AzTrials
AzTrials

StrokeNeuroExoNCT05374486

EEG Brain-Machine Interface Control of an Upper-Limb Robotic Exoskeleton for Robot-Assisted Rehabilitation After Stroke

A study testing NeuroExo co-robot neurorehabilitation system in people with Stroke and Hemiparesis, run by University of Houston at 3 sites in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

The goal of this study is to develop a clinically feasible, low-cost, nonsurgical neurorobotic system for restoring function to motor-impaired stroke survivors that can be used at the clinic or at home. Read more about this study

Who is it for?
Ages 20 to 65 years
Conditions the study is for
Stroke, Hemiparesis
What is being tested?
NeuroExo co-robot neurorehabilitation system
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
3 sitesUnited States
Study dates
25 Apr 2022to Aug 2022
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 20 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • subjects between the ages of 20-65, male or female,
  • mild-to- moderate unilateral stroke confirmed by brain CT or MRI scan and manifested by a Glasgow Coma scale (GCS) score between 15 and 9 documented within 6 months,
  • the ability to perform 20deg of active wrist/elbow for upper limb robotic movement on the affected side, no planned alteration in lower/upper- extremity therapy/medication for muscle tone during course of study,
  • Anticipated length of needed acute interdisciplinary rehabilitation of 30 days or more.
  • Patients are required to have a MMSE>=24 to rule out those with cognitive impairments.
  • Patients will have to have normal/near normal strength in one upper/lower extremity and appreciable weakness in the other upper/lower extremity.

Who cannot join

  • history of traumatic brain injury prior to the current episode,
  • Severe neurologic or psychiatric condition preventing participation in rehabilitation and physical therapy activities (patients unable or unwilling to receive instruction and effectively complete a simple assigned task as determined by MMSE>=24 specified in inclusion criteria).
  • Women and minorities will be recruited as long as they meet the inclusion criteria.

Trial locations and contacts

3 sites in 1 country.

United States3 sites, 3 recruiting
  • The Institute for Rehabilitation and Research (TIRR) at Memorial Hermann

    Houston, Texas, 77030

    Shuo-Hsiu "James" Chang, PhD, 713-799-7016, shuo-hsiu.chang@uth.tmc.edu

    Not yet recruiting
  • TIRR Memorial Hermann Hospital

    Houston, Texas, 77056

    Gerard E Francisco, MD, 713-797-5244, gerard.e.francisco@uth.tmc.edu

    Shuo-Hsiu Chang, PT, PhD, 713-799-7016, Shuo-Hsiu.Chang@uth.tmc.edu

    Recruiting
  • University of Houston

    Houston, Texas, 77204

    Jose L Contreras-Vidal, PhD, 713-743-4429, jlcontreras-vidal@uh.edu

    Jose L Contreras-Vidal, PhD

    Recruiting

Other trials in United States

About this study

Official title: PFI-RP: Smart Co-robot System for Cost-Effective Patient-Centered Robotic Rehabilitation

The goal of this study is to develop a clinically feasible, low-cost, nonsurgical neurorobotic system for restoring function to motor-impaired stroke survivors that can be used at the clinic or at home. Moreover, another goal is to understand how physical rehabilitation assisted by robotic device combined with electroencephalograph (EEG) can benefit adults who have had stroke to improve functions of their weaker arm.

The proposed smart co-robot training system (NeuroExo) is based on a physical upper-limb robotic exoskeleton commanded by a non-invasive brain machine interface (BMI) based on scalp EEG to actively include the participant in the control loop .

The study will demonstrate that the Neuroexo smart co-robot arm training system is feasible and effective in improving arm motor functions in the stroke population for their use at home.The NeuroExo study holds the promise to be cost-effective patient-centered neurorehabilitation system for improving arm functions after stroke.

Read the detailed description

This study has two phases: The first phase will consist of baseline recordings for system calibration and training sessions to be conducted in a clinical setting. The second phase will consist of NeuroExo BMI-exo neurotherapy to be conducted at the participant's home. Throughout the study and after completion of the study, movement and brain activity will be analyzed to assess function of the affected upper extremity and changes in brain activity associated with the neurotherapy.

Conditions
Stroke, Hemiparesis
Being tested
NeuroExo co-robot neurorehabilitation system
Medical subject headings
Stroke, Paresis

What participants receive

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

  • NeuroExo co-robot neurorehabilitation systemDevice

    Also called Brain-Machine Interface, Brain-Computer Interface, Neurorobotics, Rehabilitation Robotics

    In this longitudinal study, adult subjects with hemiparesis due to chronic stroke will receive robotic-assisted upper-arm training through an EEG-based BMI control of robotic exoskeleton to study the changes in upper extremity motor function, cortical plasticity (using the EEG). After one screening visit, two baseline visits for EEG signal screens, six onsite training sessions will be provided with the NeuroExo system, followed by 60 home therapy sessions (2 sessions per day, 5 days per week for 6 weeks). If the participant have completed at least 50 sessions of neurotherapy at home, the participant will complete a set of measurements to assess function of the affected upper arm and brain activity within 3 days after the last session for post-assessment visit, and one-month post follow-up session. The total amount of time for this study is 16-20 weeks.

Study groups in NCT05374486
Study groupRoleWhat they receive
NeuroExoExperimentalNeuroExo is a device which includes a robotic exoskeleton that you were in your affected arm to assist you with arm movements, a headset that you wear on your head to measure your brain activity and detect your intention to move, and a graphical user interface that allows you to initiate and stop neurotherapy, and track your motor performance.
Receives: Device: NeuroExo co-robot neurorehabilitation system

What is being measured

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

  1. Change From Baseline in Fugl-Meyer Arm (FMA) Motor Score

    FMA is a stroke-specific, performance based impairment index. It quantitatively measures impairment based on Twitchell and Brunnstrom's concept of sequential stages of motor return in hemiplegic stroke patients. It uses an ordinal scale for scoring of 33 items for the upper limb component of the F-M scale (0:can not perform; 1:can perform partially; 2:can perform fully). Total range is 0-66, 0 being poor and 66 normal.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  2. Neural Activity (Cortical Dynamics) Measured by Electroencephalography (EEG) Movement-related Cortical Potential (MRCP) Amplitude

    EEG activity in the delta, theta, alpha, beta and gamma bands will be assessed. Scalp EEG electrodes will be located over the motor cortex, specifically, central (Cz, C1- C4), fronto- central (FCz, FC1 - FC4) and centro-parietal electrodes (CPz, CP1 - CP4). Further, to account for left hand vs. right hand impairment, the electrode locations will be flipped for individuals with right hand impairment. Increased MRCP amplitude indicates increased activation of the ipsi-lesional hemisphere or inhibition of competing contra-lesional hemisphere, following motor relearning.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  3. Cortical Dynamics Measured by Electroencephalography (EEG) Movement-related Cortical Potential (MRCP) Latency

    EEG activity in the low-frequency delta band will be assessed. Scalp EEG electrodes will be located over the motor cortex, specifically, central (Cz, C1- C4), fronto- central (FCz, FC1 - FC4) and centro-parietal electrodes (CPz, CP1 - CP4). Further, to account for left hand vs. right hand impairment, the electrode locations will be flipped for individuals with right hand impairment. MRCP latency is the duration of MRCP prior to movement onset, and is defined as time difference starting from 50% of peak amplitude until the time of movement onset. Increased MRCP latency indicates increased activation of the ipsi-lesional hemisphere or inhibition of competing contra-lesional hemisphere, following motor relearning.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  4. Movement Quality as Assessed by Exoskeleton Kinematics

    A higher value indicates better movement quality.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  5. Movement Quality as Assessed by Exoskeleton Kinematics - Number of Peaks

    Number of peaks is a metric related to the shape of the velocity profile. A higher number of peaks implies jerkier movement. A lower number of peaks indicates better movement quality (that is, movements are less jerky).

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  6. Movement Quality as Assessed by Exoskeleton Kinematics - Time to First Peak

    Time to 1st Peak is a metric related to the shape of the velocity profile, and is reported as [(time to first peak) divided by (total movement duration)]. This value is usually less than the ideal value of 0.5, or 50%, of the total movement duration when a movement has more than one peak. The closer the value is to the ideal value of 0.5, the more well-balanced are the movements.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

Secondary outcomes (4)
  1. Score on Action Research Arm Test (ARAT)

    The ARAT is used to assess subject's ability to manipulate-lift-release objects horizontally and vertically, which differs in size, weight and shape. The test consists of 19 items divided into 4 sub-tests (grasp, grip, pinch, gross arm movement) and each item is rated on a 4-point scale. The possible total score ranges between 0-57. Higher scores indicate better performance.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  2. Score on Jebsen-Taylor Hand Function Test (JTHFT)

    The JTHFT is a motor performance test and assesses the time needed to perform 7 everyday activities (for example, flipping cards and feeding). Score is reported as items completed per second.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  3. Grip Strength

    A grip dynamometer will be used to measure maximum gross grasp force.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

  4. Pinch Strength

    A pinch gauge will be used to measure maximum pinch force.

    Measured: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment

Timeline

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

  1. First posted16 May 2022
  2. Study start25 Apr 2022
  3. Primary completionAug 2022 (estimated)
  4. Study completionAug 2022 (estimated)

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
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05374486
Sponsor's protocol ID
G0501521
Other IDs
HSC-MS-20-1287
Acronym
NeuroExo
Status last verified
May 2022
First submitted
10 May 2022
Last updated
16 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: There is no plan to make IPD available to other researchers.

Publications

  • Bhagat NA, Yozbatiran N, Sullivan JL, Paranjape R, Losey C, Hernandez Z, Keser Z, Grossman R, Francisco GE, O'Malley MK, Contreras-Vidal JL. Neural activity modulations and motor recovery following brain-exoskeleton interface mediated stroke rehabilitation. Neuroimage Clin. 2020;28:102502. doi: 10.1016/j.nicl.2020.102502. Epub 2020 Nov 19.

    PubMed 33395991
  • Sullivan JL, Bhagat NA, Yozbatiran N, Paranjape R, Losey CG, Grossman RG, Contreras-Vidal JL, Francisco GE, O'Malley MK. Improving robotic stroke rehabilitation by incorporating neural intent detection: Preliminary results from a clinical trial. IEEE Int Conf Rehabil Robot. 2017 Jul;2017:122-127. doi: 10.1109/ICORR.2017.8009233.

    PubMed 28813805
  • Bhagat NA, Venkatakrishnan A, Abibullaev B, Artz EJ, Yozbatiran N, Blank AA, French J, Karmonik C, Grossman RG, O'Malley MK, Francisco GE, Contreras-Vidal JL. Design and Optimization of an EEG-Based Brain Machine Interface (BMI) to an Upper-Limb Exoskeleton for Stroke Survivors. Front Neurosci. 2016 Mar 31;10:122. doi: 10.3389/fnins.2016.00122. eCollection 2016.

    PubMed 27065787
  • Bhagat NA, French J, Venkatakrishnan A, Yozbatiran N, Francisco GE, O'Malley MK, Contreras-Vidal JL. Detecting movement intent from scalp EEG in a novel upper limb robotic rehabilitation system for stroke. Annu Int Conf IEEE Eng Med Biol Soc. 2014;2014:4127-4130. doi: 10.1109/EMBC.2014.6944532.

    PubMed 25570900
  • Venkatakrishnan A, Francisco GE, Contreras-Vidal JL. Applications of Brain-Machine Interface Systems in Stroke Recovery and Rehabilitation. Curr Phys Med Rehabil Rep. 2014 Jun 1;2(2):93-105. doi: 10.1007/s40141-014-0051-4.

    PubMed 25110624

Questions about this trial

What is this clinical trial studying?

A study testing NeuroExo co-robot neurorehabilitation system in people with Stroke and Hemiparesis, run by University of Houston at 3 sites in United States.

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 6 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 16 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. 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?

Results are not available in the source record.

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

Contact Study Coordinator (713 799 7016, shuo-hsiu.chang@uth.tmc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Fugl-Meyer Arm (FMA) Motor Score (time frame: Baseline, immediately after end of treatment (within a week), and 4 weeks after end of treatment). The study lists 6 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 NCT05374486, which also lists 5 linked publications.

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 16 May 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in