Evidence-Based Robot-Assistant in Neurorehabilitation

Study Overview
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Brief Summary
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The purpose of this study is to investigate the efficacy, acceptability, and safety of the therapeutic system E-BRAiN for the treatment of stroke-related impairments.

Detailed Description
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This randomized controlled trial, RCT with cross-over design sequentially allocates participants with stroke-related impairment to both a two week course of conventional rehabilitation therapy and a two week course of therapy using the therapy system E-BRAiN (purpose-built therapy system using a socially interactive humanoid robot); participants are randomly allocated to the sequences conventional => robot or robot => conventional. Stroke survivors with one of the target syndromes, i.e. mild arm paresis, or moderate to severe arm paresis, or visuospatial neglect are invited to participate.

Official Title
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E-BRAiN - Evidence-Based Robot-Assistant in Neurorehabilitation

Conditions
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Stroke, Paresis, Neglect, Hemispatial

Intervention / Treatment
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* Device: E-BRAiN therapy
* Behavioral: Conventional therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age at study entry ≥ 18 years Stroke (ischemic stroke, non-traumatic intracerebral haemorrhage, subarachnoidal haemorrhage) Incomplete arm paresis (Motricity Index, arm score >1 [Min] and < 100 [Max]) or Visuospatial neglect (clinical signs and NET subtest star cancellation score < 50) Candidate able to consent and provides informed consent or legal representative provides informed consent Exclusion Criteria: Pregnant or breast feeding Obliged to live in an institution by law or public authority With case presentation arm paresis: another condition that causes arm paresis is present With case presentation visuospatial neglect: another condition that causes a relevant visual-perceptual deficit that cannot be compensated is present; exception: homonymous visual field deficits are not an exclusion criterion

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Conventional therapy<br>Length of period: 2 weeks | Behavioral: Conventional therapy<br>* Conventional therapy specifies the neurorehabilitation therapy as applied as regular treatment.<br>|
| Experimental: Therapy assisted by a humanoid robot (E-BRAiN)<br>Length of period: 2 weeks Fixed dose: 10 therapy sessions with E-BRAiN | Device: E-BRAiN therapy<br>* The therapy system E-BRAiN is a purpose-built therapy system using a socially interactive humanoid robot and provides individualised therapy for arm rehabilitation based on the evidence-based therapies arm basis training, arm ability training, or mirror therapy for arm rehabilitation (paresis) or neurovisual training (neglect).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change scores over two weeks for the standardised primary outcome measure | Change scores are difference scores for assessments taken two weeks apart. Changes scores are based on standardised outcome measures. Assessment scores for each measure (see below) are standardised using the known variance in stroke survivor populations for the respective measure. The following assessments will be used for standardised outcome measures: Nine-Hole-Peg-Test, NHPT (finger dexterity) and Box-and-Block Test, BBT (gross manual dexterity) (for participants with mild arm paresis); Fugl Meyer, Arm motor score, FM Arm (selective arm and hand movement capacity) (participants with moderate to severe arm paresis); Neglect-Test, NET (spatial visual attention) (participants with visual neglect). | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Drop-out rate | Drop-outs | 2 weeks | 
| Goal attainment | Goal attainment Scale (GAS) | 2 weeks | 
| Change scores over two weeks for Motivation for therapy | Change scores are difference scores for assessments taken two weeks apart with Visual Analogue Scales (VAS) for motivational factors (Min 0, Max 100) | 2 weeks | 
| Change scores over two weeks for Emotional distress | Change scores are difference scores for assessments taken two weeks apart with the Hospital Anxiety and Depression Scale (HADS) | 2 weeks | 
| Work alliance | Assessment of the perceived work alliance for the period of two weeks prior using the Work Alliance Inventory (WAI) | 2 weeks | 
| Adverse events | Adverse events documentation for the period of two weeks | 2 weeks |