Feasibility of Unsupervised Therapy After Stroke in the Home Setting with a Hand Rehabilitation Device (ReHandyBot): an Exploratory Study

Swiss Federal Institute of Technology1 site in 1 country15 target enrollmentNovember 13, 2023

ConditionsStroke

Overview

Phase: Not Applicable
Intervention: Not specified
Conditions: Stroke
Sponsor: Swiss Federal Institute of Technology
Enrollment: 15
Locations: 1
Primary Endpoint: Dose of unsupervised therapy - Minutes
Status: Recruiting
Last Updated: last year

Overview Investigators Eligibility Criteria Outcomes Sites Similar Trials

Overview

Brief Summary

The ReHandyBot is a robot for hand rehabilitation after stroke. The aims of this study are (1) to investigate the feasibility of unsupervised therapy with the ReHandyBot with stroke inpatients, first in a rehabilitation clinic and then at participants' home, (2) to evaluate the usability of the ReHandyBot (user interface, implemented exercises, and gaming environment, which were adapted for independent usage), and (3) to quantify the dose of additional robotic therapy that patients perform without supervision.

The study consists of two primary phases. The first is a familiarization phase performed at the clinic, where therapists teach to the participants how to perform the exercises with the robot. Then, if capable of training with the robot safely, after discharge from the clinic participants can bring the robot home and autonomously train with it. The hypothesis is that unsupervised therapy might be a possible way to increase therapy dose for stroke patients, with the potential to further improve recovery of hand function, with minimal additional burden for therapists and for the healthcare system.

Registry

clinicaltrials.gov

Start Date

November 13, 2023

End Date

April 2026

Last Updated

last year

Study Type

Interventional

Study Design

Single Group

Sex

All

Investigators

Sponsor

Swiss Federal Institute of Technology

Responsible Party

Sponsor

Eligibility Criteria

Inclusion Criteria

•Informed Consent signed by the subject;
•female and male patients between 18 and 90 years old;
•acute/subacute stroke (recruitment within 12 weeks from stroke onset);
•pre-stroke modified Rankin score ≤ 1;
•National Institutes of Health Stroke Scale (NIHSS) ≥ 1 in at least one of the items regarding motor functions, sensory functions and ataxia;
•possibility (e.g., enough space) to set up the ReHandyBot at home.

Exclusion Criteria

•modified Ashworth Scale \> 2 for one or more of the following muscles: shoulder adductors, forearm pronator and supinator, flexors and extensors of elbow, wrist and fingers;
•moderate to severe aphasia: Goodglass-Kaplan's scale \< 3;
•moderate to severe cognitive deficits: levels of cognitive functioning-revised (LCF-R) \< 9;
•functional impairment of the upper limb due to other pathologies;
•severe pain in the affected arm: visual analogue scale for pain (VASp) ≥ 5;
•other pathologies which may interfere with the study;
•pacemakers and other active implants;
•after discharge the patient will go to an assisted living facility (e.g., care home).

Outcomes

Primary Outcomes

Dose of unsupervised therapy - Minutes

Time Frame: This is measured during the intervention (i.e., during the six weeks of unsupervised therapy at home).

Daily dose in minutes of self-administered robot-assisted therapy performed by subjects in the home setting without supervision.

Dose of unsupervised therapy - Repetitions

Time Frame: This is measured during the intervention (i.e., during the six weeks of unsupervised therapy at home).

Daily dose in number of task repetitions of self-administered robot-assisted therapy performed by subjects in the home setting without supervision.

Dose of unsupervised therapy - Percentual change in therapy time

Time Frame: This is measured during the intervention (i.e., during the six weeks of unsupervised therapy at home).

Percentage increase in therapy time due to the unsupervised robotic therapy compared to the case where the participants would perform conventional (i.e., normally prescribed) therapy only.

Secondary Outcomes

Usability as assessed by the System Usability Scale (1)(This is measured during the intervention (at the end of the familiarization phase).)
Feasibility - Adverse events(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Feasibility - Device deficiencies(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Feasibility - Subjects performing unsupervised robot-assisted training(This is calculated on completion of the study (i.e., right after last subject - last visit).)
Feasibility - Attendance(This is calculated on completion of the study protocol.)
Usability as assessed by the System Usability Scale (2)(Usability is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
Usability as assessed by the raw NASA Task Load Index (1)(This is measured during the intervention (at the end of the familiarization phase).)
Usability as assessed by the raw NASA Task Load Index (2)(Usability is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
Usability as assessed by the Post-Study System Usability Questionnaire (1)(This is measured during the intervention (at the end of the familiarization phase).)
Usability as assessed by the Post-Study System Usability Questionnaire (2)(Usability is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
Evolution of patient's satisfaction with robot-assisted therapy as assessed by a 5-point scale(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Usability - Intrinsic Motivation Inventory (1)(This is measured during the intervention (at the end of the familiarization phase).)
Usability - Intrinsic Motivation Inventory (2)(User experience is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in usability metrics (i.e., System Usability Scale, NASA Task Load Index, Post-Study System Usability Questionnaire, and Intrinsic Motivation Inventory)(This is calculated at the end of the study (i.e., at the end of the six weeks of unsupervised therapy at home).)
User experience - Customer Satisfaction Score (1)(This is measured during the intervention (at the end of the familiarization phase).)
User experience - Customer Satisfaction Score (2)(User experience is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
User experience - Net Promoter Score (1)(This is measured during the intervention (at the end of the familiarization phase).)
User experience - Net Promoter Score (2)(User experience is measured again at the end of the study protocol (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in the user experience metrics (i.e., Customer Satisfaction Score and Net Promoter Score)(This is calculated at the end of the study (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in upper limb functions as assessed by the Fugl-Meyer Assessment of Upper Extremities (FMA-UE)(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in upper limb functions as assessed by the ABILHAND(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in upper limb functions as assessed by the Box and Block (BBT) test(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in upper limb functions as assessed by the Motor Evaluation Scale for Upper Extremities in Stroke Patients (MESUPES)(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in upper limb functions as assessed by the modified Ashworth Scale (mAS)(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in the active Range of Motion (aROM) for grasping measured in millimeters as assessed by the custom robotic assessment "aROM - Hand"(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in the active Range of Motion (aROM) for forearm rotation measured in degrees as assessed by the custom robotic assessment "aROM - Forearm"(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in proprioception as assessed by the custom robotic assessment "JND" measuring the minimum difference in length (mm) and/or angle (degrees) that a patient can perceive(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Change in haptic perception as assessed by the custom robotic assessment "Weber Fraction" measuring the minimum difference in stiffness that a patient can perceive in percentage(This is calculated at the end of the study, after performing the final measurements (i.e., at the end of the six weeks of unsupervised therapy at home).)
Content of robotic therapy - Intensity(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Content of robotic therapy - Performance(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Content of robotic therapy - Effective time ratio(This is monitored over the whole protocol duration (i.e., from beginning of the first week to the end of the six weeks of unsupervised therapy at home).)
Parameters influencing unsupervised robot-assisted therapy(This is calculated at the end of the study (i.e., at the end of the six weeks of unsupervised therapy at home).)