Improving Grasp Function in People With Sensorimotor Impairments by Combining Electrical Stimulation With a Robotic Hand Orthosis

NCT ID: NCT05976087

Last Updated: 2025-08-19

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-01

Study Completion Date

2030-06-30

Brief Summary

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Hand motor and sensory impairments resulting from neurological disorders or injuries affect more than 50 million individuals worldwide. Conditions such as stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) can cause long-term hand impairments, greatly impacting daily activities and social integration. Since traditional physiotherapy has limited effectiveness in rehabilitation, assistive devices helping in performing in daily activities have emerged as a necessary solution. Soft exoskeletons offer advantages as they are more comfortable and adaptable for the user, but they often struggle to generate sufficient force. On the other hand, electrical stimulation garments, like e-sleeves, show promise by stimulating nerves and muscles in the forearm. However, achieving precise and stable movement control remains challenging due to difficulties in electrode placement for targeted stimulation. Furthermore, none of the currently available devices are capable of artificially restoring lost sensation in users' hands, limiting their ability to manipulate with fragile objects.

Recognizing these limitations, our study proposes a solution that combines a standard hand soft exoskeleton with: (i) electrical stimulation to the fingers' flexor and extensor muscles to generate artificial muscle contractions synchronized with the exoskeleton motion, compensating for the lack of gripping force, and (ii) electrical stimulation to the nerves to artificially restore the lost sensation of touch, enabling users to receive feedback on the force they are applying when interacting with the environment. The investigators refer to this proposed combination as Sensible-Exo.

To achieve this goal, our project aims to evaluate the functional improvements in assistive and rehabilitative scenarios using SensoExo in comparison to use only the exoskeleton or having no support at all. The exoskeleton will be coupled with an electrical stimulating sleeve capable of delivering non-invasive electrical stimulation in the form of Functional Electrical Stimulation (FES) and Transcutaneous Electrical Nerve Stimulation (TENS). A glove with embedded force and bending sensors will be used to modulate the electrical stimulation. Additionally, apart from studying the enhancement of functional tasks, the investigators will explore improvements in body perception, representation, and multi-sensory integration. Indeed, the investigators also aim at identifying the way patients perceive their body by means of ad-hoc virtual reality assessments that has been developed. Before each assessment patient will perform some predefined movement in virtual reality to familiarize with it and increase embodiment.

During the study, participants will perform a range of tasks based on their residual abilities, including motor tasks (e.g., grab and release, Toronto Rehabilitation Institute Hand Function Test, grip force regulation test, virtual egg test), cognitive tasks (dual tasks), and assessments of body representation and perception. Some of these tasks will be conducted in Virtual Reality environments, both with and without active stimulation.

Detailed Description

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Conditions

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Stroke Spinal Cord Injuries Traumatic Brain Injury

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental group

Group Type EXPERIMENTAL

SensoExo

Intervention Type DEVICE

combination of sensory feedback and the use of soft exoskeleton

Interventions

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SensoExo

combination of sensory feedback and the use of soft exoskeleton

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Impairment of the motor and sensory functions of the hand in chronic stage
* The subject should have good proximal arm function (i.e. good shoulder abduction and elevation)

Exclusion Criteria

* Cognitive and communication deficits impairment
* Prior or current psychological diseases such as borderline, schizophrenia, Depression or Maniac Depression
* Major comprehension and memory deficits
* Pregnancy
* Epilepsy
* Pacemaker
* Cybersickness
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Andrea Cimolato

OTHER

Sponsor Role lead

Responsible Party

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Andrea Cimolato

Study coordinator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Stanisa Raspopovic, PhD

Role: PRINCIPAL_INVESTIGATOR

ETH Zurich

Locations

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Neuroengineering Lab

Zurich, Canton of Zurich, Switzerland

Site Status

Countries

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Switzerland

References

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Dannenbaum RM, Dykes RW. Sensory loss in the hand after sensory stroke: therapeutic rationale. Arch Phys Med Rehabil. 1988 Oct;69(10):833-9.

Reference Type BACKGROUND
PMID: 3178450 (View on PubMed)

Carey LM, Matyas TA, Oke LE. Sensory loss in stroke patients: effective training of tactile and proprioceptive discrimination. Arch Phys Med Rehabil. 1993 Jun;74(6):602-11. doi: 10.1016/0003-9993(93)90158-7.

Reference Type BACKGROUND
PMID: 8503750 (View on PubMed)

Finnerup NB, Johannesen IL, Fuglsang-Frederiksen A, Bach FW, Jensen TS. Sensory function in spinal cord injury patients with and without central pain. Brain. 2003 Jan;126(Pt 1):57-70. doi: 10.1093/brain/awg007.

Reference Type BACKGROUND
PMID: 12477697 (View on PubMed)

Fujimoto ST, Longhi L, Saatman KE, Conte V, Stocchetti N, McIntosh TK. Motor and cognitive function evaluation following experimental traumatic brain injury. Neurosci Biobehav Rev. 2004 Jul;28(4):365-78. doi: 10.1016/j.neubiorev.2004.06.002.

Reference Type BACKGROUND
PMID: 15341032 (View on PubMed)

Dannenbaum RM, Jones LA. The assessment and treatment of patients who have sensory loss following cortical lesions. J Hand Ther. 1993 Apr-Jun;6(2):130-8. doi: 10.1016/s0894-1130(12)80294-8.

Reference Type BACKGROUND
PMID: 8343879 (View on PubMed)

Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003 Sep;34(9):2181-6. doi: 10.1161/01.STR.0000087172.16305.CD. Epub 2003 Aug 7.

Reference Type BACKGROUND
PMID: 12907818 (View on PubMed)

Wade DT. Measuring arm impairment and disability after stroke. Int Disabil Stud. 1989 Apr-Jun;11(2):89-92. doi: 10.3109/03790798909166398.

Reference Type BACKGROUND
PMID: 2698395 (View on PubMed)

Fuhrer MJ, Rintala DH, Hart KA, Clearman R, Young ME. Relationship of life satisfaction to impairment, disability, and handicap among persons with spinal cord injury living in the community. Arch Phys Med Rehabil. 1992 Jun;73(6):552-7.

Reference Type BACKGROUND
PMID: 1622304 (View on PubMed)

Noreau L, Fougeyrollas P. Long-term consequences of spinal cord injury on social participation: the occurrence of handicap situations. Disabil Rehabil. 2000 Mar 10;22(4):170-80. doi: 10.1080/096382800296863.

Reference Type BACKGROUND
PMID: 10798305 (View on PubMed)

Butzer T, Lambercy O, Arata J, Gassert R. Fully Wearable Actuated Soft Exoskeleton for Grasping Assistance in Everyday Activities. Soft Robot. 2021 Apr;8(2):128-143. doi: 10.1089/soro.2019.0135. Epub 2020 Jun 18.

Reference Type BACKGROUND
PMID: 32552422 (View on PubMed)

Beekhuizen KS. New perspectives on improving upper extremity function after spinal cord injury. J Neurol Phys Ther. 2005 Sep;29(3):157-62. doi: 10.1097/01.npt.0000282248.15911.38.

Reference Type BACKGROUND
PMID: 16398948 (View on PubMed)

Lambercy O, Dovat L, Yun H, Wee SK, Kuah CW, Chua KS, Gassert R, Milner TE, Teo CL, Burdet E. Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study. J Neuroeng Rehabil. 2011 Nov 16;8:63. doi: 10.1186/1743-0003-8-63.

Reference Type BACKGROUND
PMID: 22087842 (View on PubMed)

Marquez-Chin C, Popovic MR. Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: a review. Biomed Eng Online. 2020 May 24;19(1):34. doi: 10.1186/s12938-020-00773-4.

Reference Type BACKGROUND
PMID: 32448143 (View on PubMed)

Ciancibello J, King K, Meghrazi MA, Padmanaban S, Levy T, Ramdeo R, Straka M, Bouton C. Closed-loop neuromuscular electrical stimulation using feedforward-feedback control and textile electrodes to regulate grasp force in quadriplegia. Bioelectron Med. 2019 Nov 1;5:19. doi: 10.1186/s42234-019-0034-y. eCollection 2019.

Reference Type BACKGROUND
PMID: 32232108 (View on PubMed)

Prochazka A, Gauthier M, Wieler M, Kenwell Z. The bionic glove: an electrical stimulator garment that provides controlled grasp and hand opening in quadriplegia. Arch Phys Med Rehabil. 1997 Jun;78(6):608-14. doi: 10.1016/s0003-9993(97)90426-3.

Reference Type BACKGROUND
PMID: 9196468 (View on PubMed)

Other Identifiers

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1-010428

Identifier Type: -

Identifier Source: org_study_id

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