Bimanual Motor Skill Learning Through Robotics in Chronic Cerebellar Stroke Survivors and Healthy Individuals

Study Overview
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Brief Summary
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To test capacity of chronic cerebellar stroke patients and healthy individuals to learn and retain a complex bimanual motor skill, trained on the neurorehabilitation robot REAplan® (bimanual version).

Detailed Description
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Over 3 consecutive days, healthy individuals and chronic cerebellar stroke patients (1) will be evaluated and (2) will train on the neurorehabilitation robot REAplan®. They will practice several tasks on the robot REAplan® (bimanual version), requiring either movements with the affected arm (unimanual tasks) or complex, coordinated movements with both arms (bimanual tasks). In addition, several classical clinical scales and tests will be used to evaluate overall motor-sensory-cognitive functions (clinical tests, questionnaires, ...). Hand/digits motor function will be also evaluated with the kinetic device DexTrain®.

Official Title
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Bimanual Motor Skill Learning Through Robotics in Chronic Cerebellar Stroke Survivors and Healthy Individuals

Conditions
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Chronic Cerebellar Stroke, Healthy Individuals (Controls)

Intervention / Treatment
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* Device: Bimanual motor skill learning with the REAplan® rehabilitation robot


Participation Criteria
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Eligibility Criteria
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STROKE PATIENTS: Inclusion Criteria: having a chronic cerebellar stroke (>6 months) aged 18-90 years with a demonstrated stroke (ischemic or hemorrhagic) lesion on brain imaging Exclusion Criteria: difficulty in understanding or executing commands drug/alcohol abuse severe aphasia / cognitive deficits interfering with study inability to voluntarily move the affected arm (i.e. complete paralysis of the arm) multiple strokes / dementia / psychiatric condition HEALTHY INDIVIDUALS: Inclusion Criteria: 18-90 years Exclusion Criteria: neurological conditions interfering with the study drug/alcohol abuse pyschiatric condition

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Evaluation of bimanual motor skill learning
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Chronic Cerebellar Stroke<br>Participants with a chronic cerebellar stroke | Device: Bimanual motor skill learning with the REAplan® rehabilitation robot<br>* REAplan® rehabilitation robot: training to perform complex, coordinated, bimanual movements<br>|
| Active Comparator: Healthy Individuals (Controls)<br>healthy participants | Device: Bimanual motor skill learning with the REAplan® rehabilitation robot<br>* REAplan® rehabilitation robot: training to perform complex, coordinated, bimanual movements<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in bi-SAT | Bimanual Speed/Accuracy Trade-off measured by the REAplan robot bimanual Speed/Accuracy Trade-off: mathematical computation of the relationship bewteen speed and accuracy | Change between day 1 to 3 | 
| Change in bi-CO | Bimanual Coordination factor measured by the REAplan robot bimanual Coordination factor : mathematical measure of the phase coherence between velocities of both arms | Change between day 1 to 3 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bi-SAT | On bimanual REACHING (REAplan robot) bimanual Speed/Accurady Trade-off: mathematical computation of the relationship | Day 1 + day 3 | 
| bi-CO | On bimanual REACHING (REAplan robot) bimanual Coordination factor: mathematical measure of the phase coherence between velocities of both arms | Day 1 + day 3 | 
| change in bi-Force | Bimanual forces : forces exerted in the wrong direction by each arm (Newtons) | Change between day 1 to 3 | 
| bi-Force | On bimanual REACHING (REAplan robot) bimanual forces : forces exerted in the wrong direction by each arm (Newtons) | Day 1 + day 3 | 
| bi-smoothness | On bimanual REACHING (REAplan robot) Smoothness of movement : Spectral Arc Length (SPARC) | Day 1+ day 3 | 
| bi-error | on bimanual REACHING (REAplan robot) Error in centimeters or degrees during bimanual reaching | Day 1 + day 3 | 
| Dextrain | Kinetic device measuring the movements of each finger: error and co-activation (percentage) | Day 1 + day 3 | 
| Dextrain | Kinetic device measuring the movements of each finger: speed (milliseconds) | Day 1 + day 3 | 
| Dextrain | Kinetic device measuring the movements of each finger: force (Newton) | Day 1 + day 3 | 
| BBT | Box & Blocks Test (timed transfert of blocks from one space to the other) | Day 1 + day 3 | 
| Modified International Cooperative Ataxia Rating Scale (MICARS) | Ataxia scale A high score describes strong ataxia and a low score describes weak ataxia | Day 1 | 
| Fugl Meyer Upper extremity test | Tests impairments of the upper limb after stroke | Day 2 | 
| Corsi block | Tests the visuo-spatial memory | Day 2 | 
| Montreal Cognitive Assessment (MoCA) | Tests the short-term memory, visuospatial skills, executive functions, attention, concentration, working memory, language and orientation in time and space | Day 2 | 
| Abilhand and activlim | Questionnaire about the bimanual hability during activities of the daily life | Day 3 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Cerebellar Disorders, Cerebrovascular Disorders, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Vascular Diseases, Cardiovascular Diseases, Cerebellar Stroke, Cerebellar Hemorrhage, Cerebellar Infarction