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StrokeNCT05903235

Mixed Reality and Virtual Reality Technology With Mirror Therapy for Stroke Rehabilitation

A study testing Virtual Reality-based Mirror Therapy (VR+MT), Mixed Reality-based Mirror Therapy (MR+MT) and Traditional Mirror Therapy (MT) in people with Stroke and Cerebrovascular Disorders, run by Chang Gung Memorial Hospital at 1 site in Taiwan.

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Sites and contacts
Official record

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Trial summary

The specific study aims will be: 1. To design and develop the hardware and software of the VR+MT and MR+MT systems. 2. To test the feasibility of the VR+MT and MR+MT systems from the patients and to collect the feedback of users with respect to their experiences. 3. Read more about this study

Who is it for?
Ages 20 to 80 years
What is being tested?
Virtual Reality-based Mirror Therapy (VR+MT), Mixed Reality-based Mirror Therapy (MR+MT) and Traditional Mirror Therapy (MT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteTaiwan
Study dates
13 Mar 2024to 31 Jul 2027
Phase
Interventional

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 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • diagnosed with unilateral stroke
  • age of 20 to 80 years
  • a baseline Fugl-Meyer Assessment of the Upper Extremity score of 20 to 60
  • able to follow the study instructions and provide the feedback of user experiences verbally
  • diagnosed with unilateral stroke
  • more than 6 months after stroke onset
Show all 10Show fewer
  • age of 20 to 80 years
  • a baseline Fugl-Meyer Assessment of the Upper Extremity score of 20 to 60
  • able to follow the study instructions
  • capable of participating in the assessment process and treatment program

Who cannot join

  • diagnosed with global or receptive aphasia
  • the presence of severe neglect
  • the existence of major medical problems or comorbidities that could interfere with upper-limb usage and pain, or disrupt visual or auditory perception
  • Phase Ⅱ: Validation and Comparison of Clinical Treatment Efficacy
  • diagnosed with global or receptive aphasia
  • the presence of severe neglect
  • the existence of major medical problems or comorbidities that could interfere with upper-limb usage and pain, or disrupt visual or auditory perception

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Taiwan1 site, 1 recruiting
  • Taoyuan Chang Gung Memorial Hospital

    Taoyuan City, 333

    Yu-Wei Hsieh, PhD, +886-3-2118800 ext. 3820, ywhsieh@mail.cgu.edu.tw

    Recruiting

Other trials in Taiwan

About this study

Official title: Technology-based and Activity-based Design of Mirror Therapy Principles: Two Mixed Reality and Virtual Reality Mirrored-hand Systems for Stroke Rehabilitation

The specific study aims will be:

  1. To design and develop the hardware and software of the VR+MT and MR+MT systems.
  2. To test the feasibility of the VR+MT and MR+MT systems from the patients and to collect the feedback of users with respect to their experiences.
  3. To examine the treatment effects of VR+MT and MR+MT compared to the traditional MT (i.e., control group) in patients with stroke by conducting a randomized controlled trial.
  4. To identify who will be the possible good responders to VR+MT and MR+MT based on their baseline motor functions and mental imagery abilities.
Read the detailed description

Phase Ⅰ: Design and Development of the VR+MT and MR+MT Systems \& Feasibility Study

Sixteen patients with stroke will be recruited in this phase Ⅰ study. During the pilot testing, each stroke patient will use each of the VR+MT and MR+MT systems with the assistance of a researcher holding the occupational therapist certification. The order of the feasibility test of the 2 systems will be counterbalanced across the patients. At the end of the feasibility study of each system, the patients will be asked to complete the System Usability Scale, Virtual Reality Sickness Questionnaire, and a self-designed questionnaire to assess the user experience and perspective about these new systems and their view of its suitability for stroke patients.

Phase Ⅱ: Validation and Comparison of Clinical Treatment Efficacy

This three-arm, single-blind, randomized controlled trial will investigate the treatment effects among the 3 groups of VR+MT, MR+MT, and traditional MT. An estimated 45 patients with stroke will be recruited to participate in this phase Ⅱ study. Each participant will receive a total of 15 training sessions (40 minutes per session) within 5 weeks. Clinical outcome measures will be conducted at baseline, at immediately after treatment, and at 1 month follow-up after treatment.

Being tested
Virtual Reality-based Mirror Therapy (VR+MT), Mixed Reality-based Mirror Therapy (MR+MT), Traditional Mirror Therapy (MT)
Keywords
digital rehabilitation, mixed reality, virtual reality, cerebrovascular accident, mirror visual feedback
Medical subject headings
Stroke, Cerebrovascular Disorders, Central Nervous System Diseases

What participants receive

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

  • Virtual Reality-based Mirror Therapy (VR+MT)Behavioural

    In this VR+MT group, the patients will be instructed to perform the unilateral movements of the non-affected upper limb simultaneously while observing the animated hand as mirroring reflection of the affected hand within the immersive environment, which presented on the goggle via the VR+MT system.

  • Mixed Reality-based Mirror Therapy (MR+MT)Behavioural

    In the MR+MT group, the patients will be instructed to perform the unilateral movements of the non-affected upper limb concurrently meanwhile watching the real-time mirroring image reflection of the non-affected upper limb's movements of the patients captured, transformed, and superimposed on the affected upper limb, which projected to the screen from the front side via the MR+MT system.

  • Traditional Mirror Therapy (MT)Behavioural

    In the traditional MT group, patients will be instructed to perform the unilateral movements of the non-affected upper limb at the same time while watching the mirror of a mirror box placed in front of the patient's midsagittal plane, in which the illusory reflection of the non-affected upper limb appears as if it were the another affected upper limb.

Study groups in NCT05903235
Study groupRoleWhat they receive
Virtual Reality-based Mirror Therapy (VR+MT)ExperimentalIn each therapy session, the patients will execute 2 upper-limb functional tasks, starting with easy then more complex tasks.
Receives: Behavioral: Virtual Reality-based Mirror Therapy (VR+MT)
Mixed Reality-based Mirror Therapy (MR+MT)ExperimentalThe patients will execute 2 upper-limb functional tasks in each session.
Receives: Behavioral: Mixed Reality-based Mirror Therapy (MR+MT)
Traditional Mirror Therapy (MT)Active comparatorThe patients will execute 2 to 3 categories of activities per training session: (1) active range of motion exercises, (2) reaching movement or object manipulation, and (3) upper-limb functional tasks.
Receives: Behavioral: Traditional Mirror Therapy (MT)

What is being measured

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

  1. Change scores of Fugl-Meyer Assessment of the Upper Extremity

    The Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) is a measure with sound psychometric properties to evaluate upper-limb hemiparesis of patients following stroke. The total, proximal and distal scores of the FMA-UE range from 0 to 66, from 0 to 42, and from 0 to 24, respectively; a higher score indicates better upper-limb motor function.

    Measured: baseline, 5 weeks, 9 weeks

  2. Change scores of Nottingham Extended Activities of Daily Living scale

    The Nottingham Extended Activities of Daily Living scale is an ease-of-use measure with sound reliability and validity to assess independence of more complex daily function. Each item scores ranged from 0 (no/unable) to 3 (on my own/able) with a total score range of 0 to 66. A higher score indicates greater independence of instrumental activities of daily living.

    Measured: baseline, 5 weeks, 9 weeks

Secondary outcomes (8)
  1. Change scores of grip strengths

    The Jamar® Plus+ Digital Hand Dynamometer has been designed similarly to the reliable and validated Jamar Hydraulic Hand Dynamometer to measure the grip strength. The grip strengths of both hands were alternatively measured in kilograms (kg) by adopting the average of three measurements.

    Measured: baseline, 5 weeks, 9 weeks

  2. Change scores of lateral pinch strengths

    The Jamar® Plus+ Digital Pinch Gauge has been developed and widely used with the advantages of an easy-to-read digital readout and being capable of storing data. The lateral pinch strengths of both hands will be alternatively measured in kilograms (kg) by adopting the average of three measurements.

    Measured: baseline, 5 weeks, 9 weeks

  3. Change scores of palmar pinch strengths

    The Jamar® Plus+ Digital Pinch Gauge has been developed and widely used with the advantages of an easy-to-read digital readout and being capable of storing data. The palmar pinch strengths of both hands will be alternatively measured in kilograms (kg) by adopting the average of three measurements.

    Measured: baseline, 5 weeks, 9 weeks

  4. Change scores of Box and Block Test

    The Box and Block Test (BBT) is a tool with sound reliability and validity to evaluate hand dexterity. The number of cubes moved represents the BBT score, with a higher score indicating better gross dexterity.

    Measured: baseline, 5 weeks, 9 weeks

  5. Change scores of Revised Nottingham Sensory Assessment

    The Revised Nottingham Sensory Assessment is a standardized measure with good reliability to evaluate sensory function of patients following stroke. The scores of the tactile sensation, proprioception, and stereognosis subscales range from 0 to 108, from 0 to 21, and from 0 to 22, respectively; a higher score indicates better somatosensory function.

    Measured: baseline, 5 weeks, 9 weeks

  6. Change scores of Chedoke Arm and Hand Activity Inventory

    The Chedoke Arm and Hand Activity Inventory is a reliable and validated measure to evaluate the independence of patients following stroke to perform activities of daily living with an affected upper limb. Each task scores ranged from 1 (total assist) to 7 (complete independence) with a total score range of 13 to 91. A higher score indicates greater recovery of arm and hand function.

    Measured: baseline, 5 weeks, 9 weeks

  7. Change scores of the health state of EQ-5D-5L

    The questionnaire of EQ-5D-5L comprises 5 dimensions, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and uses a 5-point Likert scale scored from 1 (no problem) to 5 (unable to/extreme problems); whereas, the numerical description of 5-dimension questionnaire represents the health state.

    Measured: baseline, 5 weeks, 9 weeks

  8. Change scores of the visual analogue scale of EQ-5D-5L

    The visual analogue scale of EQ-5D-5L score will be scored from 0 to 100. A higher score indicates better overall current health.

    Measured: baseline, 5 weeks, 9 weeks

Timeline

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

  1. First posted15 Jun 2023
  2. Study start13 Mar 2024
  3. Primary completion31 Jul 2027 (estimated)
  4. Study completion31 Jul 2027 (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
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05903235
Sponsor's protocol ID
202201968A3
Status last verified
Oct 2026
First submitted
6 Jun 2023
Last updated
22 Oct 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

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