Assisted Rehabilitation Care During Post-stroke mANaGement: fEasibiLity Assessment

NCT ID: NCT03787433

Last Updated: 2020-06-16

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

Total Enrollment

41 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-11-23

Study Completion Date

2020-06-12

Brief Summary

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The ARCANGEL study evaluates the feasibility of introducing ARC (Assisted Rehabilitation Care), a new device for home-based post-stroke rehabilitation in the current clinical practise. All the stroke survivors included in the study will received their own equipment to be used at home for 6 months.

Detailed Description

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Some relevant studies have indicated that approximately 36% of these survivors (i.e. more than 9 million in 2013 only) are left with significant disabilities 5 years after their stroke, and \>40% (i.e. more than 10 million) require assistance with activities of daily living.

Despite evidence that participation in formal rehabilitative therapies lessens disability after stroke, less than a third receive inpatient or outpatient therapies. Of those who do access therapies, the frequency of use varies by geographic location and socioeconomic status. In this context, the development of new strategies able to expand the access to rehabilitation to an increased number of stroke patients, also enabling home-based conduction and monitoring, are increasingly necessary both for patients, their families and for the healthcare and social services sustainability. Since many barriers could limit access to continuous physical rehabilitation for these patients, devices that complement or assist in the rehabilitation process can be of great help.

Among different approaches proposed by the scientific community, technological systems based on accelerometers seem to be among the most promising. Accelerometers are small low cost electronic devices, able to measure body parts acceleration on three axes. Many researchers have already highlighted that accelerometers have the capability to provide reliable and objective information on quantity and intensity of patient limbs movements during recovery process.

Wearable devices such as accelerometers allow to monitor exercises and daily activities. Machine learning methodologies have already been applied for modelling and contextualizing accelerometric signals to identify activity types (walking, dressing, eating, washing up, etc.) or to recognize to which rehabilitative exercise these signals are linked to. These techniques allow to estimate the recorded movement quality, providing information useful to identify the context in which movements are performed. Results of these type of studies are promising and they demonstrate that machine learning is a preferred approach for accelerometric data analysis, since able to exceed actual limits that today are hampering commercial product development for real time analysis of movement.

Within this scenario, Camlin-ARC takes its place. ARC is a platform based on wearable inertial sensors and machine learning algorithms, designed to bring the rehabilitation at post-stroke patients' home, following hospital discharge.

Conditions

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Stroke

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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ARC - Assisted Rehabilitation Care

All study participants will be asked to use ARC during for their post-stroke home based rehabilitation for up to 6 months.

ARC - Assisted Rehabilitation Care

Intervention Type DEVICE

ARC is a platform based on wearable inertial sensors and machine learning algorithms, designed to bring the rehabilitation at post-stroke patients' home, following hospital discharge.

The product has been created with the purpose to improve physical skills and patient independence accordingly, in the six months following the acute event. ARC aims to optimize, ease and make more accessible the path of post-stroke rehabilitation during post-acute phase, in real life settings.

Interventions

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ARC - Assisted Rehabilitation Care

ARC is a platform based on wearable inertial sensors and machine learning algorithms, designed to bring the rehabilitation at post-stroke patients' home, following hospital discharge.

The product has been created with the purpose to improve physical skills and patient independence accordingly, in the six months following the acute event. ARC aims to optimize, ease and make more accessible the path of post-stroke rehabilitation during post-acute phase, in real life settings.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Stroke Diagnosis, with a stable clinical condition
* Age \> 18
* Modified Rankin score lower or equal to 4 or Barthel Index score greater than 10 at the time of enrollment
* Patients must be able to keep the standing position without or with minimum assistance
* Patient giving written consent and engage

Exclusion Criteria

* Significant cognitive impairment and behavioral disorders - judged by a responsible clinician
* Poor communication or reading skills - judged by a Speech and Language Therapist
* Orthopedic limitation (fractures, amputations, advance osteoarthritis, active rheumatoid arthritis)
* Head trauma
* Epilepsy, not pharmacologically controlled
* Severe spatial neglect
* Neurodegenerative and neuromuscular diseases
* Severe spasticity
* Patient not giving written consent and not engage
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Northern Health and Social Care Trust

OTHER_GOV

Sponsor Role collaborator

Azienda Sanitaria Locale 3, Torino

OTHER

Sponsor Role collaborator

Camlin Ltd

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Frances Johnston, MSc

Role: STUDY_DIRECTOR

Northern Health and Social Care Trust

Locations

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Azienda Sanitaria Locale 3, Torino

Pinerolo, , Italy

Site Status

Northern Health and Social Care Trust

Antrim, Northern Ireland, United Kingdom

Site Status

Countries

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Italy United Kingdom

References

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Krueger H, Koot J, Hall RE, O'Callaghan C, Bayley M, Corbett D. Prevalence of Individuals Experiencing the Effects of Stroke in Canada: Trends and Projections. Stroke. 2015 Aug;46(8):2226-31. doi: 10.1161/STROKEAHA.115.009616.

Reference Type BACKGROUND
PMID: 26205371 (View on PubMed)

Duncan PW, Zorowitz R, Bates B, Choi JY, Glasberg JJ, Graham GD, Katz RC, Lamberty K, Reker D. Management of Adult Stroke Rehabilitation Care: a clinical practice guideline. Stroke. 2005 Sep;36(9):e100-43. doi: 10.1161/01.STR.0000180861.54180.FF. No abstract available.

Reference Type BACKGROUND
PMID: 16120836 (View on PubMed)

Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Anderson CS. Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989-1990. Stroke. 2002 Apr;33(4):1034-40. doi: 10.1161/01.str.0000012515.66889.24.

Reference Type BACKGROUND
PMID: 11935057 (View on PubMed)

Hackett ML, Duncan JR, Anderson CS, Broad JB, Bonita R. Health-related quality of life among long-term survivors of stroke : results from the Auckland Stroke Study, 1991-1992. Stroke. 2000 Feb;31(2):440-7. doi: 10.1161/01.str.31.2.440.

Reference Type BACKGROUND
PMID: 10657420 (View on PubMed)

Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep. 2013 Jun;15(6):331. doi: 10.1007/s11883-013-0331-y.

Reference Type BACKGROUND
PMID: 23591673 (View on PubMed)

Noorkoiv M, Rodgers H, Price CI. Accelerometer measurement of upper extremity movement after stroke: a systematic review of clinical studies. J Neuroeng Rehabil. 2014 Oct 9;11:144. doi: 10.1186/1743-0003-11-144.

Reference Type BACKGROUND
PMID: 25297823 (View on PubMed)

Uswatte G, Foo WL, Olmstead H, Lopez K, Holand A, Simms LB. Ambulatory monitoring of arm movement using accelerometry: an objective measure of upper-extremity rehabilitation in persons with chronic stroke. Arch Phys Med Rehabil. 2005 Jul;86(7):1498-501. doi: 10.1016/j.apmr.2005.01.010.

Reference Type BACKGROUND
PMID: 16003690 (View on PubMed)

Wong WY, Wong MS, Lo KH. Clinical applications of sensors for human posture and movement analysis: a review. Prosthet Orthot Int. 2007 Mar;31(1):62-75. doi: 10.1080/03093640600983949.

Reference Type BACKGROUND
PMID: 17365886 (View on PubMed)

Zhou H, Hu H, Harris N. Application of wearable inertial sensors in stroke rehabilitation. Conf Proc IEEE Eng Med Biol Soc. 2005;2005:6825-8. doi: 10.1109/IEMBS.2005.1616072.

Reference Type BACKGROUND
PMID: 17281841 (View on PubMed)

Lara González-Villanueva et al., A Tool for Linguistic Assessment of Rehabilitation Exercises. Applied Soft Computing, Special issue on hybrid intelligent methods for health technologies 14(Part A): 120-31, 2013. doi:10.1016/j.asoc.2013.07.010.

Reference Type BACKGROUND

Mannini A, Sabatini AM. Machine learning methods for classifying human physical activity from on-body accelerometers. Sensors (Basel). 2010;10(2):1154-75. doi: 10.3390/s100201154. Epub 2010 Feb 1.

Reference Type BACKGROUND
PMID: 22205862 (View on PubMed)

Parkka J, Ermes M, Korpipaa P, Mantyjarvi J, Peltola J, Korhonen I. Activity classification using realistic data from wearable sensors. IEEE Trans Inf Technol Biomed. 2006 Jan;10(1):119-28. doi: 10.1109/titb.2005.856863.

Reference Type BACKGROUND
PMID: 16445257 (View on PubMed)

Lara OD, Labrador MA. A Survey on Human Activity Recognition using Wearable Sensors. IEEE Communications Surveys & Tutorial 15(3), 2013.

Reference Type BACKGROUND

Garcia-Ceja E, Brena RF, Carrasco-Jimenez JC, Garrido L. Long-term activity recognition from wristwatch accelerometer data. Sensors (Basel). 2014 Nov 27;14(12):22500-24. doi: 10.3390/s141222500.

Reference Type BACKGROUND
PMID: 25436652 (View on PubMed)

Other Identifiers

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ARCANGEL

Identifier Type: -

Identifier Source: org_study_id

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