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CompletedNCT03444961Updated Jul 14, 2021Results posted

Computer-Assisted Rehabilitation Environment Training After Argus Retinal Prosthesis

An interventional study of CAREN system training in Retinitis Pigmentosa, sponsored by The Cleveland Clinic. Completed at 1 site in United States. Open to participants aged 25 Years to 100 Years. Per ClinicalTrials.gov, last updated 2021-07-14.

Sponsored by The Cleveland Clinic · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
4
Allocation
Not applicable
Ages
25 Years to 100 Years
Sex
All
01

Study summary

The goal of the current project is to fill the unmet clinical needs around the objective assessment of visual function and develop outcome-oriented visual rehabilitation approach using the computer assisted rehabilitation environment (CAREN) system for Argus recipients.

02

Conditions studied

  • Retinitis Pigmentosa

Keywords

  • Argus II Retinal Prosthesis System
  • Rehabilitation
03

Who can participate

Ages eligible
25 Years to 100 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Recipient of the Argus II Retinal Prosthesis System
  • Ability to provide informed consent
  • Ability to follow two-step commands
  • Ability to ambulate 300+ feet with or without visual assistance
  • Able to tolerate Argus device turned on for >20 continuous minutes.

Exclusion criteria

Exclusion Criteria:

  • Dementia
  • Musculoskeletal contraindication to exercise or walking
  • Cardiopulmonary contraindication exercise (i.e. uncontrolled heart failure, cardiac arrhythmia, or pulmonary disease).
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
4 participants (actual)

Study arms

  • Experimental
    CAREN system training

    CAREN training

    Device: CAREN system training

Interventions

  • DeviceCAREN system training

    CAREN allows Argus users to be trained and enhance their device usage in a safe, controlled, and standardized environment.

05

What researchers measure

Primary outcomes

  1. Effects of CAREN Virtual Reality System on Obstacle Course Navigation

    Obstacle course navigation - time (seconds) to complete an obstacle course (walking forward while navigating over a ramp and curb)

    Time frame: 6 wks

  2. Time to Complete the Timed Up and Go Test Before and After CAREN Virtual Reality System Training

    Timed Up and Go testing - functional mobility test that requires the individual to stand from a chair, ambulate three meters to a target, turn around, return to the chair, and sit down. Participants were asked to complete two trials was recorded, with a maximum time of 60 seconds per trial.

    Time frame: 6 wks

  3. Effects of CAREN Virtual Reality System on Square Localization Visual Function Test

    The square localization test presents a 2.75" square (250 pixels) at a random location on a black background and the patient is instructed to try to touch the square. The test measures the patient's ability to locate an object and results are calculated as a mean error (how far away in pixels from the square the patient touches the screen). A lower mean error (the distance from the square) indicates better patient performance.

    Time frame: 6 wks

  4. Effects of CAREN Virtual Reality System on Direction of Motion Visual Function Test.

    The direction of motion test assesses the patient's ability to determine the direction an object is moving. The patient is presented with a white line (1.4'' wide) that moves across the screen in a random series of directions and angles. Patients are instructed to trace their finger on the monitor in the direction they perceived the line moved. Results are calculated as a mean error (how far off, in degrees, was the patient from the direction of the moving line). The higher the mean error/score, the worse the outcome.

    Time frame: 6 wks

  5. Effects of CAREN Virtual Reality System on Grating Visual Acuity Visual Function Test

    The grating visual acuity test measures the patient's visual acuity using the principles of acuity charts modified for ultra-low vision subjects. The patients are presented with black and white bars in one of four orientations (horizontal, vertical, diagonal to the left or diagonal to the right). The bars are present on the screen for 5 seconds during which the patient may scan the screen and then provide a verbal response as to which orientation they perceived the bars. The widths of the bars are varied to evaluate different levels of visual acuity. A lower score is associated with better outcomes with 2.9 being the worst possible score.

    Time frame: 6 wks

  6. Effects of CAREN Virtual Reality System on Gait Assessment

    Subject's gait assessed by meters traveled while localizing objects on the CAREN system. The higher scores are associated with better outcomes (further distance walked).

    Time frame: 6 wks

Other outcomes

  1. Effects of CAREN Virtual Reality System on Activities-specific Balance Confidence (ABC) Scale Questionnaire

    The Activities-specific Balance Confidence Scale (ABC Scale) is a structured questionnaire that measures an individual's confidence in performing activities without losing balance. It is a 0% to 100% continuous response scale with 0 representing "no confidence" and 100 representing "complete confidence."

    Time frame: 6 wks

06

Results

Posted Jul 14, 2021

Participant flow

Participant flow — Overall Study
MilestoneCAREN System Training
Started4
Completed4
Not completed0

Outcome measures

PrimaryEffects of CAREN Virtual Reality System on Obstacle Course Navigation

Obstacle course navigation - time (seconds) to complete an obstacle course (walking forward while navigating over a ramp and curb)

Time frame:
6 wks
Reported as:
Mean · seconds
Effects of CAREN Virtual Reality System on Obstacle Course Navigation
secondsPre-CAREN System TrainingPost-CAREN Training
Effects of CAREN Virtual Reality System on Obstacle Course Navigation51.25 (28 to 117)33.75 (28 to 117)
PrimaryTime to Complete the Timed Up and Go Test Before and After CAREN Virtual Reality System Training

Timed Up and Go testing - functional mobility test that requires the individual to stand from a chair, ambulate three meters to a target, turn around, return to the chair, and sit down. Participants were asked to complete two trials was recorded, with a maximum time of 60 seconds per trial.

Time frame:
6 wks
Reported as:
Mean · seconds
Time to Complete the Timed Up and Go Test Before and After CAREN Virtual Reality System Training
secondsPre - CAREN System TrainingPost-CAREN System Training
Time to Complete the Timed Up and Go Test Before and After CAREN Virtual Reality System Training52.8 ± 6.639.29 ± 10.86
PrimaryEffects of CAREN Virtual Reality System on Square Localization Visual Function Test

The square localization test presents a 2.75" square (250 pixels) at a random location on a black background and the patient is instructed to try to touch the square. The test measures the patient's ability to locate an object and results are calculated as a mean error (how far away in pixels from the square the patient touches the screen). A lower mean error (the distance from the square) indicates better patient performance.

Time frame:
6 wks
Reported as:
Mean · pixels
Effects of CAREN Virtual Reality System on Square Localization Visual Function Test
pixelsPre-CAREN System TrainingPost-CAREN System Training
Effects of CAREN Virtual Reality System on Square Localization Visual Function Test274.62 (104.12 to 463.47)245.43 (104.12 to 463.47)
PrimaryEffects of CAREN Virtual Reality System on Direction of Motion Visual Function Test.

The direction of motion test assesses the patient's ability to determine the direction an object is moving. The patient is presented with a white line (1.4'' wide) that moves across the screen in a random series of directions and angles. Patients are instructed to trace their finger on the monitor in the direction they perceived the line moved. Results are calculated as a mean error (how far off, in degrees, was the patient from the direction of the moving line). The higher the mean error/score, the worse the outcome.

Time frame:
6 wks
Reported as:
Mean · degrees
Effects of CAREN Virtual Reality System on Direction of Motion Visual Function Test.
degreesPre-CAREN System TrainingPost-CAREN System Training
Effects of CAREN Virtual Reality System on Direction of Motion Visual Function Test.65.68 (14.51 to 95.16)58.12 (14.51 to 95.16)
PrimaryEffects of CAREN Virtual Reality System on Grating Visual Acuity Visual Function Test

The grating visual acuity test measures the patient's visual acuity using the principles of acuity charts modified for ultra-low vision subjects. The patients are presented with black and white bars in one of four orientations (horizontal, vertical, diagonal to the left or diagonal to the right). The bars are present on the screen for 5 seconds during which the patient may scan the screen and then provide a verbal response as to which orientation they perceived the bars. The widths of the bars are varied to evaluate different levels of visual acuity. A lower score is associated with better outcomes with 2.9 being the worst possible score.

Time frame:
6 wks
Reported as:
Mean · logMAR
Effects of CAREN Virtual Reality System on Grating Visual Acuity Visual Function Test
logMARCAREN System Training
Effects of CAREN Virtual Reality System on Grating Visual Acuity Visual Function Test2.53 (1.7 to 2.9)
PrimaryEffects of CAREN Virtual Reality System on Gait Assessment

Subject's gait assessed by meters traveled while localizing objects on the CAREN system. The higher scores are associated with better outcomes (further distance walked).

Time frame:
6 wks
Reported as:
Mean · meters
Effects of CAREN Virtual Reality System on Gait Assessment
metersPre-CAREN System TrainingPost-CAREN System Training
Effects of CAREN Virtual Reality System on Gait Assessment111.05 (72.84 to 159.70)130.7 (72.84 to 159.70)
Other pre-specifiedEffects of CAREN Virtual Reality System on Activities-specific Balance Confidence (ABC) Scale Questionnaire

The Activities-specific Balance Confidence Scale (ABC Scale) is a structured questionnaire that measures an individual's confidence in performing activities without losing balance. It is a 0% to 100% continuous response scale with 0 representing "no confidence" and 100 representing "complete confidence."

Time frame:
6 wks
Reported as:
Mean · units on a scale
Effects of CAREN Virtual Reality System on Activities-specific Balance Confidence (ABC) Scale Questionnaire
units on a scalePre-CAREN System TrainingPost-CAREN System Training
Effects of CAREN Virtual Reality System on Activities-specific Balance Confidence (ABC) Scale Questionnaire48.125 (0 to 100)34.375 (0 to 100)

Adverse events

Collected over AE's were collected over the course of 6 months while patients were enrolled/actively participating in the study.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
CAREN System Training0/4 (0%)0/4 (0%)0/4 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)CAREN System Training
<=18 years0
Between 18 and 65 years1
>=65 years3
Sex: Female, Male
Sex: Female, Male(Participants)CAREN System Training
Female1
Male3
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)CAREN System Training
Hispanic or Latino0
Not Hispanic or Latino4
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)CAREN System Training
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White4
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)CAREN System Training
United States4
07

Study locations

1 site
  • Cleveland Clinic
    Cleveland, Ohio 44195, United States
08

References and documents

Publications

  • Rachitskaya A, Yuan A, Davidson S, Streicher M, DeBenedictis M, Rosenfeldt AB, Alberts J. Computer-Assisted Immersive Visual Rehabilitation in Argus II Retinal Prosthesis Recipients. Ophthalmol Retina. 2020 Jun;4(6):613-619. doi: 10.1016/j.oret.2019.11.007. Epub 2019 Nov 15. PubMed 31937474 ↗

Study documents

  • Protocol and statistical analysis plan · Oct 1, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03444961
Lead sponsor
The Cleveland Clinic
Responsible party
Aleksandra Rachitskaya, MD (Assistant Professor of Ophthalmology, Cleveland Clinic Lerner College of Medicine, The Cleveland Clinic) — Principal investigator
First posted
Feb 26, 2018
Start date
Jan 30, 2018
Primary completion
Jun 20, 2018
Completion
Jun 20, 2018
Results posted
Jul 14, 2021
Last update
Jul 14, 2021

Study contacts

Aleksandra Rachitskaya, MD
principal investigator · The Cleveland Clinic

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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