Multiple Sclerosis Clinical Trial
Official title:
Effect of a Training Regime Featuring the I-TRAVLE System on Arm Function and Skill Performance in Persons With Multiple Sclerosis and Chronic Stroke Patients: a Single Arm Trial
Rationale: Approx. 80% of acute stroke patients suffer from acute hemiparesis. Stroke
patients have not reached their full potential when they are discharged from hospital. It is
proven that extra training opportunities lead to further improvement. To date, new training
possibilities, such as robotic techniques for rehabilitation, virtual reality training
systems and tele-rehabilitation are being developed to aid in the training of stroke
patients.
Objective: To obtain preliminary evidence on the efficacy of an individualised, intensive
6-week technology-assisted training regime, featuring a robotics-based self-adapting arm
training system (I-TRAVLE) in a virtual context, focussed on improvement of arm function and
arm skill performance in chronic stroke patients with low to moderate proximal
(shoulder/arm) muscle strength.
Study design: single arm prospective cohort study. Study population: 16 stroke patients in
the chronic phase after their stroke, aged >=18, diagnosed with a central paresis of the
arm, having low to moderate proximal (shoulder and arm) muscle strength.
Intervention (if applicable): Haptic feedback of the I-TRAVLE robot either supports or
challenges the patient to perform movements of the arm, thereby training motor control and
co-ordination of the affected arm. Also strength and endurance of arm muscle use may be
trained. The I-TRAVLE based training will last 6 weeks. Each week participants will attend
training sessions on 3 days, during which they will train 2x 30 minutes, interspaced by at
least half an hour to avoid (general) fatigue and overuse.
Main study parameters/endpoints: Baseline measurements will be performed 3x prior to the
start of the intervention, each interspaced by 1 week to assess baseline stability or any
fluctuations in baseline values. In these chronic stroke patients spontaneous improvement is
not expected. Also measurements will be performed at 0 weeks and at 12 weeks post training.
Primary outcome measures: Wolf Motor Function Test, ABILHAND, and Goal Attainment Scaling.
Secondary outcome measures are: motricity index, plate tapping task, active range of motion,
perceived strength and fatigue.
All tests and exercises are pain free, easy to perform, non-intrusive, and not high demanding. Subjects will have to undergo an assessment via a movement protocol as well as clinical outcome tests. In both cases the type of assessment does not differ from the normal assessment at a rehabilitation centre. The training is assisted using a robotic device called the Haptic Master (HM). The participant's arm is attached to the HM via a gimbal. The HM has a number of safety features to avoid overload on the participant's arm. Any potential risk for overload is minimised by a) careful build-up of the training regime; b) regular check-ups; and c) checking the participant's status prior to the next training session. ;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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