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

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

Detailed Description
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Over 3 consecutive days, healthy individuals and chronic stroke patients (1) will be evaluated and (2) will train on the neurorehabilitation robot REAplan(R). They will practice several tasks on the robot REAplan (R) (bimanual version), requiring either movements with the affected arm (unimanual tasks) and 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, ...).

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

Conditions
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Stroke

Intervention / Treatment
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* Device: Bimanual motor skill learning with the REAplan(R) rehabilitation robot


Participation Criteria
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Eligibility Criteria
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STROKE PATIENTS : Inclusion Criteria: having a chronic stroke (>6 months) aged 18-90 years with demonstrate a stroke 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 botulinum toxin injections (to be evaluated) 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 Motor skill learning with a rehabilitation robot
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: intervention<br>Training on the rehabilitation robot REAplan(R) to learn complex, coordinated bimanual movements | Device: Bimanual motor skill learning with the REAplan(R) rehabilitation robot<br>* REAplan(R) rehabilitation robot : training to perform complex, coordinated, bimanual movements<br>|
| Active Comparator: control intervention<br>Training on the rehabilitation robot REAplan(R) with simple movements | Device: Bimanual motor skill learning with the REAplan(R) rehabilitation robot<br>* REAplan(R) 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 |
| --- | --- | --- |
| bi-SAT, bimanual Speed/Accurady Trade-off measured by the REAplan robot | bimanual Speed/Accurady Trade-off: mathematical computation of the relationship bewteen speed and accuracy | change between baseline (Day 1) and after training (Day 3) | 
| bi-CO, bimanual Coordination factor measured by the REAplan robot | bimanual Coordination factor, mathematical measure of the phase coherence between speeds of both arms | change between baseline (Day 1) and after training (Day 3) | 
| bi-Force, bimanual Coordination factor measured by the REAplan robot | bimanual forces, forces exerted in the wrong direction by each arm (Newtons) | change between baseline (Day 1) and after training (Day 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 | change between baseline (Day 1) and after training (Day 3) | 
| bi-Force on bimanual REACHING (REAplan robot) | bimanual forces, forces exerted in the wrong direction by each arm (Newtons) | change between baseline (Day 1) and after training (Day 3) | 
| bi-CO on bimanual REACHING (REAplan robot) | bimanual Coordination factor, mathematical measure of the phase coherence between speeds of both arms | change between baseline (Day 1) and after training (Day 3) | 
| bi-smoothness on bimanual REACHING (REAplan robot) | Smoothness of movement : Spectral Arc Length (SPARC) | change between baseline (Day 1) and after training (Day 3) | 
| bi-error on bimanual REACHING (REAplan robot) | Error in centimeres or degrees during bimanual reaching | change between baseline (Day 1) and after training (Day 3) | 
| BBT | Box & Blocks Test (timed transfert of blocks from one space to the other, 3 trials/hand) | change between baseline (Day 1) and after training (Day 3) | 
| whole-hand GF | whole-hand Grip Force (GF) measured with a dynamometer, 3 trials/hand) | change between baseline (Day 1) and after training (Day 3) | 
| Visual Analog Scale for fatigue (VAS fatigue) | Visual Analog Scale to evaluate fatigue = a psychometric response scale which can be used in questionnaires. It is a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. When responding to a VAS item, respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end-points. Range : 0- 10. | change between baseline (Day 1) and after training (Day 3) |