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CompletedNCT01774669YouGrabberUpdated Apr 7, 2016

Effectiveness Study on a Virtual Reality Based Training System for Stroke Patients

A Phase 3 interventional study of YouGrabber training device from YouRehab Ltd. and Therapy (PT, OT) in Cerebrovascular Accident, Hemorrhagic Stroke and Stroke, sponsored by Reha Rheinfelden. Completed at 2 sites in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2016-04-07.

Sponsored by Reha Rheinfelden · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
54
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The patient study is a phase III trial designed as a single-blinded, randomised, controlled multi-centre trial with repeated measurement events (ME). Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU). Figure 1 illustrates the study overview.

The study focuses on the evaluation of the YouGrabber efficacy compared to conventional therapy in an outpatient setting.

Research question: Do patients after stroke in the YouGrabber training group show higher postintervention performance in the Box and Block Test (BBT) compared to patients in the conventional therapy group? Hypothesis: H0: The investigators hypothesise that there will be no group differences after 16 training sessions or after the two month follow-up period.

H1: The investigators hypothesise that there will be a group difference after the 16 training sessions and after the two month follow-up period.

Aim: The aim of the project is to design and implement a single-blinded, randomised controlled multi-centre trial comparing YouGrabber training and conventional therapy in patients after stroke.

Patients will be randomly allocated to either the experimental group (EG) or the control group (CG) after the second ME (T0). Group allocation will be based on a computer-generated randomisation list (one for each centre, (MATLAB, 2007b, Mathworks Inc., USA) created by a researcher not involved into the study. Randomisation lists and corresponding token will be stored in the clinics' pharmacy. Patients will draw a token before the first therapy session. The token will be marked and stored until study finalisation in the pharmacy.

Group allocation will remain concealed for the independent assessor until study finalisation. Patients and treating therapists will be reminded not to talk about patient's group allocation with other therapists or participants.

Patients in both study groups (EG, CG) will receive the same amount of 16 sessions lasting for 45 minutes each. During each therapy appointment patients can decide to stop the training at any time.

Patients allocated to EG will have the opportunity to participate in two semi-structured interviews to evaluate their expectations and experiences with the virtual reality therapy with YouGrabber.

Treating therapists will have the opportunity to participate in one focus group meeting to evaluate their experiences with the virtual reality training, its advantages and disadvantages. Interview and focus group participation will be voluntary.

02

Conditions studied

  • Cerebrovascular Accident
  • Hemorrhagic Stroke
  • Stroke

Keywords

  • ischemic stroke
  • hemorrhagic stroke
  • upper limb
  • virtual reality
  • physiotherapy
  • occupational therapy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • ≥ 6 months after first-ever stroke (ischemic, haemorrhagic)
  • Able to sit in a normal chair without armrests and without support of the back rest
  • Persistent motor deficit of the arm and hand confirmed by the Chedoke-McMaster Stroke Assessment (CMSA) subscale arm level 7>x=/>3 and subscale hand level 7>x=/>2.

Exclusion criteria

Exclusion Criteria:

  • Previous or current other functional deficits of arm and hand motor function not due to stroke.
  • Severe cognitive deficits MMSE ≤ 20.
  • Severe spatial-visual disorders, e.g. severe visual neglect confirmed by a Line-Bisection-Test.
  • History of epileptic seizures triggered by visual stimuli (e.g. television, video games) within the last six months.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
54 participants (actual)

Study arms

  • Experimental
    YouGrabber training device from YouRehab Ltd.

    Patients in the experimental group (EG) will receive 16 training sessions lasting for 45 minutes each.

    Device: YouGrabber training device from YouRehab Ltd.

  • Active comparator
    Conventional therapy

    Patients in the control group (CG) will receive 16 therapy sessions (physiotherapy or occupational therapy) lasting for 45 minutes each.

    Other: Therapy (PT, OT)

Interventions

  • DeviceYouGrabber training device from YouRehab Ltd.

    Patients in the experimental group (EG) will receive 16 training sessions lasting for 45 minutes each. The treatment focus is the upper extremity, in particular finder and hand function, movement coordination, and speed.

  • OtherTherapy (PT, OT)

    Patients in the control group (CG) will receive 16 therapy sessions physiotherapy or occupational therapy) lasting for 45 minutes each. The therapy focuses on upper limb movements, in particular finger and hand movements. Furthermore, movement coordination and speed shall be trained.

05

What researchers measure

Primary outcomes

  1. Box and Block Test (BBT)

    Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU).

    Time frame: 15 months

Secondary outcomes

  1. Chedoke-McMaster Stroke Assessment (CMSA)

    Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU).

    Time frame: 15 months

  2. Chedoke Arm and Hand Activity Inventory (CAHAI)

    Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU).

    Time frame: 15 months

  3. Stroke Impact Scale (SIS)

    Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU).

    Time frame: 15 months

Other outcomes

  1. active range of motion (ROM)

    Patients will be evaluated by a blinded assessor on five occasions: twice within two weeks at baseline before intervention start (BL, T0), once after eight treatment sessions (T1), once after the intervention (T2), and once after a two month follow-up period (FU).

    Time frame: 15 months

  2. Extended Barthel Index (EBI)

    Time frame: 15 months

  3. Mini Mental State Examination (MMSE)

    Time frame: 15 months

  4. Edinburgh Handedness Inventory (EHI)

    Time frame: 15 months

06

Study locations

2 sites
  • Reha Rheinfelden
    Rheinfelden, Aargau 4310, Switzerland
  • Inselspital Bern
    Bern, 3010, Switzerland
07

References and documents

Publications

  • Schuster-Amft C, Eng K, Suica Z, Thaler I, Signer S, Lehmann I, Schmid L, McCaskey MA, Hawkins M, Verra ML, Kiper D. Effect of a four-week virtual reality-based training versus conventional therapy on upper limb motor function after stroke: A multicenter parallel group randomized trial. PLoS One. 2018 Oct 24;13(10):e0204455. doi: 10.1371/journal.pone.0204455. eCollection 2018. PubMed 30356229 ↗
  • Schuster-Amft C, Eng K, Lehmann I, Schmid L, Kobashi N, Thaler I, Verra ML, Henneke A, Signer S, McCaskey M, Kiper D. Using mixed methods to evaluate efficacy and user expectations of a virtual reality-based training system for upper-limb recovery in patients after stroke: a study protocol for a randomised controlled trial. Trials. 2014 Sep 6;15:350. doi: 10.1186/1745-6215-15-350. PubMed 25194928 ↗
08

Registry details

Key details

Study ID
NCT01774669
Lead sponsor
Reha Rheinfelden
Collaborators
YouRehab Inc., Swiss Commission for Technology and Innovation
Responsible party
PD Dr. Daniel Kiper (Principal Investigator, University of Zurich) — Principal investigator
First posted
Jan 24, 2013
Start date
Jan 2013
Primary completion
Apr 2016
Completion
Apr 2016
Last update
Apr 7, 2016

Study contacts

Daniel Kiper, PD PhD
principal investigator · University and ETH Zurich, Institute for Neuroinformatics

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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