Optimize Motor Learning to Improve Neurorehabilitation (OnLINE)

University of Bern

Status: Completed

Conditions: Stroke; Neurologic Disorder

Treatments: Behavioral: Robotic motor training

Study type: Interventional

Funder types: Other

Identifiers

NCT04759976

2018-01179

Details and patient eligibility

About

The objective of this study is to develop and evaluate novel robotic training strategies that modulate errors based on the subjects' individual motor and cognitive needs. For this purpose, healthy adults and neurologic patients will participate in robotic motor learning experiments. Patients have a diagnosis of a neurological disease (i.e., stroke, spinal cord injury, multiple sclerosis, Guillain-Barré syndrome) limiting arm motor function.

Full description

Neurological patients (e.g., after stroke) engage in intensive and expensive neurorehabilitation therapy to regain part of their former motor functional ability to perform everyday activities with often limited and unsatisfactory outcome. Robots became a promising supplement or even alternative for neurorehabilitation therapy, providing cost-effective, high repetition and task-oriented training. However, results of an initial body of work comparing the effectiveness of robotic training strategies are highly inconclusive. A possible explanation is that most current robotic systems cover only one neurorehabilitation strategy (e.g. reducing or augmenting movement errors) and may thus insufficiently address the subjects' individual needs and the characteristics of the task to be learned. In this study, Investigators will perform several motor learning experiments with healthy adult and neurological patients in order to evaluate the relative motor and cognitive benefits of newly developed robotic training strategies that modulate errors based on the subject's age, skill level and tasks characteristics. The effects of the new strategies will be compared to classical robotic assistance, and to non-robotic feedback approaches, such as visual feedback. The culmination of this work may help to optimize training benefits of already existing rehabilitation robots.

Enrollment: 259 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged ≥18 years
• Informed Consent as documented by signature ("Informed Consent" form)
• Bodyweight <120 kg
• Ability to communicate effectively with the examiner so that the validity of the patient's data could not be compromised

Exclusion criteria

• Excessive spasticity of the affected arm (Ashworth Scale ≥3)
• Serious medical or psychiatric disorder
• Orthopaedic, rheumatological, or other disease restricting movements of the paretic arm
• Shoulder subluxation
• Skin ulcerations at the paretic arm
• Cyber-sickness (i.e., nausea when looking at a screen or playing computer games)
• Serious cognitive defects or aphasia preventing effective use of the robotic devices
• Severe visual and auditory impairments

Trial design

Primary purpose: Basic Science

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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259 participants in 1 patient group

Robotic motor training

Experimental group

Description:

Participants will perform motor tasks (i.e. movements) with upper limb robotic devices applying different strategies (e.g. supporting or challenging the subject, or being fully compliant).

Treatment:

Behavioral: Robotic motor training