Wrist-worn Sensors for Tele-Rehabilitation of the Hemiparetic Upper Extremity

BioSensics60 enrolled

Overview

Stroke and other causes of central nervous system damage can result in debilitating loss of motor control that is often more pronounced in one limb than the other. Using or attempting to use the affected limb during activities of daily living, despite considerable difficulty, stimulates neuroplasticity and motor function recovery. The investigators are conducting a clinical study to test the efficacy of wrist-worn sensors that encourage affected limb use during activities of daily living.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Stroke Hemiparesis

Interventions

Wearable sensors and biofeedbackDEVICE

Participants in the Experimental Arm will wear sensors to monitor their upper limb movement and will receive feedback from these sensors to encourage usage of the impaired limb during activities of daily living.

Eligibility

Sex: ALLMin age: 21 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Ischemic or hemorrhagic stroke at least 3 months prior to study enrollment * Mild-to-moderate to severe upper-limb motor impairments (as measured by a score between 21 and 50 on the arm section of the Fugl-Meyer scale). Exclusion Criteria: * Cognitive impairments that would significantly interfere with their ability to follow instructions (as measured by a score lower than 23 on the Mini Mental State Examination scale) * Severe attention deficits or hemispatial neglect (as measured by the Mesulam Cancellation test and the Line Bisection test); * Severe range-of-motion limitations (as measured via physical examination) or severe spasticity (as measured using the Modified Ashworth scale) that would prevent safe performance of home-based exercises; * Proprioceptive deficits that impair their ability to process feedback (as measured using the Fugl-Meyer Assessment-upper extremity; sensory section). * Implantable medical devices that are not compliant with the ISO 14117:2012 and/or ANSI/AAMI PC69 standards for Bluetooth compatibility. We will ask subjects to provide us with their medical device record card and verify that the device complies with the above-mentioned standards. If not, they will be excluded from the study. * Participation in upper-extremity rehabilitation program (i.e. outpatient occupational therapy, research study, ...). * Recent (\< 3 months) Botox injection in the upper-extremity or plan to undergo injections during the study timeline.

Locations (1)

Spaulding Rehabilitation Hospital

Charlestown, Massachusetts, United States

RECRUITING

Outcomes

Primary Outcomes

Change in Fugl-Meyer during intervention

Change in Fugl-Meyer Upper Extremity Assessment Scale score from baseline (measure of upper extremity impairment, score range from 0 to 66 points, higher values are considered a better outcome).

Time frame: 12 weeks

Change in Motor Activity Log Quality Score during intervention

Change in Motor Activity Log Quality Score from baseline (measure of hemiparetic upper extremity use in daily life, score range from 0 to 5 points, higher values are considered a better outcome)

Time frame: 12 weeks

Change in Motor Activity Log Quantity Score during intervention

Change in Motor Activity Log Quantity Score from baseline (measure of hemiparetic upper extremity use in daily life, score range from 0 to 5 points, higher values are considered a better outcome)

Time frame: 12 weeks

Change in Fugl-Meyer during washout

Change in Fugl-Meyer Upper Extremity Assessment Scale score from end of intervention to follow-up (measure of upper extremity impairment, score range from 0 to 66 points, higher values are considered a better outcome).

Time frame: 12 weeks (end of intervention), 20 weeks (follow-up)

Change in Motor Activity Log Quality Score during washout

Change in Motor Activity Log Quality Score from end of intervention to follow-up (measure of hemiparetic upper extremity use in daily life, score range from 0 to 5 points, higher values are considered a better outcome)

Time frame: 12 weeks (end of intervention), 20 weeks (follow-up)

Change in Motor Activity Log Quantity Score during washout

Change in Motor Activity Log Quantity Score from end of intervention to follow-up (measure of hemiparetic upper extremity use in daily life, score range from 0 to 5 points, higher values are considered a better outcome)

Central Contacts

Catherine Adans-Dester, PT

CONTACT

617-952-6321 cadans-dester@partners.org

Data from ClinicalTrials.gov

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Secondary Outcomes

Change in Wolf Motor Function Test time-subscale during intervention

Change in Wolf Motor Function Test time-subscale score from baseline (measure of upper extremity function, score range from 0 to 120 seconds, lower values are considered a better outcome)

Time frame: 12 weeks

Change in Wolf Motor Function Test quality-subscale during intervention

Change in Wolf Motor Function Test quality-subscale score from baseline (measure of upper extremity function, score range from 0 to 5 points, higher values are considered a better outcome)

Time frame: 12 weeks

Change in Wolf Motor Function Test time-subscale during washout

Change in Wolf Motor Function Test time-subscale score from end of intervention to follow-up (measure of upper extremity function, score range from 0 to 120 seconds, lower values are considered a better outcome)

Time frame: 12 weeks (end of intervention), 20 weeks (follow-up)

Change in Wolf Motor Function Test quality-subscale during washout

Change in Wolf Motor Function Test quality-subscale score from end of intervention to follow-up (measure of upper extremity function, score range from 0 to 5 points, higher values are considered a better outcome)

Time frame: 12 weeks (end of intervention), 20 weeks (follow-up)