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Robot-based Therapy for Upper Limb Sensorimotor Impairments After Stroke

Not Applicable
Completed
Conditions
Stroke
Interventions
Device: Robot-based therapy
Registration Number
NCT05007002
Lead Sponsor
KU Leuven
Brief Summary

After a stroke, more than two out of three patients experience problems with upper limb movement and sensation. Current evidence on treatment of upper limb sensory impairments is scarce and shows unclear results. Robot-based therapy has been increasingly used to treat upper limb motor impairments, with similar positive results as compared to conventional therapy. This study aims to investigate a novel robot-based therapy program for treatment of upper limb sensory impairments. The therapy program consists of 10 one-hour session spread over 4 weeks and will be evaluated for its effect in 20 chronic stroke patients. The investigators hypothesize that a 4-week robot-based therapy program can improve upper limb sensation and movement.

Detailed Description

Up to 70% of stroke survivors show upper limb impairments consisting of motor and/or somatosensory impairments. These impairments often persist well into the chronic stage, and may lead to significant limitations in activities of daily living and may negatively affect quality of life. Different interventions have been investigated to treat upper limb motor impairments, including robot-based therapy, which shows similar positive results as compared to conventional therapy. Evidence on interventions for somatosensory impairments is scarce and often of low quality. This study therefore aims to evaluate the effect of a robot-based therapy program on sensorimotor function of the upper limb in a group of 20 chronic stroke patients.

The robot-based therapy will be provided using the Kinarm End-Point Lab (BKIN Technologies Ltd., Canada) and consists of passive and active therapy tasks for proprioception and sensory processing. The therapy consists of 10 one-hour sessions spread over 4 weeks. Clinical and robot-based motor and somatosensory assessments will be performed at 4 time points: twice at baseline, once at mid intervention, and once after 10 hours of therapy. The investigators hypothesize to find improvement in both upper limb motor and somatosensory function after the therapy program. The results from this pilot study will provide a basis for further research.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • At least 18 years old
  • A first-ever unilateral, supratentorial stroke (as defined by WHO)
  • In the chronic phase after stroke (i.e. being at least 6 months after stroke)
  • Motor deficits of the upper limb (Fugl-Meyer Motor Assessment - Upper Extremity < 60/66)
  • Somatosensory deficits of the upper limb (Erasmus modified Nottingham Sensory Assessment < 36/40)
  • Ability to perform, at least to some extent, active shoulder abduction and wrist extension against gravity
  • Ability to perform passive and active sensory processing assessment task (primary outcome measure)
Exclusion Criteria
  • History of previous stroke or TIA
  • Any serious musculoskeletal and/or other neurological conditions
  • Serious communication or cognitive deficits
  • No written informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Robot-based therapyRobot-based therapyChronic stroke patients receiving robot-based therapy
Primary Outcome Measures
NameTimeMethod
Kinarm: sensory processing taskChange during 4 weeks of therapy provided at least 6 months after stroke

Newly-developed task on the Kinarm End-Point Lab used to assess passive and active sensory processing

Secondary Outcome Measures
NameTimeMethod
Kinarm: arm movement matching taskChange during 4 weeks of therapy provided at least 6 months after stroke

Assessment of limb movement sense using a mirror-matching task on the Kinarm Exoskeleton Lab

Kinarm: visually guided reaching taskChange during 4 weeks of therapy provided at least 6 months after stroke

Assessment of motor function using a 4-target centre-out reaching task on the Kinarm End-Point Lab

Tactile discrimination testChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of sensory processing with an area under the curve based scoring system, with higher scores meaning better performance

Action research arm testChange during 4 weeks of therapy provided at least 6 months after stroke

Timed clinical assessment of motor activity performance on an ordinal scale ranging from 0 to 57, with higher scores meaning better performance

Erasmus modified Nottingham sensory assessmentChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of somatosensory function (including exteroception, proprioception and sensory processing) on an ordinal scale ranging from 0 to 40, with higher scores meaning better performance

Kinarm: sensory processing taskChange during the last 2 weeks of a 4-week therapy protocol provided at least 6 months after stroke

Newly-developed task on the Kinarm End-Point Lab used to assess passive and active sensory processing

Kinarm: arm position matching taskChange during 4 weeks of therapy provided at least 6 months after stroke

Assessment of limb position sense using a 9-target mirror-matching task on the Kinarm Exoskeleton Lab

Fugl-Meyer upper extremity assessmentChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of motor function on an ordinal scale ranging from 0 to 66, with higher scores meaning better performance

Kinarm: working memory taskChange during 4 weeks of therapy provided at least 6 months after stroke

Assessment of working memory on the Kinarm End-Point Lab, by asking the participant to remember the position of 3, 4, 5 or 6 targets simultaneously.

Functional tactile object recognition testChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of sensory processing on an ordinal scale ranging from 0 to 42, with higher scores meaning better performance

Sensorimotor action research arm testChange during 4 weeks of therapy provided at least 6 months after stroke

Timed clinical assessment of sensorimotor performance on an ordinal scale ranging from 0 to 57, with higher scores meaning better performance

Star cancellation testChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of visuospatial neglect on an ordinal scale ranging from 0 to 54, with higher scores meaning better performance, and a score below 44 indicating the presence of visuospatial neglect

Montreal cognitive assessmentChange during 4 weeks of therapy provided at least 6 months after stroke

Clinical assessment of cognitive function on an ordinal scale ranging from 0 to 30, with higher scores meaning better performance

Trial Locations

Locations (1)

KU Leuven

🇧🇪

Leuven, Belgium

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