MedPath

Towards Understanding Upper Limb Rehabilitation After Stroke

Completed
Conditions
Stroke
Registration Number
NCT04721561
Lead Sponsor
KU Leuven
Brief Summary

After a stroke, more than two out of three patients experience problems with upper limb movement and sensation. During the past decade, robotic technology has been increasingly used to asses these problems in a detailed and accurate manner. However, sensory processing, one of the most important sensory functions, has not been assessed using robotic technology yet. Therefore, the investigators have developed a robotic assessment of sensory processing. During this study, the investigators aim to initially validate this novel assessment. The investigators aim to examine 20 chronic stroke patients and 20 age-matched healthy controls using the robotic assessment on one hand, and a set of existing clinical assessments on the other hand. The investigators hypothesize that stroke patients will have a poorer performance on this novel robotic assessment compared to age-matched healthy controls, and that these findings are similar to what is found with existing clinical assessments.

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. It is therefore of utmost importance to accurately assess upper limb impairments. Clinical assessments exist for both motor and somatosensory function, but lack good psychometric properties. Robotic technology show promising potential and is readily available to assess motor function and proprioception. Robotic assessment for sensory processing is currently not yet available, despite being the most relevant somatosensory function. Indeed, sensory processing shows the strongest association with upper limb movement, and only shows incomplete recovery at 6 months after stroke.

The investigators recently developed a novel robotic assessment of sensory processing, using the Kinarm End-Point Lab (BKIN Technologies Ltd., Canada). This cross-sectional study was set up to initially validate this novel robotic assessment and to collect pilot data to form the basis for future research. 20 chronic stroke patients and 20 age-matched controls will be recruited and will undergo extensive clinical and robotic assessment of upper limb motor and somatosensory function. The investigators hypothesize stoke patients with sensory processing deficits to have a worse performance on this novel robotic assessment compared to healthy controls and patients without sensory processing deficits. The investigators also hypothesize to see moderate to high correlations between the robotic assessment of sensory processing, and clinical assessments for both somatosensory and motor function.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Kinarm: sensory processing taskOnce in the chronic phase (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: position matching taskOnce in the chronic phase (at least 6 months after stroke)

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

Erasmus modified Nottingham sensory assessmentOnce in the chronic phase (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

Tactile discrimination testOnce in the chronic phase (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 testOnce in the chronic phase (at least 6 months after stroke)

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

Kinarm: visually guided reachingOnce in the chronic phase (at least 6 months after stroke)

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

Perceptual threshold of touchOnce in the chronic phase (at least 6 months after stroke)

TENS-based assessment of exteroception on a continuous scale, with lower scores meaning better performance

Tactile functional object recognitionOnce in the chronic phase (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

Stereognosis section of the original Nottingham sensory assessmentOnce in the chronic phase (at least 6 months after stroke)

Clinical assessment of sensory processing on an ordinal scale ranging from 0 to 22, with higher scores meaning better performance

Wrist position sense testOnce in the chronic phase (at least 6 months after stroke)

Clinical assessment of wrist position sense on a continuous scale, with lower scores meaning better performance

Fugl-Meyer upper extremity assessmentOnce in the chronic phase (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

Barthel indexOnce in the chronic phase (at least 6 months after stroke)

Clinical assessment of activities of daily living on an ordinal scale ranging from 0 to 20, with higher scores meaning better performance

Montreal cognitive assessmentOnce in the chronic phase (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

Star cancellation testOnce in the chronic phase (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

Trial Locations

Locations (1)

KU Leuven

🇧🇪

Leuven, Belgium

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