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NeglectNEGLECTARM3DNCT07290218

Tridimensional Robotic Assessment of Neglect in Brain Injured Patients

An observational study of Neglect and Brain Injured Patients, run by Fondazione Don Carlo Gnocchi ETS at 3 sites in Italy.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to assess the usability and feasibility of a robotic and virtual reality-based system called NeglectARm 3D for the three-dimensional assessment of unilateral spatial neglect (USN) in patients with brain injury due to ischemic or hemorrhagic stroke. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Neglect, Brain Injured Patients, Stroke
What is being tested?
Evaluation with a Non-CE-Marked Robotic Device
Type of treatment
Medical device
How many people
15 participants
Where
3 sitesItaly
Study dates
1 Jan 2026to 30 Nov 2026
Phase
Observational
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The enrollment phase will be conducted at the IRCCS Fondazione Don Carlo Gnocchi in Florence (FI) and at the Fondazione Don Carlo Gnocchi in Sant'Angelo dei Lombardi (AV), in Italy. Each patient will be considered enrolled after assessment of inclusion and exclusion criteria and after signing the informed consent form. A total of 15 patients will be recruited, with 10 participants at the Florence center and 5 participants at the Sant'Angelo dei Lombardi center.

Who may be able to join

  • Age > 18 years;
  • Diagnosis of ischemic or hemorrhagic stroke;
  • Diagnosis of Unilateral Spatial Neglect (assessed by The Hearts Test, Oxford Cognitive Screen, cut-off ± 2);
  • Signed informed consent form.

Who cannot join

  • Presence of language deficits (inability to complete the OCS test);
  • Presence of cognitive decline prior to the stroke event;
  • Presence of severe visual and/or hearing impairments;
  • Language barriers;
  • Orthopedic, neurological, or psychiatric conditions that could interfere with the study or with the assessment of motor and cognitive function;
  • Uncontrolled epilepsy despite antiepileptic treatment;
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  • Behavioral disorders that may interfere with study participation;
  • Presence of medical devices whose functioning could be compromised (e.g., pacemaker, etc.);
  • Object-centered neglect (assessed by the OCS Hearts Test; object asymmetry ± 2).

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Francesca Cecchi, MD contact

fcecchi@dongnocchi.it

Italy3 sites
  • IRCSS Fondazione Don Carlo Gnocchi

    Florence, FI, 50143

    Francesca Cecchi, MD, fcecchi@dongnocchi.it

    Andrea Mannini, PhD, amannini@dongnocchi.it

  • Scuola Superiore Sant'Anna

    Pisa, PI, 56127

    Egidio Falotico, PhD, egidio.falotico@santannapisa.it

    Sabina Nuti, PhD, rettrice@santannapisa.it

  • Fondazione Don Carlo Gnocchi, Polo Specialistico Riabilitativo

    Sant'Angelo dei Lombardi, AV, 83054

    Anna Estraneo

    Alfonso Magliacano

Other trials in Italy

About this study

The goal of this clinical trial is to assess the usability and feasibility of a robotic and virtual reality-based system called NeglectARm 3D for the three-dimensional assessment of unilateral spatial neglect (USN) in patients with brain injury due to ischemic or hemorrhagic stroke.

The main questions it aims to answer are:

Read more
  • Is the NeglectARm 3D system usable and feasible for patients with USN?
  • Do the robotic measurements show preliminary reliability and validity compared with conventional clinical neglect assessments (e.g., BIT, CBS)?

Participants will:

  • Perform two assessment sessions, three weeks apart (T0 and T1);
  • Interact with the NeglectARm 3D system using a robotic end-effector and a VR headset to reach sequentially presented targets in a 3D virtual space;
  • Receive robotic assistance if targets are not reached, allowing the system to record trajectories, spatial positions, and assistance applied;
  • Complete standard clinical neglect tests to enable comparison between robotic and conventional measures.

This study aims to develop a repeatable, standardized, and objective tool for the assessment of USN in patients with brain injury, potentially improving evaluation of depth perception and spatial attention deficits.

Read the detailed description

This observational, non-commercial study evaluates the usability and feasibility of the NeglectARm 3D system, a robotic and virtual reality-based tool for three-dimensional assessment of Unilateral Spatial Neglect (USN) in patients with brain injury due to ischemic or hemorrhagic stroke. Participants undergo two assessment sessions (T0 and T1), spaced three weeks apart, which include clinical neglect assessments using standard instruments and robotic evaluations with two test-retest trials per session.

The robotic component is the Franka Research 3 arm, a force-sensitive manipulator with seven degrees of freedom and torque sensors in each joint, providing industrial-quality pose repeatability of ±0.1 mm and minimal path deviation at high speeds. The virtual reality component is the Meta Quest 3 headset, which delivers high-resolution, smooth, and immersive visual feedback and tracks hand movement in real time using integrated sensors and RGB cameras.

During each session, participants reach sequentially presented stimuli in a 3D virtual space using their unaffected hand, in contact with the robotic end-effector. The system measures three-dimensional kinematics and provides assistance if the participant cannot reach a target independently. The robot operates in shared control mode, remaining transparent when the participant can reach a target autonomously ("patient-guided") and guiding the participant along the optimal trajectory when assistance is required ("robot-guided"), ensuring safe and natural movement.

The system records spatial positions and assistance parameters, enabling the construction of a map of target interactions and extraction of parameters for instrumental assessment of USN. Between assessment sessions, participants continue conventional rehabilitation. Data management includes checks for consistency and range, with source data verification performed by comparing robotic measurements with recorded observations. The study plans to enroll 15 patients, each completing two assessment sessions, to evaluate usability, feasibility, and preliminary reliability and validity of the system.

Being tested
Evaluation with a Non-CE-Marked Robotic Device
Keywords
Neglect, Brain injured patients, Tridimensional robotic assessment, Force-sensitive robot system, Virtual reality (VR) headset, Collaborative robotic system
Medical subject headings
Stroke

What participants receive

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

  • Evaluation with a Non-CE-Marked Robotic DeviceDevice

    Participants are assessed using a non-CE-marked robotic device to evaluate its usability and safety for three-dimensional assessment of Unilateral Spatial Neglect (USN), and to collect preliminary data on reliability and validity. This evaluation is part of the study and does not constitute an assigned intervention.

Study groups in NCT07290218
Study groupRoleWhat they receive
USN Patients CohortThis single cohort includes patients diagnosed with Unilateral Spatial Neglect (USN) who are undergoing conventional neuromotor rehabilitation. The study involves the evaluation of a non-CE-marked robotic device to assess its usability and safety for three-dimensional assessment of USN, as well as to collect preliminary data on the reliability and validity of the device's measurements.
Receives: Device: Evaluation with a Non-CE-Marked Robotic Device

What is being measured

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

  1. Usability of the NeglectARm 3D system

    Evaluation of usability of the NeglectARm 3D system using the HUBBI scale. The HUBBI (eHealth Usability Benchmarking Instrument) is a specialized tool for assessing the usability of eHealth services. It consists of 18 items rated on a 5-point Likert scale across seven key usability categories, focusing on the unique aspects of digital health platforms. This measure provides an indication of how repeatable, standardized, and safe the system is for the three-dimensional assessment of Unilateral Spatial Neglect (USN).

    Measured: Baseline and 3 weeks from baseline

  2. Feasibility of the NeglectARm 3D system

    Evaluation of feasibility of the NeglectARm 3D system, assessed by recording the type and number of side effects or system failures occurring during robotic evaluation. This measure provides an indication of how repeatable, standardized, and safe the system is for the three-dimensional assessment of Unilateral Spatial Neglect (USN).

    Measured: Baseline and 3 weeks from baseline

Secondary outcomes (10)
  1. Behavioral Inattention Test (BIT) - Conventional subtest

    The BIT is a short screening battery of tests used to identify and quantify Unilateral Spatial Neglect (USN), consisting of 6 conventional paper-and-pencil subtests and 9 behavioral subtests.The BIT Conventional subtest consists of 6 items: line crossing, letter cancelation, star cancellation, figure and shape copying, line bisection, and representational drawing. It provides a maximum score of 146.

    Measured: Baseline and 3 weeks from baseline

  2. Catherine Bergego Scale (CBS)

    The Catherine Bergego Scale (CBS) is an observational tool designed to assess Unilateral Spatial Neglect (USN) in ecological contexts, such as activities of daily living. It consists of 10 items rated from 0 (no neglect) to 3 (severe neglect), with a maximum total score of 30; higher scores indicate greater neglect.

    Measured: Baseline and 3 weeks from baseline

  3. Motricity Index (MI)

    The Motricity Index (MI) is an ordinal method of measuring limb strength. For the upper extremity, shoulder abduction, elbow flexion, and pinch grip are considered; for the lower extremity, hip flexion, knee extension, and ankle dorsiflexion are considered. It ranges from 0 (worse) to 100 (normal strength). Measurements are taken bilaterally.

    Measured: Baseline and 3 weeks from baseline

  4. Montreal Cognitive Assessment (MoCA)

    The Montreal Cognitive Assessment (MoCA) is a widely used screening assessment for detecting cognitive impairment. It ranges from 0 (worst) to 30 (best).

    Measured: Baseline and 3 weeks from baseline

  5. Convergent validity between NeglectARm 3D measures and Behavioral Inattention Test (BIT) - Conventional subtest

    Convergent validity will be assessed by calculating correlation coefficients between instrumental (robot-based) measures of Unilateral Spatial Neglect (USN) recorded by the NeglectARm 3D system and the total score of the BIT Conventional subtest (BIT-C). Correlations between instrumental and clinical measures will be calculated using Pearson or Spearman correlation coefficients, depending on variable distribution. The outcome measure is the correlation coefficient between each instrumental measure and the BIT-C total score at each time point.

    Measured: Baseline and 3 weeks from baseline

  6. Convergent validity between NeglectARm 3D measures and Catherine Bergego Scale (CBS)

    Convergent validity will be assessed by calculating correlation coefficients between instrumental (robot-based) measures of Unilateral Spatial Neglect (USN) recorded by the NeglectARm 3D system and the total score of the CBS. Correlations between instrumental and clinical measures will be calculated using Pearson or Spearman correlation coefficients, depending on variable distribution. The outcome measure is the correlation coefficient between each instrumental measure and the CBS total score at each time point.

    Measured: Baseline and 3 weeks from baseline

  7. Test-retest reliability of total test execution time recorded by NeglectARm 3D

    Test-retest reliability of total test execution time recorded by the NeglectARm 3D system will be evaluated by comparing two repetitions of the robotic assessment performed within the same session at T0 and at T1. The outcome measure is the Intraclass Correlation Coefficient (ICC) between the two repetitions at each time point.

    Measured: Within-session at baseline and within-session at 3 weeks from baseline

  8. Test-retest reliability of number of targets identified without robotic assistance

    Test-retest reliability of the number of targets identified without robotic assistance during the NeglectARm 3D task will be evaluated by comparing two repetitions of the robotic assessment performed within the same session at T0 and at T1. The outcome measure is the Intraclass Correlation Coefficient (ICC) between the two repetitions at each time point.

    Measured: Within-session at baseline and within-session at 3 weeks from baseline

  9. Test-retest reliability of the number of targets not identified autonomously

    Test-retest reliability of the number of targets not identified autonomously (i.e., targets for which the robot had to provide assistance) during the NeglectARm 3D task will be evaluated by comparing two repetitions of the robotic assessment performed within the same session at T0 and at T1. The outcome measure is the Intraclass Correlation Coefficient (ICC) between the two repetitions at each time point.

    Measured: Within-session at baseline and within-session at 3 weeks from baseline

  10. Test-retest reliability of total robot intervention time

    Test-retest reliability of total robot intervention time during the NeglectARm 3D task will be evaluated by comparing two repetitions of the robotic assessment performed within the same session at T0 and at T1. The outcome measure is the Intraclass Correlation Coefficient (ICC) between the two repetitions at each time point.

    Measured: Within-session at baseline and within-session at 3 weeks from baseline

Timeline

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

  1. First posted18 Dec 2025
  2. Study start1 Jan 2026 (estimated)
  3. Primary completion31 Oct 2026 (estimated)
  4. Study completion30 Nov 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
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07290218
Sponsor's protocol ID
NEGLECTARM3D
Other IDs
PNC00000007
Acronym
NEGLECTARM3D
Status last verified
Sep 2025
First submitted
21 Nov 2025
Last updated
18 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Kim YM, Chun MH, Yun GJ, Song YJ, Young HE. The effect of virtual reality training on unilateral spatial neglect in stroke patients. Ann Rehabil Med. 2011 Jun;35(3):309-15. doi: 10.5535/arm.2011.35.3.309. Epub 2011 Jun 30.

    PubMed 22506138
  • Chen ZJ, Gu MH, He C, Xiong CH, Xu J, Huang XL. Robot-Assisted Arm Training in Stroke Individuals With Unilateral Spatial Neglect: A Pilot Study. Front Neurol. 2021 Jul 8;12:691444. doi: 10.3389/fneur.2021.691444. eCollection 2021.

    PubMed 34305798
  • Fordell H, Bodin K, Eklund A, Malm J. RehAtt - scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality. Top Stroke Rehabil. 2016 Jun;23(3):191-9. doi: 10.1080/10749357.2016.1138670. Epub 2016 Mar 8.

    PubMed 27077985

Questions about this trial

What is this clinical trial studying?

An observational study of Neglect and Brain Injured Patients, 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 9 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: opening soon, as of the sponsor's last update on 18 Dec 2025. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Egidio Falotico, PhD (+39050 883457, egidio.falotico@santannapisa.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Usability of the NeglectARm 3D system (time frame: Baseline and 3 weeks from baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07290218, which also lists 3 linked publications.

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 18 Dec 2025.

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