Transforming Robot-mediated Telerehabilitation: Citizen Science for Rehabilitation

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to advance upper limb robot-mediated tele-rehabilitation for patients recovering from stroke by empowering them through active science participation. By varying the tasks' features and affordances of a platform that combines a low-cost haptic device on one hand, and an online citizen science platform on the other, investigators will evaluate different strategies for social telerehabilitation. the two fundamental modes of social interaction - competition and cooperation - in addition to a control condition. Specifically, citizen science activities will be performed by competing, cooperating, or isolated users, and their rehabilitation effectiveness examined. Such effectiveness will be measured by (i) participants' rehabilitation performance (inferred from sensorimotor data acquired through the platform and directly quantified by a supervising therapist); (ii) participants' motivations to contribute (measured through surveys administered online); and (iii) participants' emotional well-being and sense of self-esteem (measured through online surveys).

Official Title
-----------------
Feasibility of a Kinect-Based Citizen Science Telerehabilitation Platform

Conditions
-----------------
Stroke, Hemiparesis

Intervention / Treatment
-----------------
* Behavioral: Output-Focus Condition
* Behavioral: Input-Focus Condition


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: For treatment group: post-stroke hemiparesis >3 months ability to stand or sit independently sufficient cognitive skills to perform the exercises as demonstrated full passive range of motion in the affected arm but limited active movement as determined by a upper extremity Fugl-Meyer score of <50/66 technical savvy and interest to use an internet platform For control group: (ii) no history of learning disabilities (iii) technical savvy and interest to use an internet platform Exclusion Criteria: For treatment group: visual deficit such as deficit in visual acuity, eye movements, visual field cut, or neglect medical comorbidity such as other neurological conditions (e.g. Parkinson's disease, brain tumor, epilepsy), or previous injury to the upper limb pain in the upper limbs that prevents full passive range of motion to perform the exercises. For control group: visual deficit such as deficit in visual acuity, eye movements, visual field cut, or neglect any previous injury or medical condition that prevents full passive range of motion to perform the exercises.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stroke Patients<br> | Behavioral: Output-Focus Condition<br>* Users are asked to tag more, and force feedback is exerted the more points the user has<br>Behavioral: Input-Focus Condition<br>* Users are asked to tag more and force feedback is exerted based on the number of images the user has analyzed.<br>|
| Active Comparator: Healthy Controls<br> | Behavioral: Output-Focus Condition<br>* Users are asked to tag more, and force feedback is exerted the more points the user has<br>Behavioral: Input-Focus Condition<br>* Users are asked to tag more and force feedback is exerted based on the number of images the user has analyzed.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fugl-Meyer scale | Stroke-specific, performance-based impairment index. It is designed to assess motor functioning, balance, sensation and joint functioning in patients with post-stroke hemiplegia. | 1 Month | 
| Video-based motion analysis | Passive and active range-of-motion measurements of the affected and unaffected arm using video-based motion analysis | 1 Month | 
| assessment of tone using Ashworth scale | this scale measures resistance during passive soft-tissue stretching and is used as a simple measure of spasticity. | 1 Month | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
cognitive skills, technical, internet platform, Stroke, Hemiparesis