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Assessment of a Robotic Exoskeleton for Upper Limb Rehabilitation

Not Applicable
Recruiting
Conditions
Spinal Cord Injuries
Registration Number
NCT05615766
Lead Sponsor
University of Liverpool
Brief Summary

Rehabilitation robotics has the potential to facilitate rehabilitation at home and empower people with spinal injuries to self-manage increasing their independence and improving their quality of life.

The objective of this study is to assess for the first time in the NHS the efficacy of a commercial robotic orthosis for upper limb rehabilitation in patients with spinal cord injury. The device is produced by Myomo (myomo.com) which is an American company. We will be assessing the wearable robotic orthosis also known as robotic exoskeleton in two different neuro-rehabilitation centres: National Spinal injuries Unit in Glasgow (Scotland) and The Robert Jones and Agnus Hunt Orthopaedic Hospital in Oswestry (England). The study will involve nine spinal cord injured tetraplegic inpatients in total.

Patients will follow a twelve-week rehabilitation programme with three to four sessions per week in addition to their usual care and rehabilitation. Each session lasts for approximately 45 minutes. Participants arm function, range of motion, spasticity level will be measured before, half-way and at the end of the programme to assess change in these and other parameters. Training will focus on the dominant arm of the patient and compared to the other arm at every assessment stage.

We shall evaluate therapists' and patients' satisfaction with the commercial device in addition to assessing various clinical measures to evaluate the efficacy of using the robotic orthosis in rehabilitation and recovery of arm function.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
9
Inclusion Criteria
  • Age 18+ years.
  • The levels of C5 C6 Asia C/D would provide individuals with elbow and hand impairment and potentially functional shoulder movements. C7, C8 individuals could also benefit from the hand component of the device.
  • Some gross shoulder movement at start of the trial to enable changes at the elbow/hand, to have the greatest potential for functional change.
  • Preservation of hand sensation as base for motor restoration.
  • Some sitting balance would give the best opportunity for the arm to be released for functional upper limb activity.
  • EMG (muscle activity) evidence of active finger flexion, extension and elbow flexion extension Grade 1-2.
  • Minimal or No community functional use of upper limb at start of trial.
  • Spasticity MAS 1-3/5.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Spinal Cord Independence Measure version III (SCIM III)Change from baseline (week 1) at 12 weeks

assesses performance in activities of daily living and mobility for individuals with spinal cord injury

Secondary Outcome Measures
NameTimeMethod
Canadian Occupational Performance Measure (COPM)Change from baseline (week 1) at 6 weeks and 12 weeks

COPM assesses the patient's perceived occupational performance in the areas of selfcare, productivity, and leisure

The Graded Redefined Assessment of Strength, Sensation and Prehension (GRASSP).Change from baseline (week 1) at 6 weeks and 12 weeks

The GRASSP is a clinical impairment measure for the upper limb for use after tetraplegia. The measure includes three domains which are important in describing hand function.

The modified Ashworth scaleChange from baseline (week 1) at 6 weeks and 12 weeks

Ashworth scale is the most universally accepted clinical spasticity assessment tool used to measure the increase of muscle tone.

Range of MotionChange from baseline (week 1) at 6 weeks and 12 weeks

to assess the capability of a joint to go through its complete spectrum of movements

Trial Locations

Locations (2)

Royal National Orthopaedic Hospital (Stanmore)

🇬🇧

London, United Kingdom

The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust

🇬🇧

Oswestry, United Kingdom

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