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StrokeITERNCT06489145

Multi-domain Improvements in High-TEchnology Rehabilitation Programs for Post-stroke Patients

A study testing Technology-enhanced Rehabilitation and Multidisciplinary Traditional Rehabiltiation in people with Stroke, run by University of Milano Bicocca at 1 site in Italy.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Through a multi-method, multi-informant, and patient-centred approach, the study aims to investigate the experience of use and the effectiveness of rehabilitation technology (robotics and virtual reality - VR) in post-stroke patients and their caregivers and therapists Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Stroke
What is being tested?
Technology-enhanced Rehabilitation and Multidisciplinary Traditional Rehabiltiation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteItaly
Study dates
24 Jun 2024to 30 Sep 2025
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Acute stroke event occurring within a maximum of 12 months prior to treatment;
  • Age over 18 years;
  • Acceptable hyposthenia evaluated with the Motricity Index (scores less than the maximum)
  • Spasticity, if present, compatible with limb function (MAS score < 2)
  • Mental health condition allowing for a full understanding of the study objectives and completion of self-report measures
  • Any informal caregiver (e.g., family member, friend) who continuously assists the enrolled patient for at least half a day;
  • Physiotherapists who assist enrolled patients throughout the entire intervention period
  • Physiotherapists who have sufficient professional experience in use of rehabilitation technology in post-stroke rehabilitation programs;

Who cannot join

  • Severe clinical condition (e.g., cognitive impairment - MMSE score < 24), presence of sever apraxia, complete upper limbs hemiplegia, severe upper limb sensory disorders, joint fractures and dislocations);
  • clinical non-eligibility to the use of exoskeleton devices as per technical specifications of the devices
  • Inability or difficulty in completing self-report measures in Italian and/or secondary illiteracy;
  • Presence of psychiatric pathology in medical history or recent psychiatric pathology that could affect reliability of data collected;
  • Refusal or withdrawal of informed consent at any stage of the study.
  • Caregivers
Show all 13Show fewer
  • Inability or difficulty in understanding Italian language and/or illiteracy;
  • Refusal or withdrawal of informed consent at any stage of the study
  • Therapists
  • Physiotherapists who partially assist enrolled patients throughout the entire intervention period
  • Study 2 (ID: RM-2024-803)
  • Therapists
  • Refusal or withdrawal of informed consent at any stage of the study

Trial locations and contacts

1 site in 1 country.

Marco D'Addario, PhD contact

02 6448 3824

marco.daddario@unimib.it

Francesco Zanatta, PhD contact

francesco.zanatta@unimib.it

Italy1 site, 1 recruiting
  • University of Milano-Bicocca

    Milan, 20126

    Marco D'Addario, 02 6448 3824, marco.daddario@unimib.it

    Recruiting

Other trials in Italy

About this study

Official title: Users' Experience and Cognitive Improvement in High-technology Rehabilitation Programs for Post-stroke Patients: a Multi-method, Multi-informant, Patient-centred Approach

Through a multi-method, multi-informant, and patient-centred approach, the study aims to investigate the experience of use and the effectiveness of rehabilitation technology (robotics and virtual reality - VR) in post-stroke patients and their caregivers and therapists

Read the detailed description

The present research will consist of two parallel studies.

Study 1 (ID: 0025654/24). As a first goal the study aims to investigate pre- post-intervention changes on patients' motor, functional, cognitive, psychological and quality of life outcomes. Intervention effects will be estimated among patients participating in technology-enhanced rehabilitation programs and compared to those undergoing traditional treatment only.

As a second goal, the study aims to evaluate patients' subjective rehabilitation experience, treatment expectations and compliance, and (in case of technology use) devices usability, acceptability and psychosocial impact.

As a third goal, the study aims to extend the evaluation on rehabilitation experience to patients' caregivers, specifically investigating their treatment expectations and, at the end of the intervention, treatment satisfaction.

As a fourth goal, the study aims to evaluate the rehabilitation experience and technology experience of use in patients' therapists, specifically investigating their treatment expectations and, at the end of the intervention, patients' compliance and participation levels in the treatment.

Study 2 (ID: RM-2024-803). Therapists will be also involved in a parallel qualitative investigation through focus-groups to further explore the barriers and facilitators related to the implementation of technological devices into post-stroke rehabilitation programs.

Conditions
Stroke
Being tested
Technology-enhanced Rehabilitation, Multidisciplinary Traditional Rehabiltiation
Keywords
Stroke Rehabilitation, Technology, Cognition, Quality of Life, Well-Being, Experience of Use
Medical subject headings
Stroke

What participants receive

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

  • Technology-enhanced RehabilitationDevice

    Based on their individualized rehabilitation project, patients will undergo robot-assisted therapy (RAT) and/or virtual reality (VR)-based treatment.

    RAT will consist of the use exoskeleton devices intended for the treatment of upper limbs (Armeo-Spring™) or for the lower limbs (Lokomat™) impairments.

    VR-based rehabilitation will be conducted non-immersive VR devices: the ProKin 252™ (TechnoBody SRL, Italy), the D-Wall™ (TechnoBody SRL, Italy), and the Walker View™ (TechnoBody SRL, Italy).

    Technology-enhanced treatment duration (number of sessions, minutes of use) will strictly depend on patients' rehabilitation needs and individualized rehabilitation program. Overall, part of the duration of the whole treatment will be dedicated to the use of the technological device, resulting in the same amount of rehabilitation for all participants.

  • Multidisciplinary Traditional RehabiltiationOther

    Patients will receive traditional treatment consisting of two daily one-hour session (4 weeks, 20 sessions) and including rehabilitation activities like range of motion exercises (passive, active assisted and active), progressive resistive exercises, balance and strength training, and aerobic conditioning. The intervention procedures will follow the routine multidisciplinary clinical practice of the Institute where the study will be carried out. Procedures will be adapted according to patient's medical diagnosis, disability severity, and to the consequent rehabilitation objectives in favor of an individualized rehabilitation project and program. If necessary, patients might therefore undergo parallel rehabilitation activities (ie, occupational therapy, speech therapy, cognitive stimulation) that will be kept under control throughout data collection and analyses.

Study groups in NCT06489145
Study groupRoleWhat they receive
Technology-enhanced RehabilitationExperimentalPatients will participate in technology-enhanced rehabilitation programs in addition to multidisciplinary traditional treatment.
Receives: Device: Technology-enhanced Rehabilitation; Other: Multidisciplinary Traditional Rehabiltiation
Standard RehabilitationActive comparatorPatients will participate in multidisciplinary traditional treatment only
Receives: Other: Multidisciplinary Traditional Rehabiltiation

What is being measured

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

  1. Pre-post Intervention Change in Motor impairment

    Changes will be assessed with the Motricity Index (MI). Higher scores indicate lower motor impairment in terms of muscle strength and upper and lower limbs motricity (range: 0-33).

    Measured: Baseline to 4-week follow-up

  2. Pre-post Intervention Change in Spasticity

    Changes will be assessed with the Asworth modified Scale (MAS). Higher scores indicate higher spasticity (range: 0-4 for each body part assessed)

    Measured: Baseline to 4-week follow-up

  3. Pre-post Intervention Change in upper limbs sensory and motor functions

    Changes will be assessed with the Fugl-Meyer Upper Extremity Scale (FMUE). Higher scores indicate lower sensory-motor disability (Upper limb motor function, range: 0-66; lower limb motor function, range: 0-34; sensory function, range:0-24; balance, range: 0-14; joint range of motion, range: 0-44; joint pain, range:0-44).

    Measured: Baseline to 4-week follow-up

  4. Pre-post Intervention Change in Autonomy in Activities of Daily Living (ADLs)

    Changes will be assessed with the Barthel Index Modified (BIM). Higher scores (range: 0-100) indicate higher autonomy levels in ADLs (chair/bed transfer, ambulation, stair climbing, toilet transfer, bowel control, bladder control, bathing, dressing, personal hygiene, feeding).

    Measured: Baseline to 4-week follow-up

  5. Pre-post Intervention Change in Functional Disability

    Changes will be assessed with the Functional Independence Measure (FIM), which includes two sub-scales evaluating motor (range: 13-91) and cognitive (range: 5-35) domains in relation to disability. Higher scores indicate lower levels of motor and cognitive disability.

    Measured: Baseline to 4-week follow-up

  6. Pre-post Intervention Change in global cognition

    Changes will be assessed with the Mini Mental State Examination (MMSE), which includes sub-scores on temporal and spatial orientation, attention, executive functions, memory, language, and visual-spatial abilities. Higher scores indicate better global cognitive functioning (range: 0-30)

    Measured: Baseline to 4-week follow-up

  7. Pre-post Intervention Change in Long-term Verbal Memory

    Changes will assessed with the Rey Auditory Verbal Memory Test (RAVLT). Higher scores indicate better long-term verbal memory functioning (range: 0-15)

    Measured: Baseline to 4-week follow-up

  8. Pre-post Intervention Change in Short-term Verbal Memory

    Changes will be assessed with the Digit Span Task (DST). Higher scores indicate better short-term verbal memory functioning (range: 3-9)

    Measured: Baseline to 4-week follow-up

  9. Pre-post Intervention Change in Long-term Visual-spatial Memory

    Changes will be assessed with the Rey-Osterrieth Complex Figure Test. Higher scores indicate better long-term visual.spatial memory functioning (range: 0-36)

    Measured: Baseline to 4-week follow-up

  10. Pre-post Intervention Change in Short-term Visual-spatial Memory

    Changes will be assessed with the Corsi Block-Tapping Test. Higher scores indicate better short-term visual-spatial memory functioning (range: 3-9)

    Measured: Baseline to 4-week follow-up

  11. Pre-post Intervention Change in Visual-Spatial Attention

    Changes will be assessed with the Multiple Features Target Cancellation (MFTC) test. Higher scores indicate better attentional and visual search abilities (range: 0-13)

    Measured: Baseline to 4-week follow-up

  12. Pre-post Intervention Change in Executive Functions

    Changes will be assessed with the Trail Making Test (TMT). Higher time scores (i.e., seconds) indicate worse divided attention, cognitive flexibility, shifting and visual-motor coordination functions

    Measured: Baseline to 4-week follow-up

  13. Pre-post Intervention Change in Verbal Fluency

    Changes will be assessed with Phonemic and Semantic Verbal Fluency tests. Higher scores (i.e., number of words) indicated better linguistic and verbal fluency functions

    Measured: Baseline to 4-week follow-up

  14. Pre-post Intervention Change in Perceived Health Status

    Changes will be assessed with the EuroQoL Visual Analogue Scale (EQ-VAS). Higher scores indicate better perceived health status (range: 0-100)

    Measured: Baseline to 4-week follow-up

  15. Pre-post Intervention Change in Perceived Health-related Quality of Life

    Changes will be assessed with the Short-Form Health Survey-12 (SF-12). Higher scores in bot sub-scales (Mental Health and Physical Health) indicate better perceived health-related quality of life (range: 0-100)

    Measured: Baseline to 4-week follow-up

  16. Pre-post Intervention Change in Anxiety and Depression Symptoms

    Changes will be assessed with the Hospital Anxiety and Depression Scale (HADS). Higher scores indicated more severe anxiety and depression symptoms (range: 0-21)

    Measured: Baseline to 4-week follow-up

Secondary outcomes (6)
  1. Change in Patient's Subjective Rehabilitation Experience

    Changes will be monitored through Ecological Momentary Assessment (EMA) method. Patients will be asked to fill out a daily diary after each therapy session and indicate their rehabilitation experience in terms of engagement, motivation, enjoyment and satisfaction. Selected items from the Intrinsic Motivation Inventory (IMI) will be administered. Higher scores indicate better subjective rehabilitation experience.

    Measured: Baseline to 4-week follow-up (Repeated measures throughout the trial)

  2. Rehabilitation Outcomes Expectations

    Expectations will be assessed with the Expectancy sub-scale of the Credibility/Expectancy Questionnaire (CEQ). The assessment will be carried out on patients, their caregivers and therapists. Higher scores indicate more positive expectations on rehabilitation outcomes (range: 0-100)

    Measured: Baseline

  3. Satisfaction with Rehabilitation Treatment

    Satisfaction levels in patients' caregivers will be assessed with Involvement practices scale. Higher scores indicate more positive caregiver's perception of information giving from rehabilitation staff, involvement in decision-making, and training to collaborate (range: 0-30)

    Measured: Baseline to 4-week follow-up

  4. Technology Perceived Usability

    Perceived usability of the technological devices implemented will be assessed with the System Usability Scale (SUS). Higher scores indicate better technological device usability (range: 0-100)

    Measured: 4-week follow-up

  5. Technology Acceptance

    Acceptance will be assessed with the Technology Assisted Rehabilitation Patient Perception Questionnaire (TARPP-Q). Higher scores indicate higher technology acceptance in terms of engagement levels, usability, distress and perceived hindrance (range: 31-124)

    Measured: 4-week follow-up

  6. Technology Psychosocial Impact

    Psychosocial impact will be assessed with the Psychosocial Impact of Assistive Device Scale (PIADS). Higher scores indicate better impact on patient's perceived adaptability (range: -18/+18), ability (range: -36/+36), and self-esteem (range: -24/+24).

    Measured: 4-week follow-up

Timeline

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

  1. First posted5 Jul 2024
  2. Study start24 Jun 2024
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion30 Sep 2025 (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
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06489145
Sponsor's protocol ID
0025654/24
Other IDs
RM-2024-803
Acronym
ITER
Status last verified
Jul 2024
First submitted
25 Jun 2024
Last updated
9 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Technology-enhanced Rehabilitation and Multidisciplinary Traditional Rehabiltiation in people with Stroke, run by University of Milano Bicocca 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 8 inclusion and 13 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 9 Dec 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?

Results are not available in the source record.

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

Contact Marco D'Addario, PhD (02 6448 3824, marco.daddario@unimib.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pre-post Intervention Change in Motor impairment (time frame: Baseline to 4-week follow-up). The study lists 16 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Dec 2024.

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ITER Clinical Trial NCT06489145 | AzTrials