Multi-domain Improvements in High-TEchnology Rehabilitation Programs for Post-stroke Patients

NCT ID: NCT06489145

Last Updated: 2024-12-09

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

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-24

Study Completion Date

2025-09-30

Brief Summary

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Through a multi-method, multi-informant, and patient-centred approach, the study aims to investigate the experience of use and the effectiveness of rehabilitation technology (robotics and virtual reality - VR) in post-stroke patients and their caregivers and therapists

Detailed Description

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The present research will consist of two parallel studies.

Study 1 (ID: 0025654/24). As a first goal the study aims to investigate pre- post-intervention changes on patients' motor, functional, cognitive, psychological and quality of life outcomes. Intervention effects will be estimated among patients participating in technology-enhanced rehabilitation programs and compared to those undergoing traditional treatment only.

As a second goal, the study aims to evaluate patients' subjective rehabilitation experience, treatment expectations and compliance, and (in case of technology use) devices usability, acceptability and psychosocial impact.

As a third goal, the study aims to extend the evaluation on rehabilitation experience to patients' caregivers, specifically investigating their treatment expectations and, at the end of the intervention, treatment satisfaction.

As a fourth goal, the study aims to evaluate the rehabilitation experience and technology experience of use in patients' therapists, specifically investigating their treatment expectations and, at the end of the intervention, patients' compliance and participation levels in the treatment.

Study 2 (ID: RM-2024-803). Therapists will be also involved in a parallel qualitative investigation through focus-groups to further explore the barriers and facilitators related to the implementation of technological devices into post-stroke rehabilitation programs.

Conditions

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Stroke

Keywords

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Stroke Rehabilitation Technology Cognition Quality of Life Well-Being Experience of Use

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Technology-enhanced Rehabilitation

Patients will participate in technology-enhanced rehabilitation programs in addition to multidisciplinary traditional treatment.

Group Type EXPERIMENTAL

Technology-enhanced Rehabilitation

Intervention Type DEVICE

Based on their individualized rehabilitation project, patients will undergo robot-assisted therapy (RAT) and/or virtual reality (VR)-based treatment.

RAT will consist of the use exoskeleton devices intended for the treatment of upper limbs (Armeo-Spring™) or for the lower limbs (Lokomat™) impairments.

VR-based rehabilitation will be conducted non-immersive VR devices: the ProKin 252™ (TechnoBody SRL, Italy), the D-Wall™ (TechnoBody SRL, Italy), and the Walker View™ (TechnoBody SRL, Italy).

Technology-enhanced treatment duration (number of sessions, minutes of use) will strictly depend on patients' rehabilitation needs and individualized rehabilitation program. Overall, part of the duration of the whole treatment will be dedicated to the use of the technological device, resulting in the same amount of rehabilitation for all participants.

Multidisciplinary Traditional Rehabiltiation

Intervention Type OTHER

Patients will receive traditional treatment consisting of two daily one-hour session (4 weeks, 20 sessions) and including rehabilitation activities like range of motion exercises (passive, active assisted and active), progressive resistive exercises, balance and strength training, and aerobic conditioning. The intervention procedures will follow the routine multidisciplinary clinical practice of the Institute where the study will be carried out. Procedures will be adapted according to patient's medical diagnosis, disability severity, and to the consequent rehabilitation objectives in favor of an individualized rehabilitation project and program. If necessary, patients might therefore undergo parallel rehabilitation activities (ie, occupational therapy, speech therapy, cognitive stimulation) that will be kept under control throughout data collection and analyses.

Standard Rehabilitation

Patients will participate in multidisciplinary traditional treatment only

Group Type ACTIVE_COMPARATOR

Multidisciplinary Traditional Rehabiltiation

Intervention Type OTHER

Patients will receive traditional treatment consisting of two daily one-hour session (4 weeks, 20 sessions) and including rehabilitation activities like range of motion exercises (passive, active assisted and active), progressive resistive exercises, balance and strength training, and aerobic conditioning. The intervention procedures will follow the routine multidisciplinary clinical practice of the Institute where the study will be carried out. Procedures will be adapted according to patient's medical diagnosis, disability severity, and to the consequent rehabilitation objectives in favor of an individualized rehabilitation project and program. If necessary, patients might therefore undergo parallel rehabilitation activities (ie, occupational therapy, speech therapy, cognitive stimulation) that will be kept under control throughout data collection and analyses.

Interventions

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Technology-enhanced Rehabilitation

Based on their individualized rehabilitation project, patients will undergo robot-assisted therapy (RAT) and/or virtual reality (VR)-based treatment.

RAT will consist of the use exoskeleton devices intended for the treatment of upper limbs (Armeo-Spring™) or for the lower limbs (Lokomat™) impairments.

VR-based rehabilitation will be conducted non-immersive VR devices: the ProKin 252™ (TechnoBody SRL, Italy), the D-Wall™ (TechnoBody SRL, Italy), and the Walker View™ (TechnoBody SRL, Italy).

Technology-enhanced treatment duration (number of sessions, minutes of use) will strictly depend on patients' rehabilitation needs and individualized rehabilitation program. Overall, part of the duration of the whole treatment will be dedicated to the use of the technological device, resulting in the same amount of rehabilitation for all participants.

Intervention Type DEVICE

Multidisciplinary Traditional Rehabiltiation

Patients will receive traditional treatment consisting of two daily one-hour session (4 weeks, 20 sessions) and including rehabilitation activities like range of motion exercises (passive, active assisted and active), progressive resistive exercises, balance and strength training, and aerobic conditioning. The intervention procedures will follow the routine multidisciplinary clinical practice of the Institute where the study will be carried out. Procedures will be adapted according to patient's medical diagnosis, disability severity, and to the consequent rehabilitation objectives in favor of an individualized rehabilitation project and program. If necessary, patients might therefore undergo parallel rehabilitation activities (ie, occupational therapy, speech therapy, cognitive stimulation) that will be kept under control throughout data collection and analyses.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Acute stroke event occurring within a maximum of 12 months prior to treatment;
* Age over 18 years;
* Acceptable hyposthenia evaluated with the Motricity Index (scores less than the maximum)
* Spasticity, if present, compatible with limb function (MAS score \< 2)
* Mental health condition allowing for a full understanding of the study objectives and completion of self-report measures


* Any informal caregiver (e.g., family member, friend) who continuously assists the enrolled patient for at least half a day;


* Physiotherapists who assist enrolled patients throughout the entire intervention period


* Physiotherapists who have sufficient professional experience in use of rehabilitation technology in post-stroke rehabilitation programs;

Exclusion Criteria

* Severe clinical condition (e.g., cognitive impairment - MMSE score \< 24), presence of sever apraxia, complete upper limbs hemiplegia, severe upper limb sensory disorders, joint fractures and dislocations);
* clinical non-eligibility to the use of exoskeleton devices as per technical specifications of the devices
* Inability or difficulty in completing self-report measures in Italian and/or secondary illiteracy;
* Presence of psychiatric pathology in medical history or recent psychiatric pathology that could affect reliability of data collected;
* Refusal or withdrawal of informed consent at any stage of the study.

Caregivers


* Inability or difficulty in understanding Italian language and/or illiteracy;
* Refusal or withdrawal of informed consent at any stage of the study

Therapists


* Physiotherapists who partially assist enrolled patients throughout the entire intervention period

Study 2 (ID: RM-2024-803)

Therapists


* Refusal or withdrawal of informed consent at any stage of the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Milan

OTHER

Sponsor Role collaborator

Istituti Clinici Scientifici Maugeri SpA

OTHER

Sponsor Role collaborator

University of Milano Bicocca

OTHER

Sponsor Role lead

Responsible Party

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Marco D'Addario

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Patrizia Steca, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Milano Bicocca

Marco D'Addario, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Milano Bicocca

Alessandra Gorini, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Milan

Locations

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University of Milano-Bicocca

Milan, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Marco D'Addario, PhD

Role: CONTACT

Phone: 02 6448 3824

Email: [email protected]

Francesco Zanatta, PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Marco D'Addario

Role: primary

Other Identifiers

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RM-2024-803

Identifier Type: OTHER

Identifier Source: secondary_id

0025654/24

Identifier Type: -

Identifier Source: org_study_id