Robotic Evaluations of Motor Learning During Stroke Neurorehabilitation

NCT ID: NCT05106140

Last Updated: 2021-11-03

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

RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-20

Study Completion Date

2026-09-01

Brief Summary

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The RELEARN trial is a a prospective longitudinal cohort study sampled by convenience. Stroke survivors and healthy control individuals will be recruited to analyze motor learning in the upper extremity and its neural basis in early stroke recovery.

Detailed Description

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In stroke rehabilitation, clinicians guide the relearning of motor skills to promote recovery and improve function. A common assumption is that motor learning interacts with processes that are involved in tissue repair and helps to engage neuroplastic mechanisms that promote recovery. One of the biggest roadblocks for advancing the treatment of motor deficits is that we do not understand how motor learning changes after stroke, and critically, if poor recovery is due to a loss in an individual's ability to adapt or learn. Existing clinical tests do not directly assess motor learning. This means that therapists can profile stroke impairments (motor, sensory, cognitive, etc.) but cannot directly measure a patient's ability to learn, which is likely an important factor in recovery.

The RELEARN trial will pair robotics, an objective tool to assess post-stroke arm impairment, with neuroimaging to link motor learning deficits with possible influencing factors (sensory, motor, cognitive function) and damage in specific brain areas.

Participants with stroke will undergo clinical and robotic evaluations at baseline (within 1-13 days post-stroke), at 6 weeks, at 12 weeks, and again at 26 weeks. An MRI assessment will occur during week 6. Stroke participants will complete a 24hr retention assessment after baseline visit and week 26 visit.

Control participants will undergo a single robotic evaluation and a 24hr retention assessment.

Conditions

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Stroke

Keywords

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Rehabilitation Neuroimaging Motor Learning Early Stroke Recovery Neuroplasticity Limb Dominance

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Stroke Participants

This group will include stroke survivors from the Calgary Stroke Program who are over 18 years of age.

Magnetic Resonance Imaging (MRI)

Intervention Type OTHER

A research MRI will be performed at 6-weeks post-stroke to document stroke lesion location and size.

Kinarm Robotic Exoskeleton Assessment

Intervention Type DEVICE

The Kinarm Robotic Exoskeleton is a device used to provide therapy and assessment. The device has framework that supports the arms and these supports are adjustable to ensure a comfortable fit. Motors attached to the framework move the arms and record shoulder and elbow movements.

The assessment involves performing a number of tasks using the Kinarm to measure proprioceptive and motor impairment, adaptation to force and visual disturbances, and retention after 24 hours.

Clinical Assessment

Intervention Type OTHER

The clinical assessment will be performed by a qualified stroke therapist and include a number of verified measurements to examine: reflexes, strength, apraxia, somatosensation, physical abilities, and cognition.

Control Participants

This group will include healthy individuals from the community who are matched for age and sex to stroke participants.

Kinarm Robotic Exoskeleton Assessment

Intervention Type DEVICE

The Kinarm Robotic Exoskeleton is a device used to provide therapy and assessment. The device has framework that supports the arms and these supports are adjustable to ensure a comfortable fit. Motors attached to the framework move the arms and record shoulder and elbow movements.

The assessment involves performing a number of tasks using the Kinarm to measure proprioceptive and motor impairment, adaptation to force and visual disturbances, and retention after 24 hours.

Clinical Assessment

Intervention Type OTHER

The clinical assessment will be performed by a qualified stroke therapist and include a number of verified measurements to examine: reflexes, strength, apraxia, somatosensation, physical abilities, and cognition.

Interventions

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Magnetic Resonance Imaging (MRI)

A research MRI will be performed at 6-weeks post-stroke to document stroke lesion location and size.

Intervention Type OTHER

Kinarm Robotic Exoskeleton Assessment

The Kinarm Robotic Exoskeleton is a device used to provide therapy and assessment. The device has framework that supports the arms and these supports are adjustable to ensure a comfortable fit. Motors attached to the framework move the arms and record shoulder and elbow movements.

The assessment involves performing a number of tasks using the Kinarm to measure proprioceptive and motor impairment, adaptation to force and visual disturbances, and retention after 24 hours.

Intervention Type DEVICE

Clinical Assessment

The clinical assessment will be performed by a qualified stroke therapist and include a number of verified measurements to examine: reflexes, strength, apraxia, somatosensation, physical abilities, and cognition.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* First time, unilateral ischemic stroke in middle cerebral artery territory, motor and/or sensory tracts and confirmed by clinical examination (including neuroimaging)
* 7±6 days post-stroke
* Upper limb impairment
* \>18 years old
* Fugl-Meyer upper extremity score between 30 and 57
* Vision better than 20/50 (corrected)
* Able to follow 3-step task commands


* \>18 years old
* Good health

Exclusion Criteria

* History of:

1. past undiagnosed stroke (evident on neuroimaging),
2. neglect (screened with Behavioral Inattention Test),
3. apraxia, or
4. upper extremity orthopedic or muscular issues
* Secondary neurologic injury or disease (e.g., Parkinson's)
* Contraindication to MRI
* Medical or neuropsychiatric conditions that would interfere with study outcomes, or where participation presents a risk to the subject
* Enrollment in an interventional trial that supplements standard therapy


• Significant upper limb neurologic or orthopedic conditions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

University of Calgary

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tyler Cluff, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Calgary, Calgary, Alberta, Canada

Sean Dukelow, MD PhD FRCPC

Role: PRINCIPAL_INVESTIGATOR

University of Calgary, Calgary, Alberta, Canada

Locations

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Carewest Dr. Vernon Fanning Centre

Calgary, Alberta, Canada

Site Status RECRUITING

University of Calgary - Kinesiology Building

Calgary, Alberta, Canada

Site Status RECRUITING

Foothills Hospital - Main Building

Calgary, Alberta, Canada

Site Status RECRUITING

University of Calgary - Teaching Research and Wellness (TRW) Building

Calgary, Alberta, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Rachel Stone, BA

Role: CONTACT

Phone: 403-944-4050

Email: [email protected]

Facility Contacts

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Sean Dukelow, MD PhD FRCPC

Role: primary

Tyler Cluff, PhD

Role: primary

Sean Dukelow, MD PhD FRCPC

Role: primary

Sean Dukelow, MD PhD FRCPC

Role: primary

Other Identifiers

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REB21-0441

Identifier Type: -

Identifier Source: org_study_id