol Neurosurg Psychiatry. 2016 May;87(5):526-30. doi: 10.1136/jnnp-2015-310344. Epub 2015 Jun 11.

Reference Type BACKGROUND
PMID: 26069298 (View on PubMed)

Kwakkel G, Wagenaar RC, Twisk JW, Lankhorst GJ, Koetsier JC. Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial. Lancet. 1999 Jul 17;354(9174):191-6. doi: 10.1016/S0140-6736(98)09477-X.

Reference Type BACKGROUND
PMID: 10421300 (View on PubMed)

Feys H, De Weerdt W, Verbeke G, Steck GC, Capiau C, Kiekens C, Dejaeger E, Van Hoydonck G, Vermeersch G, Cras P. Early and repetitive stimulation of the arm can substantially improve the long-term outcome after stroke: a 5-year follow-up study of a randomized trial. Stroke. 2004 Apr;35(4):924-9. doi: 10.1161/01.STR.0000121645.44752.f7. Epub 2004 Mar 4.

Reference Type BACKGROUND
PMID: 15001789 (View on PubMed)

Jette DU, Warren RL, Wirtalla C. The relation between therapy intensity and outcomes of rehabilitation in skilled nursing facilities. Arch Phys Med Rehabil. 2005 Mar;86(3):373-9. doi: 10.1016/j.apmr.2004.10.018.

Reference Type BACKGROUND
PMID: 15759214 (View on PubMed)

Lohse KR, Lang CE, Boyd LA. Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation. Stroke. 2014 Jul;45(7):2053-8. doi: 10.1161/STROKEAHA.114.004695. Epub 2014 May 27.

Reference Type BACKGROUND
PMID: 24867924 (View on PubMed)

Birkenmeier RL, Prager EM, Lang CE. Translating animal doses of task-specific training to people with chronic stroke in 1-hour therapy sessions: a proof-of-concept study. Neurorehabil Neural Repair. 2010 Sep;24(7):620-35. doi: 10.1177/1545968310361957. Epub 2010 Apr 27.

Reference Type BACKGROUND
PMID: 20424192 (View on PubMed)

Kwakkel G, van Peppen R, Wagenaar RC, Wood Dauphinee S, Richards C, Ashburn A, Miller K, Lincoln N, Partridge C, Wellwood I, Langhorne P. Effects of augmented exercise therapy time after stroke: a meta-analysis. Stroke. 2004 Nov;35(11):2529-39. doi: 10.1161/01.STR.0000143153.76460.7d. Epub 2004 Oct 7.

Reference Type BACKGROUND
PMID: 15472114 (View on PubMed)

Teasell R, Bitensky J, Salter K, Bayona NA. The role of timing and intensity of rehabilitation therapies. Top Stroke Rehabil. 2005 Summer;12(3):46-57. doi: 10.1310/ETDP-6DR4-D617-VMVF.

Reference Type BACKGROUND
PMID: 16110427 (View on PubMed)

Andrews AW, Li D, Freburger JK. Association of Rehabilitation Intensity for Stroke and Risk of Hospital Readmission. Phys Ther. 2015 Dec;95(12):1660-7. doi: 10.2522/ptj.20140610. Epub 2015 Jun 18.

Reference Type BACKGROUND
PMID: 26089042 (View on PubMed)

Krakauer JW, Carmichael ST, Corbett D, Wittenberg GF. Getting neurorehabilitation right: what can be learned from animal models? Neurorehabil Neural Repair. 2012 Oct;26(8):923-31. doi: 10.1177/1545968312440745. Epub 2012 Mar 30.

Reference Type BACKGROUND
PMID: 22466792 (View on PubMed)

De Wit L, Putman K, Dejaeger E, Baert I, Berman P, Bogaerts K, Brinkmann N, Connell L, Feys H, Jenni W, Kaske C, Lesaffre E, Leys M, Lincoln N, Louckx F, Schuback B, Schupp W, Smith B, De Weerdt W. Use of time by stroke patients: a comparison of four European rehabilitation centers. Stroke. 2005 Sep;36(9):1977-83. doi: 10.1161/01.STR.0000177871.59003.e3. Epub 2005 Aug 4.

Reference Type BACKGROUND
PMID: 16081860 (View on PubMed)

De Wit L, Putman K, Schuback B, Komarek A, Angst F, Baert I, Berman P, Bogaerts K, Brinkmann N, Connell L, Dejaeger E, Feys H, Jenni W, Kaske C, Lesaffre E, Leys M, Lincoln N, Louckx F, Schupp W, Smith B, De Weerdt W. Motor and functional recovery after stroke: a comparison of 4 European rehabilitation centers. Stroke. 2007 Jul;38(7):2101-7. doi: 10.1161/STROKEAHA.107.482869. Epub 2007 May 31.

Reference Type BACKGROUND
PMID: 17540968 (View on PubMed)

Hayward KS, Brauer SG. Dose of arm activity training during acute and subacute rehabilitation post stroke: a systematic review of the literature. Clin Rehabil. 2015 Dec;29(12):1234-43. doi: 10.1177/0269215514565395. Epub 2015 Jan 7.

Reference Type BACKGROUND
PMID: 25568073 (View on PubMed)

Lang CE, Macdonald JR, Reisman DS, Boyd L, Jacobson Kimberley T, Schindler-Ivens SM, Hornby TG, Ross SA, Scheets PL. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009 Oct;90(10):1692-8. doi: 10.1016/j.apmr.2009.04.005.

Reference Type BACKGROUND
PMID: 19801058 (View on PubMed)

Lang CE, Wagner JM, Edwards DF, Dromerick AW. Upper extremity use in people with hemiparesis in the first few weeks after stroke. J Neurol Phys Ther. 2007 Jun;31(2):56-63. doi: 10.1097/NPT.0b013e31806748bd.

Reference Type BACKGROUND
PMID: 17558358 (View on PubMed)

Taub E, Miller NE, Novack TA, Cook EW 3rd, Fleming WC, Nepomuceno CS, Connell JS, Crago JE. Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil. 1993 Apr;74(4):347-54.

Reference Type BACKGROUND
PMID: 8466415 (View on PubMed)

Gresham GE, Fitzpatrick TE, Wolf PA, McNamara PM, Kannel WB, Dawber TR. Residual disability in survivors of stroke--the Framingham study. N Engl J Med. 1975 Nov 6;293(19):954-6. doi: 10.1056/NEJM197511062931903.

Reference Type BACKGROUND
PMID: 1178004 (View on PubMed)

Johnson BH, Bonafede MM, Watson C. Short- and longer-term health-care resource utilization and costs associated with acute ischemic stroke. Clinicoecon Outcomes Res. 2016 Feb 23;8:53-61. doi: 10.2147/CEOR.S95662. eCollection 2016.

Reference Type BACKGROUND
PMID: 26966382 (View on PubMed)

McGuire AJ, Raikou M, Whittle I, Christensen MC. Long-term mortality, morbidity and hospital care following intracerebral hemorrhage: an 11-year cohort study. Cerebrovasc Dis. 2007;23(2-3):221-8. doi: 10.1159/000097645. Epub 2006 Dec 1.

Reference Type BACKGROUND
PMID: 17143007 (View on PubMed)

Taylor TN, Davis PH, Torner JC, Holmes J, Meyer JW, Jacobson MF. Lifetime cost of stroke in the United States. Stroke. 1996 Sep;27(9):1459-66. doi: 10.1161/01.str.27.9.1459.

Reference Type BACKGROUND
PMID: 8784113 (View on PubMed)

Zhao Y, Condon J, Lawton P, He V, Cadilhac DA. Lifetime direct costs of stroke for indigenous patients adjusted for comorbidities. Neurology. 2016 Aug 2;87(5):458-65. doi: 10.1212/WNL.0000000000002908. Epub 2016 Jul 1.

Reference Type BACKGROUND
PMID: 27371489 (View on PubMed)

Duret C, Hutin E, Lehenaff L, Gracies JM. Do all sub acute stroke patients benefit from robot-assisted therapy? A retrospective study. Restor Neurol Neurosci. 2015;33(1):57-65. doi: 10.3233/RNN-140418.

Reference Type BACKGROUND
PMID: 25420902 (View on PubMed)

Lo AC, Guarino PD, Richards LG, Haselkorn JK, Wittenberg GF, Federman DG, Ringer RJ, Wagner TH, Krebs HI, Volpe BT, Bever CT Jr, Bravata DM, Duncan PW, Corn BH, Maffucci AD, Nadeau SE, Conroy SS, Powell JM, Huang GD, Peduzzi P. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med. 2010 May 13;362(19):1772-83. doi: 10.1056/NEJMoa0911341. Epub 2010 Apr 16.

Reference Type BACKGROUND
PMID: 20400552 (View on PubMed)

Spiess MR, Jaramillo JP, Behrman AL, Teraoka JK, Patten C. Unexpected recovery after robotic locomotor training at physiologic stepping speed: a single-case design. Arch Phys Med Rehabil. 2012 Aug;93(8):1476-84. doi: 10.1016/j.apmr.2012.02.030. Epub 2012 Mar 23.

Reference Type BACKGROUND
PMID: 22446153 (View on PubMed)

Chang WH, Kim YH. Robot-assisted Therapy in Stroke Rehabilitation. J Stroke. 2013 Sep;15(3):174-81. doi: 10.5853/jos.2013.15.3.174. Epub 2013 Sep 27.

Reference Type BACKGROUND
PMID: 24396811 (View on PubMed)

Masiero S, Poli P, Rosati G, Zanotto D, Iosa M, Paolucci S, Morone G. The value of robotic systems in stroke rehabilitation. Expert Rev Med Devices. 2014 Mar;11(2):187-98. doi: 10.1586/17434440.2014.882766. Epub 2014 Jan 30.

Reference Type BACKGROUND
PMID: 24479445 (View on PubMed)

Tefertiller C, Pharo B, Evans N, Winchester P. Efficacy of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011;48(4):387-416. doi: 10.1682/jrrd.2010.04.0055.

Reference Type BACKGROUND
PMID: 21674390 (View on PubMed)

Waldner A, Tomelleri C, Hesse S. Transfer of scientific concepts to clinical practice: recent robot-assisted training studies. Funct Neurol. 2009 Oct-Dec;24(4):173-7.

Reference Type BACKGROUND
PMID: 20412721 (View on PubMed)

Babaiasl M, Mahdioun SH, Jaryani P, Yazdani M. A review of technological and clinical aspects of robot-aided rehabilitation of upper-extremity after stroke. Disabil Rehabil Assist Technol. 2016;11(4):263-80. doi: 10.3109/17483107.2014.1002539. Epub 2015 Jan 20.

Reference Type BACKGROUND
PMID: 25600057 (View on PubMed)

Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-Assisted Training for Walking After Stroke: A Major Update of the Evidence. Stroke. 2017 Jun 16:STROKEAHA.117.018018. doi: 10.1161/STROKEAHA.117.018018. Online ahead of print. No abstract available.

Reference Type BACKGROUND
PMID: 28626059 (View on PubMed)

Schuster-Amft C, Kool J, Moller JC, Schweinfurther R, Ernst MJ, Reicherzer L, Ziller C, Schwab ME, Wieser S, Wirz M; SRTI study group. Feasibility and cost description of highly intensive rehabilitation involving new technologies in patients with post-acute stroke-a trial of the Swiss RehabTech Initiative. Pilot Feasibility Stud. 2022 Jul 5;8(1):139. doi: 10.1186/s40814-022-01086-0.

Reference Type BACKGROUND
PMID: 35791026 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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ZHAW-SRTI

Identifier Type: -

Identifier Source: org_study_id

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