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StrokeSCORESNCT06109324

Sensory and Cognitive Outcomes of Robotic Exercises in Stroke (SCORES)

A study testing Robotic Rehabilitation of the upper limb and Conventional Rehabilitation of the upper limb in people with Stroke, run by Fondazione Don Carlo Gnocchi ETS at 3 sites in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Based on the findings of meta-analyses, upper limb robotic rehabilitation has shown to enhance daily living activities, motor function, and strength in stroke patients. However, when compared to traditional methods, recent randomized controlled trials conducted on larger participant groups failed to identify… Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Stroke
What is being tested?
Robotic Rehabilitation of the upper limb and Conventional Rehabilitation of the upper limb
Could I receive a placebo?
No, everyone receives an active treatment
How many people
126 participants
Where
3 sitesItaly
Study dates
13 Nov 2023to Jan 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • a single event, verified by MRI or CT;
  • age between 18 and 85 years;
  • time since stroke within six months;
  • a demographically adjusted total score of the Montreal Cognitive Assessment (MoCA) between 15.5 and 22.23

Who cannot join

  • behavioural and cognitive disorders and/or reduced compliance that would interfere with active therapy;
  • fixed contraction deformity in the affected limb that would interfere with active therapy (ankylosis, Modified Ashworth Scale = 4);
  • severe deficits in visual acuity.

Trial locations and contacts

3 sites in 1 country.

Marco Germanotta, PhD contact

+390633086553

mgermanotta@dongnocchi.it

Italy3 sites, 3 recruiting
  • IRCCS Fondazione Don Carlo Gnocchi

    Florence, 50143

    Recruiting
  • IRCCS Centro Neurolesi Bonino Pulejo

    Messina, 98123

    Recruiting
  • Fondazione Don Carlo Gnocchi - Centro Santa Maria della Provvidenza

    Roma, 00166

    Recruiting

Other trials in Italy

About this study

Official title: A Multicenter Randomized Controlled Trial on the Effects of Upper Limb Robotic Rehabilitation on Sensory and Cognitive Impairments in Subjects With Stroke. The SCORES (Sensory and Cognitive Outcomes of Robotic Exercises in Stroke) Study.

Based on the findings of meta-analyses, upper limb robotic rehabilitation has shown to enhance daily living activities, motor function, and strength in stroke patients. However, when compared to traditional methods, recent randomized controlled trials conducted on larger participant groups failed to identify significant differences in motor-related outcomes between the two approaches.

In addition to motor deficits, stroke survivors often experience cognitive decline and sensory disturbances, which can significantly impede their recovery process. The introduction of multisensory stimulation and an enriched environment through robotic interventions may offer valuable supplementary treatments in these specific areas. Nevertheless, this aspect of treatment has not been thoroughly explored.

This study seeks to assess the effectiveness of upper limb robotic rehabilitation in individuals recovering from subacute strokes, in comparison to conventional treatments. Specifically, it aims to determine whether this robotic therapy can lead to improvements in (a) cognitive deficits, (b) somatosensory impairment, and (c) how these sensory and cognitive deficits influence the process of motor recovery.

Read the detailed description

The study aims to investigate whether an upper limb robotic treatment could have a greater impact than a conventional approach on specific cognitive domains in patients with stroke, as well as in restoring the somatosensory impairment in patients with stroke.

For this aim, 126 consecutive subjects with stroke in the sub-acute phase (within 6 months after stroke) will be enrolled and randomized to either the robotic (RG) or the conventional group (CG). The sample size was calculated by means of a 2- sided, 2-sample t-test assuming: 80% power; type I error of 0.05; a mean difference of 2.15 units on the MoCA, a common standard deviation of 3.77 points (Wu 2019). Considering a dropout rate of 20%, the final sample size required was estimated to be 126 subjects.

Randomization will be stratified according to a cut-off of 18.28 on the MoCA demographically adjusted total score (inner confidence limit of the 5th centile of the normal population) indicating a borderline performance, to ensure that the subjects' characteristics in each group will be closely matched. In the RG, patients will undergo robotic therapy, while a conventional approach will be used in the CG. The rehabilitation treatments, either robotic or conventional, will be performed daily for 45 minutes, 5 days/week, for a total of 30 sessions. Patients in the RG will be treated using a set of devices that allow bi- and three-dimensional movements of the shoulder, elbow, wrist, and fingers (Aprile et al, 2019). Motor and cognitive tasks, carefully selected among those available, will be performed during the treatment, following a protocol already proposed in a previous pilot study (Aprile et al, 2021). Visual and auditory feedback will be provided to help the patients. In the RG, treatment will focus on reprogramming sensorimotor function, hypertonus inhibition, and functional improvement. Patients will be evaluated at baseline (T0), the end of the rehabilitation protocol (T1), and a 6-month follow-up (T2).

Conditions
Stroke
Being tested
Robotic Rehabilitation of the upper limb, Conventional Rehabilitation of the upper limb
Keywords
robotics, cognition, rehabilitation, upper extremity, sensorimotor
Medical subject headings
Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Robotic Rehabilitation of the upper limbOther

    Upper limb rehabilitation using a set of 4 devices. A set of motor/cognitive exercises will be selected to train also attention, memory, executive function, speed of processing, and visuospatial abilities.The following devices will be used: (a) a robotic device that allows passive, active, and active-assistive planar movements of the shoulder and elbow joints (Motore, Humanware); (b) a robotic device that allows passive, active, and active-assistive finger flexion and extension movements (Amadeo, Tyromotion); (c) a sensor-based system that allows unsupported 3-dimensional movements of shoulder, elbow, and wrist joint, both unimanual and bimanual (Pablo, Tyromotion); and (d) a robotic system that allows 3-dimensional, unimanual and bimanual, movements of the shoulder joint, with arm weight support (Diego, Tyromotion).

    The rehabilitation treatment will be performed daily for 45 minutes, 5 days/week, for a total of 30 sessions.

  • Conventional Rehabilitation of the upper limbOther

    Upper limb rehabilitation using conventional techniques, focused on upper limb reprogramming sensorimotor function, hypertonus, inhibition and functional improvement.

    The rehabilitation treatment will be performed daily for 45 minutes, 5 days/week, for a total of 30 sessions.

Study groups in NCT06109324
Study groupRoleWhat they receive
Robotic RehabilitationExperimentalNot described
Receives: Other: Robotic Rehabilitation of the upper limb
Conventional treatmentActive comparatorNot described
Receives: Other: Conventional Rehabilitation of the upper limb

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in Montreal Cognitive Assessment

    It is a validated test of cognitive impairment. It ranges from 0 (indicating worse cognitive function) to 30 (best cognitive function).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention

Secondary outcomes (17)
  1. Changes in Montreal Cognitive Assessment

    It is a validated test of cognitive impairment. It ranges from 0 (indicating worse cognitive function) to 30 (best cognitive function).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  2. Changes in Symbol Digit Modalities Test

    The Symbol Digit Modalities Test evaluates information processing speed. It consists of a simple task of replacing symbols with numbers. Using a reference key, the patient has 90 seconds to match a sequence of symbols with the correspondent numbers as rapidly as possible. Both written or oral administration can be used.

    For each correct answer, a point is assigned.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  3. Changes in Tower of London

    The Tower of London test is a tool to assess strategic decision and problem solving. The patient is required to move different colored balls on the three pegs of different lengths, according to a model and a number of established moves. The maximum time for each configuration is 60 seconds.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  4. Changes in Rey-Osterrieth Complex Figure test

    The Rey-Osterrieth Complex Figure is a neuropsychological assessment for evaluation of visuospatial abilities, memory, attention, planning, working memory and executive functions. The patient is required to copy a complex figure freehand (recognition), and then draw it from memory (recall). The score is assigned based on the correctness of each line (from 0 to 2)

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  5. Changes in Visual search test

    It is a validated measure of visual attention.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  6. Changes in Fugl-Meyer Assessment of the Upper Extremity (motor score)

    It is a stroke-specific, performance-based impairment index. It ranges from 0 (hemiplegia) to 66 points (normal).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  7. Changes in Thumb Localizing Test

    It is a standardised measure of proprioception. It ranges from 0 (normal) to 3.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  8. Changes in Semmes Weinstein filament test

    It measure the level of light touch sensation of the tips of the thumb and index finger. The Semmes Weinstein filament test kit consists of 20 flexible nylon monofilaments of constant length, but varying in diameter. They are labeled so as to give a linear scale of perceived intensity (1.65-6.65) using a logarithmic scale of applied force: labeled number = Log10 of (10 × force in milligrams). The more the labeled number increases, the thicker the filament becomes, and the more pressure is necessary to bend the filament.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  9. Changes in Fugl-Meyer Assessment of the Upper Extremity (sensation score)

    It is a stroke-specific, performance-based impairment index. It ranges from 0 (no sensation) to 12 points (normal).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  10. Changes in Box and Block test

    The Box and Block test is a standard measure for evaluating manual dexterity. The participants grasp and transfer one-inch square blocks from one compartment to the other, transferring as many as possible. The number of blocks transferred from one side to the other within 1 min is recorded.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  11. Changes in Motricity Index

    It is a validated measure of upper limb strength. It ranges from 0 (worse) to 100 (normal strength).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  12. Changes in Modified Barthel Index

    The modified is an ordinal scale used to measure performance in activities of daily living. It ranges from 0 to 100, with lower scores indicating increased disability.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  13. Changes in Numerical Rating Scale for Pain

    The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale, from 0 (no pain) to 10 (worst pain imaginable).

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  14. Changes in Neuropathic Pain Symptom Inventory

    It is a validated scale for evaluating both peripheral and central neuropathic pain. It ranges from 0 to 100 (most imaginable pain)

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  15. Changes in Douleur Neuropathique 4

    It is a validated clinician-administered screening tool for neuropathic pain. It ranges from 0 to 10; higher values means higher neuropathic pain probability.

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  16. Changes in Post-stroke Depression Rating Scale

    It is a validated measure of depression in post-stroke patients. The score ranges from 0 (best) to 45 (worse)

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

  17. Changes in Intrinsic Motivation Inventory

    The Intrinsic Motivation Inventory (IMI) is a multidimensional measurement method designed to assess participants' subjective experience related to a target activity in laboratory experiments

    Measured: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention; 6 months after the end of the intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Oct 2023
  2. Study start13 Nov 2023
  3. Primary completionMay 2025 (estimated)
  4. Study completionJan 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
126 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06109324
Sponsor's protocol ID
SCORES_clinicalstudy
Acronym
SCORES
Status last verified
Oct 2024
First submitted
23 Oct 2023
Last updated
15 Oct 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Robotic Rehabilitation of the upper limb and Conventional Rehabilitation of the upper limb in people with Stroke, run by Fondazione Don Carlo Gnocchi ETS at 3 sites in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Marco Germanotta, PhD (+390633086553, mgermanotta@dongnocchi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in Montreal Cognitive Assessment (time frame: Baseline, up to 7 days after the enrollment; up to 3 days after the intervention). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2024.

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