Stroke Clinical Trial
— VIBRAROBOTOfficial title:
EFFECTIVENESS OF INTENSIVE TREATMENT WITH ROBOTIC PLUS VIBRATION TO SENSITIVITY AND FUNCTIONALITY REHABILITATION IN STROKE PATIENTS
The Amadeo® Manual Robotic System (Tyromotion GmbH, Graz, Austria) is designed for rehabilitative treatment of the hand and fingers providing robot-assisted exercise for the finger flexors and extensors. This system has a controlled position, active, active-assisted and passive exercise mode, it also allows isometric exercises with visual feedback provided during computerized games that emphasize flexion and extension. Another of the functions that this device presents and that differentiates it from other handheld robotic systems is its vibration function. Through sensors that are placed on the fingertips, providing a vibratory proprioceptive stimulus of different frequencies. Currently, there are no published trials on the efficacy of the vibration of this device and its consequent improvement in the sensitivity and functionality of patients with hemiparesis after stroke. Investigations have been conducted in patients with peripheral lesions and in the healthy population. A preliminary study with monkeys demonstrated that the frequency of the vibration presents better results when the muscle stretch receptors are driven by a high frequency vibration, activating the neurons corresponding to the motor cortex and in the 3rd primary sensory area. More recent studies have shown the efficacy of focal vibratory stimulation applied to the wrist and forearm muscles, specifically the application to the tendon of the stimulated muscle. Regarding the most appropriate form of stimulation, the most important determining factors to highlight are the frequency of application, the duration and intensity and the time of application. The mechanism of action of local muscle vibration is to stimulate various receptors. Meissner corpuscles respond best around 40 Hz, while Vater-Pacini corpuscles around 100 Hz. Together, they are also known as rapidly adapting cutaneous receptors. In contrast, Merkel-Ranvier cells and Ruffini corpuscles are called slow-adapting and classically described as sensitive to sustained pressure. That is why authors of different studies have focused on high frequency vibration of 300 Hz, for 30 minutes. 3 times per week. The duration of vibratory stimulation, different studies show the effects of vibration and changes in the cortex after performing the treatment constantly, for about ten days, intensively three to four days a week, observing long-term changes in terms on cortical excitability.
Status | Not yet recruiting |
Enrollment | 40 |
Est. completion date | June 15, 2021 |
Est. primary completion date | May 15, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility | Inclusion Criteria: - Age: people aged between 30 and 80 years. - Diagnosis: stroke in the right hemisphere. - Right-handed. - Present hemiparesis or left hemiplegia with paralysis / paresis in his affected hand. - People with sensitivity alterations as a result of stroke. - Evolution: subacute patients (from three months to one year, and who at the same time meet the subacute criteria of the IMSERSO document of the model of care for people with brain damage, as well as chronic patients (after one year, and who meet the chronicity criteria of the IMSERSO document of the model of care for people with brain damage). - People without other concomitant pathologies that affect mobility and / or sensitivity - The acceptance and signing of the informed consent by the user. - Present a score equal to or greater than 24 points in the Mini-Mntal State Examination (MMSE). - Patients can be admitted or outpatient as long as they meet the above criteria and belong to the advanced neurorehabilitation unit. Exclusion Criteria: - Patients with Aphasia and / or Apraxia. - Patients with serious difficulties in communication. - Patients who do not present limitation of mobility and / or sensitivity. - Other concomitant diseases. - Diagnosis: left or posterior hemisphere stroke. - Scores less than 24 points on the MMSE. - Age over 80 years and under 30 years. - The non-acceptance and signing of the informed consent by the subject. - Evolution: acute patients less than three months of evolution. |
Country | Name | City | State |
---|---|---|---|
Spain | Universidad Rey Juan Carlos | Alcorcón | Madrid |
Lead Sponsor | Collaborator |
---|---|
Universidad Rey Juan Carlos |
Spain,
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Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change from Fugl Meyer Assessment scale for the upper limb (change): Pre-treatment | Motor Function | Pre-treatment | |
Primary | Change from Fugl Meyer Assessment scale for the upper limb at 1,5 months (change): Post-treatment period | Motor Function | Post-treatment (1,5 months) | |
Secondary | Semmes-Weinstein ® monofilaments for sensitivity assessment | Sensitivity. 0: no sensitivity. 1: alteration sensitivity. 2: normal. Higher scores mean a better outcome | One month and a half | |
Secondary | Motor Activity Log | Functionality. MAL scale is scored on six points, ranging from zero (never used) to five (the same as pre-stroke), and participants may select halfway scores, such as 1.5. Before its administration, the differences between the AOU and QOM scales were explained in detail and, during the test administration, these differences were emphasized at regular intervals. Higher scores mean a better outcome | One month and a half | |
Secondary | Stroke Impacte Scale. | Quality of life. The SIS version 3.0 includes 59 items and assesses 8 domains:
Strength - 4 items Hand function - 5 items ADL/IADL - 10 items Mobility - 9 items Communication - 7 items Emotion - 9 items Memory and thinking - 7 items Participation/Role function - 8 items An extra question on stroke recovery asks that the client rate on a scale from 0 - 100 how much the client feels that he/she has recovered from his/her stroke. Higher scores mean a better outcome |
One month and a half | |
Secondary | Questionnaire of satisfaction with technology | Satisfaction. Likert scale related to satisfaction. Total: 50 points. Higher scores mean a better outcome | One month and a half |
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