Effect Of Social Robots In Cerebral Palsy

NCT ID: NCT06948227

Last Updated: 2025-05-04

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-01

Study Completion Date

2025-10-25

Brief Summary

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The aim of this study is to compare the motivation of the participants, upper extremity skills and daily living activity skills of classical occupational therapy practices in children diagnosed with cerebral palsy with therapy practices using Social Robot Nao in addition to classical occupational therapy practices.

Detailed Description

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Social Robots are technological developments that are used very frequently, especially in sectors such as education, health and industry, and whose use is increasing day by day, providing services by providing human-robot interaction in various application areas. This study aims to support upper extremity skills in children diagnosed with cerebral palsy through interaction, to increase participation by teaching daily living activities, and to examine the effects of this therapy in the long term. With the social robot, occupational therapists and physiotherapists will be prevented from suffering from burnout syndrome by increasing their efficiency in therapy. One of the aims is to increase motivation in therapy through interaction with the social robot and to maintain the positive effects of therapy in the long term.

Cerebral palsy is defined as a permanent movement and posture disorder that occurs with a non-progressive lesion in the developing fetal and newborn brain and causes activity limitation. Cerebral Palsy is classified as spastic, dyskinetic, ataxic according to movement disorder, and as diplegia, quadriplegia, triplegia and hemiplegia according to the affected body part. In hemiplegic type cerebral palsy, which is the most common type in which one side of the body is used more than the other in classification according to body part, the upper extremity is generally affected more than the lower extremity. In the classification according to movement disorders, the most common one is unilateral spastic cerebral palsy, which negatively affects the ability to perform daily living activities, especially due to difficulties in grasping skills. Shoulder adduction-internal rotation contracture, elbow flexion contracture, wrist flexion-pronation contracture are the most common symptoms, especially in the upper extremity, but factors such as the patient's existing spasticity, affected muscle and age may cause changes in symptoms. Therefore, upper extremity movement analyzes are complex. Children with cerebral palsy often have difficulty with activities that the investigators need in daily life, such as grasping and manipulating objects. This difficulty occurs very often, especially when doing activities that require fine motor skills and the use of both hands (bimanual actions). The aforementioned bimanual actions are important in performing daily living activities such as buttoning shirts, tying shoelaces, opening bottle caps, and using cutlery, which require advanced fine motor skills and a large number of tasks and variety.

In recent years, new technological advances in walking, balance and upper extremity skill rehabilitation have been made available to patients with cerebral palsy. One of these is the social robot Nao, which teaches upper extremity motor functions required for daily living activities in children with cerebral palsy through imitation, and is known to be used successfully in rehabilitation. Social robots, which provide social communication by interacting with users, have been frequently used as assistants in the rehabilitation process in recent years. These social robots benefit from their physical, social and emotional characteristics to both progress in therapies and maintain commitment as well as effective communication. Thanks to these characteristics, therapies are long-lasting. Social robots are specifically designed to sustain and promote the effectiveness of therapies and education in children. The social robot Nao is more affordable than other types of robots and has a variety of functionality, making it the most frequently preferred choice in therapies. There are studies in the literature on the use of the social robot Nao in therapies to improve motor skills in daily life activities in children diagnosed with cerebral palsy. It has also been used previously in upper extremity rehabilitation and has proven to be a tool in teaching activities through imitation.

Although there are many studies in the literature on the use of social robots in rehabilitation, the examination of their effects on motivation and participation in these rehabilitation programs has been insufficient. The aim of this study is to teach upper extremity skills to children diagnosed with cerebral palsy through imitation activities using a social robot and to examine the effects on their motivation and participation. This study is original in that it adds a social robot to occupational therapy sessions and examines the effects of participation and motivation on children with cerebral palsy.

Conditions

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Cerebral Palsy (CP)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two groups as Daily Living Activities (ADL) Training Program and Social Robot Application Group.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Social Robot Application Group

The negatively affected characteristics of children with Cerebral Palsy will be determined by the occupational therapist together with their families. Activities that they cannot do in daily life will be implemented using the Social Robot Nao within the occupational therapy application to improve their upper extremity skills and motivation.

Group Type EXPERIMENTAL

Social Robot Application

Intervention Type OTHER

The basic daily life activities that the Social Robot can perform, such as eating and brushing teeth, and the ball throwing activity that affects their participation, will be coded into the robot by engineers. 1. The evaluations will be applied as in the other group, and occupational therapy sessions for upper extremity skills will be applied with the Social Robot Nao accompanied by a therapist for 6 weeks. In this group, the robot will show the selected activities to the children according to the activity application steps during the session and then ask the child to apply them. The verbal feedback that the Social Robot Nao will use will be determined and applied by the therapist. At the end of the 6th week, the second evaluations will be made and the 6-week developments of the participants in this group will be analyzed. Each session will be applied once a week for 40 minutes.

Daily Living Activities (ADL) Training Program Group

The negatively affected characteristics of children with cerebral palsy will be determined by the occupational therapist together with their families. Occupational therapy will be applied to the activities they cannot do in daily life by developing their upper extremity skills and motivation.

Group Type ACTIVE_COMPARATOR

Daily Living Activities (ADL) Training Program

Intervention Type OTHER

After the 1st assessment, activities that the investigators frequently use in daily life such as eating and brushing our teeth and activities that are appropriate for the age group of the participants and that affect their participation such as throwing a ball or playing games will be implemented with the therapist for 6 weeks. During the session, the therapist will provide practical training so that the participants can do the activities correctly and will provide a demonstration of the activity, observe whether the child compensates while performing the movements during all these activity steps and will make corrections for the movements that he/she compensates for. At the same time, the therapist will give reinforcing verbal affect for the activity skills that the participants do correctly in order to increase their motivation during the session. The 2nd Assessment will be made at the end of the 6th week in order to analyze the change during the 6-week period.

Interventions

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Daily Living Activities (ADL) Training Program

After the 1st assessment, activities that the investigators frequently use in daily life such as eating and brushing our teeth and activities that are appropriate for the age group of the participants and that affect their participation such as throwing a ball or playing games will be implemented with the therapist for 6 weeks. During the session, the therapist will provide practical training so that the participants can do the activities correctly and will provide a demonstration of the activity, observe whether the child compensates while performing the movements during all these activity steps and will make corrections for the movements that he/she compensates for. At the same time, the therapist will give reinforcing verbal affect for the activity skills that the participants do correctly in order to increase their motivation during the session. The 2nd Assessment will be made at the end of the 6th week in order to analyze the change during the 6-week period.

Intervention Type OTHER

Social Robot Application

The basic daily life activities that the Social Robot can perform, such as eating and brushing teeth, and the ball throwing activity that affects their participation, will be coded into the robot by engineers. 1. The evaluations will be applied as in the other group, and occupational therapy sessions for upper extremity skills will be applied with the Social Robot Nao accompanied by a therapist for 6 weeks. In this group, the robot will show the selected activities to the children according to the activity application steps during the session and then ask the child to apply them. The verbal feedback that the Social Robot Nao will use will be determined and applied by the therapist. At the end of the 6th week, the second evaluations will be made and the 6-week developments of the participants in this group will be analyzed. Each session will be applied once a week for 40 minutes.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Children with levels I-III according to the Gross Motor Function Classification System (GMFCS),
* Children with levels 1-3 according to the Manual Ability Classification System (MACS),
* Children with levels 0-2 according to the Modified Ashworth Scale,
* Children with levels 1-2 according to the Communication Function Classification System (CFCS),
* Children between the ages of 4-12,
* Children with cerebral palsy will be included in the study.

Exclusion Criteria

* Children who have not had any orthopedic surgery affecting the upper extremity in the last year
* Children who have any epileptic findings
* Children who have received botox in the last 6 months will be excluded from the study.
Minimum Eligible Age

4 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yeditepe University

OTHER

Sponsor Role collaborator

Medipol University

OTHER

Sponsor Role lead

Responsible Party

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Hale Nur Baş

Occupational Therapist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Devrim Tarakcı, Associate Professor

Role: STUDY_CHAIR

Medipol University

Locations

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Dilbade Special Education Rehabilitation Center

Istanbul, Eyupsultan, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Hale Nur Baş, Occupational Therapist

Role: CONTACT

+905434283853

Devrim Tarakcı, Associate Professor

Role: CONTACT

+905322052282

Facility Contacts

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Hale Nur Baş, Occupational Therapist

Role: primary

+905434283853

References

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Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007 Feb;109:8-14.

Reference Type BACKGROUND
PMID: 17370477 (View on PubMed)

Gonzalez JC, Pulido JC, Fernandez F, Suarez-Mejias C. Planning, execution and monitoring of physical rehabilitation therapies with a robotic architecture. Stud Health Technol Inform. 2015;210:339-43.

Reference Type BACKGROUND
PMID: 25991162 (View on PubMed)

Calderita LV, Manso LJ, Bustos P, Suarez-Mejias C, Fernandez F, Bandera A. THERAPIST: Towards an Autonomous Socially Interactive Robot for Motor and Neurorehabilitation Therapies for Children. JMIR Rehabil Assist Technol. 2014 Oct 7;1(1):e1. doi: 10.2196/rehab.3151.

Reference Type BACKGROUND
PMID: 28582242 (View on PubMed)

Amirova A, Rakhymbayeva N, Yadollahi E, Sandygulova A, Johal W. 10 Years of Human-NAO Interaction Research: A Scoping Review. Front Robot AI. 2021 Nov 19;8:744526. doi: 10.3389/frobt.2021.744526. eCollection 2021.

Reference Type BACKGROUND
PMID: 34869613 (View on PubMed)

Liao YH, Lin TY, Wu CC, Shih YN. Can occupational therapy manpower be replaced with social robots in a singing group during COVID-19? Work. 2021;68(1):21-26. doi: 10.3233/WOR-205096.

Reference Type BACKGROUND
PMID: 33459684 (View on PubMed)

Cortes-Perez I, Gonzalez-Gonzalez N, Peinado-Rubia AB, Nieto-Escamez FA, Obrero-Gaitan E, Garcia-Lopez H. Efficacy of Robot-Assisted Gait Therapy Compared to Conventional Therapy or Treadmill Training in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. Sensors (Basel). 2022 Dec 16;22(24):9910. doi: 10.3390/s22249910.

Reference Type BACKGROUND
PMID: 36560281 (View on PubMed)

Cacioppo M, Loos A, Lempereur M, Brochard S. Bimanual movements in children with cerebral palsy: a systematic review of instrumented assessments. J Neuroeng Rehabil. 2023 Feb 27;20(1):26. doi: 10.1186/s12984-023-01150-7.

Reference Type BACKGROUND
PMID: 36849971 (View on PubMed)

Sakzewski L, Ziviani J, Boyd R. Systematic review and meta-analysis of therapeutic management of upper-limb dysfunction in children with congenital hemiplegia. Pediatrics. 2009 Jun;123(6):e1111-22. doi: 10.1542/peds.2008-3335. Epub 2009 May 18.

Reference Type BACKGROUND
PMID: 19451190 (View on PubMed)

Rozaire J, Paquin C, Henry L, Agopyan H, Bard-Pondarre R, Naaim A, Duprey S, Chaleat-Valayer E. A systematic review of instrumented assessments for upper limb function in cerebral palsy: current limitations and future directions. J Neuroeng Rehabil. 2024 Apr 16;21(1):56. doi: 10.1186/s12984-024-01353-6.

Reference Type BACKGROUND
PMID: 38622731 (View on PubMed)

Makki D, Duodu J, Nixon M. Prevalence and pattern of upper limb involvement in cerebral palsy. J Child Orthop. 2014 May;8(3):215-9. doi: 10.1007/s11832-014-0593-0. Epub 2014 May 14.

Reference Type BACKGROUND
PMID: 24824566 (View on PubMed)

Gutterman J, Gordon AM. Neural Correlates of Impaired Grasp Function in Children with Unilateral Spastic Cerebral Palsy. Brain Sci. 2023 Jul 21;13(7):1102. doi: 10.3390/brainsci13071102.

Reference Type BACKGROUND
PMID: 37509032 (View on PubMed)

Chiu HC, Ada L. Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. J Physiother. 2016 Jul;62(3):130-7. doi: 10.1016/j.jphys.2016.05.013. Epub 2016 Jun 17.

Reference Type BACKGROUND
PMID: 27323932 (View on PubMed)

Paul S, Nahar A, Bhagawati M, Kunwar AJ. A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022 Jul 30;2022:2622310. doi: 10.1155/2022/2622310. eCollection 2022.

Reference Type BACKGROUND
PMID: 35941906 (View on PubMed)

Hunt M, Everaert L, Brown M, Muraru L, Hatzidimitriadou E, Desloovere K. Effectiveness of robotic exoskeletons for improving gait in children with cerebral palsy: A systematic review. Gait Posture. 2022 Oct;98:343-354. doi: 10.1016/j.gaitpost.2022.09.082. Epub 2022 Sep 26.

Reference Type BACKGROUND
PMID: 36306544 (View on PubMed)

Other Identifiers

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123E355

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

IMU-ERG-HNB-01

Identifier Type: -

Identifier Source: org_study_id

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