Clinical Trials Logo

Clinical Trial Summary

Even in a chronic phase after stroke, most patients have difficulty moving the affected arm, resulting in limitations in simple tasks in daily living, most frequently limiting reaching task. In the chronic phase, significant improvements are usually no longer observed. Nevertheless, even these patients can still improve their functional abilities due to exercise-dependent plasticity. A new device was developed, the deXtreme robot, a rehabilitation device that offers error-enhancement approach during three-dimensional movements. The goal error-enhancement is to elicit better accuracy, stability, fluidity and range of motion during reaching. games are projected on a screen, requiring 3D active reaching movements. The duration of the study for a single participant will be 7 consecutive working days, including 1 day of pre-intervention assessment, 5 days of training and 1 day of post-intervention assessment. The overall aim of this project is to gain knowledge into the potential of error-enhancement robot training in patients with upper limb impairments in the chronic phase after stroke. Hypothesizing that the 5-day training will have a positive effect on both the robotic and clinical outcome measures.


Clinical Trial Description

The overall aim of this study is to gain knowledge into the potential of error-enhancement robot training in patients with upper limb impairments in the chronic phase after stroke. Error-enhancement is characterized as unexpected external perturbation forces acting upon the upper limb during a reaching movement, causing the upper limb to deflect from the reaching pathway, and this results in errors. If one allows for repetitive reaching performance with the same systematic perturbation forces, then a decrease in errors and improvement in movement performance is expected. The robot used for the training, the DeXtreme, is a CE marked rehabilitation device that offers this error-enhancement approach during three-dimensional movements. The pilot study has a pre-post intervention design, recruiting 20 patients in the chronic phase after stroke. Error-enhancement treatment will be provided on day 2 to 6, i.e., for 5 consecutive days and will consist of facilitation of accuracy, range of movement, stability, and smoothness. Algorithms provide progression in terms of accuracy, range of movement, stability and smoothness, depending upon the performance of the patient. The treatment will start with the installation of the patient and a warming up, followed by a first block of DeXtreme training. Then a short break is given followed by a short conventional therapy session. The content of the conventional therapy will involve active relaxation, focusing on stretching and (auto-)mobilisation. Afterwards, a second block of training with the DeXtreme follows, and it finishes with a cooling down. A therapist trained by the company will provide all assessment and training sessions. Training with the DeXtreme is additional to the conventional therapy the patient receives. Therefore, a diary of their conventional therapy sessions will be kept, and the content will be reviewed with the patient. Advancements in upper limb motor function and activity will be evaluated through a triad of measurements including clinical and patient-reported outcomes, error-enhancement variables, and objective quantification of uni- and bimanual sensorimotor function by making use of the KINARM robotic manipulandum. These tests and questionnaires are administered on day 1 and day 7. The aim of the study is to investigate whether patients with upper limb impairments in a chronic phase after stroke clinical and meaningful benefits from 5 hours DeXtreme training. In addition, it is examined whether improvements in the upper limb outcome is the result of restitution or compensation in the upper limb function. In order to evaluate whether a randomized controlled trial is useful, the investigators will analyse the outcomes of our study twofold. (1) At group level, the investigators will calculate mean and standard deviation or median and interquartile range (based on whether data is normally distributed or not) and evaluate whether pre- to post-intervention scores for clinical, deXtreme and objective outcomes are significantly improved by means of Wilcoxon signed rank test (nonparametric), at a 0,05 significance level. Each p-value will be interpreted in a descriptive manner. (2) At patient level, the investigators will evaluate how many patients (%) achieve a clinically significant improvement based on the therapy provided. To see if the improvement might be explained by restitution or compensation, the association between the scores of the MAL-14 and the visually guided reaching task of the KINARM will be explored by Spearman correlations. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05229185
Study type Interventional
Source Universitaire Ziekenhuizen KU Leuven
Contact
Status Completed
Phase Early Phase 1
Start date January 25, 2022
Completion date November 23, 2022

See also
  Status Clinical Trial Phase
Completed NCT03780296 - Implementing Technology Enhanced Real Time Action Observation Therapy in Persons With Chronic Stroke N/A
Not yet recruiting NCT06057584 - Effect of Somatosensory Motor Intergration Training on Post-stroke Upper Limb Function. N/A
Completed NCT03228264 - A Trial Investigating Telerehabilitation as an add-on to Face-to-face Speech and Language Therapy in Post-stroke Aphasia. N/A
Completed NCT03531567 - Game-Based Home Exercise Programs in Chronic Stroke: A Feasibility Study N/A
Completed NCT02364232 - Effects of Home-based vs. Clinic-based Rehabilitation on Sensorimotor, Cognition, Daily Function, and Participation N/A
Completed NCT04121754 - Post-Stroke Walking Speed and Community Ambulation Conversion Study N/A
Completed NCT04574687 - Effects of Action Observation Therapy on Fine Motor Skills of Upper Limb Functions in Chronic Stroke Patients. N/A
Recruiting NCT04974840 - Thera-band Resisted Treadmill Training for Chronic Stroke Patients N/A
Recruiting NCT04534556 - Wireless Nerve Stimulation Device To Enhance Recovery After Stroke N/A
Completed NCT04553198 - Quantifying the Role of Sensory Systems Processing in Post-Stroke Walking Recovery N/A
Completed NCT04226417 - Effect of Home Based Transcranial Direct Current Stimulation (tDCS) With Exercise on Upper and Lower Limb Motor Functions in Chronic Stroke N/A
Recruiting NCT06049849 - Can Patients With Chronic Stroke Regain Living Independence by Daily Energizing With Biophoton Generators N/A
Active, not recruiting NCT02881736 - Proprioceptive Deficits and Anomalies in Movement-error Processing in Chronic Stroke Patients N/A
Completed NCT03208634 - Rehabilitation Multi Sensory Room for Robot Assisted Functional Movements in Upper-limb Rehabilitation in Chronic Stroke N/A
Completed NCT05183100 - Effects of Neurodynamics on Lower Extremity Spasticity - a Study in Chronic Stroke N/A
Completed NCT03326349 - Home-based Computerized Cognitive Rehabilitation in Chronic Stage Stroke N/A
Recruiting NCT04721860 - Optimizing Training in Severe Post-Stroke Walking Impairment N/A
Recruiting NCT06051539 - Outcomes and Health Economics of Stroke Using Rhythmic Auditory Stimulation N/A
Not yet recruiting NCT06060470 - Active Balance and Cardio Care Intervention on Physical and Cardiovascular Health in People With Chronic Stroke N/A
Recruiting NCT05591196 - Hand and Arm Motor Recovery Via Non-invasive Electrical Spinal Cord Stimulation After Stroke N/A