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StrokeTELEREHABNCT05250934

Robotic Telerehabilitation of the Upper Limb in Stroke

A study testing Robotic rehabilitation in people with Stroke, run by Fondazione Don Carlo Gnocchi ETS at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of the study is to investigate the feasibility and the effects of a home-based upper-limb rehabilitation treatment (based on teleconsulting, telemonitoring, and robotic telerehabilitation using the robot Icone and integrated sensors) in patients with stroke. Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Stroke
What is being tested?
Robotic rehabilitation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteItaly
Study dates
12 May 2021to 8 Aug 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ischemic or hemorrhagic stroke (verified by MRI or CT);
  • time since stroke onset > 3 months
  • cognitive abilities adequate to understand the experiments and the follow instructions
  • upper limb impairment (Fugl-Meyer Assessment - upper extremity score ≤58);
  • presence of a caregiver to supervise the treatment

Who cannot join

  • fixed contractions in the affected limb (ankylosis, Modified Ashworth Scale equal to 4);
  • inability to understand the instructions required for the study;
  • behavioral disorders that may influence therapeutic activity;
  • other orthopedic or neurological diseases
  • inability or unwillingness to provide informed consent.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Fondazione Don Carlo Gnocchi, Santa Maria della Provvidenza Center

    Rome, 00168

Other trials in Italy

About this study

Official title: Robotic Telerehabilitation: Feasibility of a Robotic Treatment of the Upper Limb With Remote Supervision in Patients With Stroke

The goal of the study is to investigate the feasibility and the effects of a home-based upper-limb rehabilitation treatment (based on teleconsulting, telemonitoring, and robotic telerehabilitation using the robot Icone and integrated sensors) in patients with stroke.

Read the detailed description

Stroke is the second leading cause of death, the third leading cause of disability in the world and the leading cause of disability in the elderly. Rehabilitation treatment is a long and costly process, the effectiveness of which is supported by strong scientific evidence. In recent years, technology has spread to the rehabilitation field and, to date, the use of rehabilitation robotics, in addition to conventional treatment, is recommended by some stroke guidelines. The coronavirus pandemic has required a reorganization of rehabilitation services, but also an enhancement of technology as a tool in the rehabilitation field that can allow treatment in compliance with social distancing. Many scientific works have in fact confirmed the usefulness of these approaches to overcome the limits imposed by the pandemic, in particular for the treatment of disabilities in stroke patients.

The rehabilitation robot Icone (CE marked medical device, Class II-A, produced by Heaxel), is a device with certification for home use and therefore suitable for telerehabilitation. The proposed study aims to test the feasibility of rehabilitation treatment in a home setting based on a system of telecounseling, telemonitoring and robotic telerehabilitation using the robot Icone and integrated sensors for patients with stroke, to overcome the limits imposed by the COVID-19 pandemic.

Patients undergo robotic telerehabilitation treatment, carried out at home. The patient is supervised by a caregiver and, remotely, by a multidisciplinary team thanks to the use of webcams and sensors embedded in the robot. The evaluations, through clinical scales and instrumental evaluations, are carried out both in presence (at the enrollment and the end of the study) and remotely (before the first telerobotic rehabilitation session, in the middle and after the last telerobotic rehabilitation session). The study is included in the Regional Smart Specialization Strategy (S3 - Biorobotics for rehabilitation) for business \& life continuity and co-financed by the European Union through LazioInnova

Conditions
Stroke
Being tested
Robotic rehabilitation
Keywords
Robotic rehabilitation, Telerehabilitation, Upper extremity
Medical subject headings
Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Robotic rehabilitationDevice

    Also called Icone (Heaxel)

    The upper limb rehabilitation will be carried out with the planar rehabilitation robot Icone (a CE Class IIA medical device manufactured by Heaxel). The proposed exercises require the patient to move a cursor on the screen using the end-effector of the robot to reach specific points (planar reaching exercises). When the patient is able to perform these exercises independently, the robot assists the movement by minimizing the interaction force applied to the hand and limiting itself to acquiring the kinematic and dynamic parameters of the exercise, which are useful in determining the state of motor skills. Icone assist the subject by applying a force to his hand that helps him complete the task in the phases where the patient plans the movement correctly but is unable to complete it. As a result, the system will enable you to perform planar elbow and shoulder movements in active, passive, or active-assisted modes, with visual and acoustic feedback.

Study groups in NCT05250934
Study groupRoleWhat they receive
Robotic groupExperimentalIn the robotic group, each patient undergoes 20 upper limb robotic telerehabilitation sessions, each session lasting 1 hour. The frequency is 5 sessions/week. Each session is performed at the patient's home, with direct supervision of a caregiver and remote supervision of a physical therapist, using three webcams able to show (a) the frontal and (b) the sagittal plane of the patient, as well as (c) the monitor of the robot.
Receives: Device: Robotic rehabilitation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in Fugl-meyer Assessment Upper Extremity motor functioning

    It is a stroke-specific, performance-based impairment index. It ranges from 0 (hemiplegia) to 66 points (normal).

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  2. Reliability of the remote evaluation of the Fugl-meyer Assessment Upper Extremity motor functioning (FMA)

    The value of the FMA obtained by means of online observation of the patient will be assessed in terms of reliability with the value obtained by means of direct observation, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  3. System Usability Scale

    It is a self-administered questionnaire to evaluate usability. It ranges from 0 to 100. Higher scores mean better usability.

    Measured: After a 4-week robotic rehabilitation intervention

  4. Technology Acceptance Model (TAM)

    It is a self-administered questionnaire to evaluate the acceptance of the provided intervention. It comprises several questions rated on a 7-point likert scale.

    Measured: After a 4-week robotic rehabilitation intervention

  5. Likert for Satisfaction

    Satisfaction will be assessed using a 11-point likert scale. It ranges from 0 to 10. Higher scores mean higher satisfaction.

    Measured: After a 4-week robotic rehabilitation intervention

Secondary outcomes (32)
  1. Changes in Fugl-meyer Assessment Upper Extremity motor functioning

    t is a stroke-specific, performance-based impairment index. It ranges from 0 (hemiplegia) to 66 points (normal).

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  2. Changes in Fugl-meyer Assessment - Sensory functioning

    It is a stroke-specific, sensory impairment index. It ranges from 0 (worse) to 12 points (best).

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  3. Changes in Fugl-meyer Assessment - Sensory functioning

    It is a stroke-specific, sensory impairment index. It ranges from 0 (worse) to 12 points (best).

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  4. Changes in Numeric Rating Scale for pain

    The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale, from 0 (no pain) to 10 (worst pain imaginable).

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  5. Changes in Numeric Rating Scale for pain

    The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale, from 0 (no pain) to 10 (worst pain imaginable).

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  6. Changes in the Independence Index

    It is a kinematic index computed by means of the robotic device. It represent the ratio between the minor and major axes of the ellipse best fitting the hand path in Cartesian coordinates during a circle drawing task.

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  7. Changes in the Independence Index

    It is a kinematic index computed by means of the robotic device. It represent the ratio between the minor and major axes of the ellipse best fitting the hand path in Cartesian coordinates during a circle drawing task.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  8. Changes in the Area Index [m2]

    It is a kinematic index computed by means of the robotic device. It represent the area of the ellipse best fitting the hand path in Cartesian coordinates during a circle drawing task.

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  9. Changes in the Area Index [m2]

    It is a kinematic index computed by means of the robotic device. It represent the area of the ellipse best fitting the hand path in Cartesian coordinates during a circle drawing task.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  10. Changes in the Path Index [mm]

    It is a kinematic index computed by means of the robotic device. It represents the mean distance of the travelled path from the ideal path during a point-to-point (reaching) task

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  11. Changes in the Path Index [mm]

    It is a kinematic index computed by means of the robotic device. It represents the mean distance of the travelled path from the ideal path during a point-to-point (reaching) task

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  12. Changes in the Movement Duration index [t]

    It is a kinematic index computed by means of the robotic device. It represents the mean time required to perform a movement during a point-to-point (reaching) task

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  13. Changes in the Movement Duration index [t]

    It is a kinematic index computed by means of the robotic device. It represents the mean time required to perform a movement during a point-to-point (reaching) task

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  14. Changes in the Peak speed index [m/s]

    It is a kinematic index computed by means of the robotic device. It represents the maximum value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  15. Changes in the Peak speed index [m/s]

    It is a kinematic index computed by means of the robotic device. It represents the maximum value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  16. Changes in the Mean speed index [m/s]

    It is a kinematic index computed by means of the robotic device. It represents the mean value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  17. Changes in the Mean speed index [m/s]

    It is a kinematic index computed by means of the robotic device. It represents the mean value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  18. Changes in the Smoothness index

    It is a kinematic index computed by means of the robotic device. It represents the ratio between the mean and the maximum value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  19. Changes in the Smoothness index

    It is a kinematic index computed by means of the robotic device. It represents the ratio between the mean and the maximum value of the speed during a point-to-point (reaching) task

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  20. Changes in the Hold index [m]

    It is a kinetic index computed by means of the robotic device. It represents the mean value of the displacement of the end-effector of the robot when the patient is required to hold it in the middle of the workspace against centrifugal forces aimed to move the end-effector toward the targets. It decreases when the patient's strength increases.

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  21. Changes in the Hold index [m]

    It is a kinetic index computed by means of the robotic device. It represents the mean value of the displacement of the end-effector of the robot when the patient is required to hold it in the middle of the workspace against centrifugal forces aimed to move the end-effector toward the targets. It decreases when the patient's strength increases.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  22. Changes in the Displacement index [m]

    It is a kinetic index computed by means of the robotic device. It represents the mean value of the displacement of the end-effector of the robot when the patient is required to move it toward the eight targets against a centripetal force that try to hold it in the middle of the workspace.

    It increases when the patient's strength increases.

    Measured: Before the intervention, after a 2-week robotic rehabilitation intervention

  23. Changes in the Displacement index [m]

    It is a kinetic index computed by means of the robotic device. It represents the mean value of the displacement of the end-effector of the robot when the patient is required to move it toward the eight targets against a centripetal force that try to hold it in the middle of the workspace.

    It increases when the patient's strength increases.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  24. Reliability of the remote evaluation of the Independence Index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  25. Reliability of the remote evaluation of the Area Index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  26. Reliability of the remote evaluation of the Path Index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  27. Reliability of the remote evaluation of the Movement Duration index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention, after a 4-week robotic rehabilitation intervention

  28. Reliability of the remote evaluation of the Smoothness index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  29. Reliability of the remote evaluation of the Peak speed index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  30. Reliability of the remote evaluation of the Mean speed index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  31. Reliability of the remote evaluation of the Hold index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.

    Measured: Before the intervention

  32. Reliability of the remote evaluation of the Displacement index

    The reliability of the index obtained by the patient using the robot at home will be assessed in terms of reliability with the value obtained by the patient using the robot in the clinic, using the Intraclass Correlation Coefficient.It increases when the patient's strength increases.

    Measured: Before the intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Feb 2022
  2. Study start12 May 2021
  3. Primary completion8 Aug 2021
  4. Study completion8 Aug 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05250934
Sponsor's protocol ID
FDG-Telerehab2021
Acronym
TELEREHAB
Status last verified
Oct 2024
First submitted
11 Feb 2022
Last updated
15 Oct 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Germanotta M, Mauro MC, Falchini F, Scotto Di Luzio F, Vollero L, Zollo L, Aprile IG. A robotic rehabilitation intervention in a home setting during the Covid-19 outbreak: a feasibility pilot study in patients with stroke. J Neuroeng Rehabil. 2025 Apr 24;22(1):93. doi: 10.1186/s12984-025-01633-9.

    PubMed 40269913

Questions about this trial

What is this clinical trial studying?

A study testing Robotic rehabilitation in people with Stroke, run by Fondazione Don Carlo Gnocchi ETS at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in Fugl-meyer Assessment Upper Extremity motor functioning (time frame: Before the intervention, after a 4-week robotic rehabilitation intervention). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05250934, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2024.

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