Functional Recovery in Stroke Patients With Task-Specific Robot-Aided Arm Therapy
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Purpose
The goal of this study is to determine whether task-oriented, robot-aided therapy is more effective than conventional physical and occupational therapy at promoting functional recovery of the affected arm in chronic hemiparetic stroke patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Stroke Upper Extremity Paresis |
Device: robot therapy (ARMin) Other: conventional therapy |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Functional Recovery in Stroke Patients With Task-Specific Robot-Aided Arm Therapy |
- Fugl Meyer Assessment Scale [ Time Frame: four and one weeks prior to intervention, four weeks after intervention started, at the end of intervention(eight weeks), two months and six months follow-up ] [ Designated as safety issue: No ]
- Wolf Motor Function Test, Stroke Impact Scale, Motor Activity Log, modified Ashworth Scale, abnormal joint synergies, active range of motion (ROM), muscle strength, and spatial precision of hand positioning. [ Time Frame: three and one weeks prior to intervention, four weeks after intervention started, at the end of intervention(eight weeks), two months and six months follow-up ] [ Designated as safety issue: No ]
- fMRI [ Time Frame: before and after 8 weeks therapy, 2-months follow-up ] [ Designated as safety issue: No ]in 20 Patients fMRI will be recorded while patients interact with an MR-compatible manipulandum
| Enrollment: | 76 |
| Study Start Date: | July 2008 |
| Study Completion Date: | September 2012 |
| Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Device: robot therapy (ARMin)
therapy of the affected arm with a robot for eight weeks, three times weekly for one hour
|
| Active Comparator: 2 |
Other: conventional therapy
physical and occupational therapy of the affected arm for eight weeks, three times weekly for one hour
|
Detailed Description:
Robotic therapy will be performed with ARMin, which is a robotic arm exoskeleton that permits 3D movements of both proximal and distal arm joints. Combined with an audiovisual display, this device allows virtual training of Activities of Daily Living (ADL) and therapeutic gaming. A patient-responsive controller enables the assistance of the device only as needed. Chronic stroke patients (>6 months post stroke) will be randomly assigned to either an experimental or a control group. The experimental group will perform task-related intensive therapy with the support of ARMin. Therapists will treat the patients of the control group with standard motor relearning therapy.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age 18 or more
- first-ever stroke (hemorrhagic or ischemic), verified by brain imaging
- stroke more than six months prior to the study
- termination of conventional therapy and stable recovery stage (outpatients)
- moderate to severe motor impairment of the arm (upper limb portion of FMA score between 8 and 38)
- ability to sit in a chair without any additional support and without leaning on the back rest
- written informed consent signed by the subject (or an authorized representative)
Exclusion Criteria:
- Excessive spasticity of the affected arm (mAS ≥ 3)
- any serious medical or psychiatric illness
- participation in any clinical investigation within 4 weeks prior to the start of this study
- anticipated need for any major surgery during the study
- women known to be pregnant or lactating
- Orthopedic, rheumatologic or other disease restricting movements of the paralyzed upper extremity
- shoulder subluxation (palpatory > 2 fingers)
- diseased or damaged skin at the paralyzed arm
- inability to communicate effectively with the neurological examiner such that the validity of the patient's data could be compromised
- cyber sickness
- pace-maker or other implanted electric devices
- body weight > 120kg
- serious cognitive deficits and aphasia preventing the performance of the ARMin treatment
- participation in any therapeutic treatment ("outside therapy") performed with the paralyzed arm during the planned study - including baseline and follow up.
Contacts and Locations| Switzerland | |
| University Hospital Balgrist | |
| Zürich, ZH, Switzerland, 8008 | |
| Study Director: | Robert Riener, Prof. | Sensory Motor Systems Lab, ETH Zürich |
| Principal Investigator: | Armin Curt, Prof. | Uniklinik Balgrist |
More Information
Additional Information:
Publications:
| Responsible Party: | University of Zurich |
| ClinicalTrials.gov Identifier: | NCT00719433 History of Changes |
| Other Study ID Numbers: | SNF ARMin III -1, SNF 325200-120621, EK-39/2007 |
| Study First Received: | July 17, 2008 |
| Last Updated: | April 19, 2013 |
| Health Authority: | Switzerland: Ethikkommission |
Keywords provided by University of Zurich:
|
stroke chronic rehabilitation robot therapy arm therapy |
Additional relevant MeSH terms:
|
Paresis Stroke Cerebral Infarction Neurologic Manifestations Nervous System Diseases Signs and Symptoms Cerebrovascular Disorders |
Brain Diseases Central Nervous System Diseases Vascular Diseases Cardiovascular Diseases Brain Infarction Brain Ischemia |
ClinicalTrials.gov processed this record on May 16, 2013