ClinicalTrials.gg
CompletedNCT05280431PCP_EXOsUpdated Aug 30, 2023

Evaluation of Exoskeleton for Upper Limb Rehabilitation in Neurological Patients

An interventional study of AGREE exoskeleton and FEXO exoskeleton in Stroke and Neurologic Disorder, sponsored by Casa di Cura Privata del Policlinico SpA. Completed at 1 site in Italy. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2023-08-30.

Sponsored by Casa di Cura Privata del Policlinico SpA · Not applicable, Interventional, and Health services research

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Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 85 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 345 studies in Stroke with a site in Italy — 92 open to participants now, 105 under way, 3 of them phase 3. Stroke · Italy.

Enrollment
169th of 263
48 · median 72
Started
2022
with 29 others
No phase
208 of 345
66 open now
Registered
195th of 345
by date

Among the 345 studies in Stroke with a site in Italy, this one is the 169th largest by enrollment of the 263 interventional ones that give a count, is one of 30 that started in 2022, is one of 208 with no phase, and was the 195th registered.

Stroke

8,258 studies on the registry are indexed under Stroke; 2,055 are open to participants now.

Browse Stroke studies →

Open to participants now

92 of the 345 studies in Stroke with a site in Italy are open now. Recruiting first, the newest first:

87 more — sign in →

All 92 open studies →

A study can be open while its sites in Italy have not opened yet or have stopped. Only those recruiting at a site in Italy →

Who these studies take

Of the 1,415 Stroke studies recruiting now, 695 (49%) set no upper age limit and 280 (20%) stop at 75 or younger; 77 take children under 18; 195 take healthy volunteers.

This study: 18 Years to 85 Years · all sexes · no healthy volunteers.

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02

Study summary

Acquired cerebrovascular trauma is the third most common cause of disability worldwide, resulting in long-term disability, limitation of activities of daily living, and reduced social participation. It is estimated that, within three months of the acute event, a high percentage of patients do not recover full function. 93% of these disabilities concern the upper limb.

To induce optimal functional reorganization after the acute cerebrovascular events or neurodegenerative diseases affecting the central nervous system, robotic assistance allows intensive exercises with specific therapeutic purposes. Indeed, they enable an intensive, repetitive, and customizable therapeutic program that is in line with the principles underlying motor learning.

Clinical investigation is needed to assess the efficacy of the proposed new technologies (AGREE and FEXO exoskeleton) and to guide subsequent developmental steps. Therefore, an exploratory clinical study is proposed to evaluate usability, tolerability, and safety, as well as to assess the effectiveness of the new technologies.

The primary objective of this study is to examine the safety and tolerability of the new active exoskeletons for upper extremity rehabilitation and validate them in a controlled environment. Furthermore, efficacy will be examined as the secondary outcome.

03

Conditions studied

  • Stroke
  • Neurologic Disorder
04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • age between 18 and 85 years;
  • motor deficit of the upper limb induced by neurological diseases (e.g., stroke, multiple sclerosis);
  • time since the acute event of at least one month;
  • Trunk Control Test score ≥ 48.

Exclusion criteria

Exclusion Criteria:

  • global aphasia;
  • presence of cognitive impairment;
  • severe unilateral spatial neglect;
  • Box and Block test \< 1;
  • Ashworth scale score ≥ 4;
  • total or severe impairment of visual acuity;
  • instability of clinical parameters or presence of severe comorbidities;
  • inadequate anthropometric measurements;
  • presence of any serious condition that may affect participation in the study (e.g., oncological, hepatic/renal, immune, metabolic/endocrine, psychiatric, respiratory or infectious disorders);
  • inability to comply with the protocol or to give .
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
48 participants (actual)

Study arms

  • Experimental
    Experimental Group (AGREE)

    15 sessions, 3 sessions per week. Each session consists of 45 minutes of training with the AGREE exoskeleton. The training session is customized to the patient's needs and can be adapted to his/her improvement during the intervention.

    Device: AGREE exoskeleton

  • Experimental
    Experimental Group (FEXO)

    15 sessions, 3 sessions per week. Each session consists of 45 minutes of training with the FEXO exoskeleton. The training session is customized to the patient's needs and can be adapted to his/her improvement during the intervention.

    Device: FEXO exoskeleton

  • Other
    Control Group (Conventional therapy)

    15 sessions, 3 sessions per week. Each session consists of 45 minutes and consists of different training modalities typically used in the rehabilitation of the arm after stroke.

    Other: Conventional therapy

Interventions

  • DeviceAGREE exoskeleton

    Upper limb exoskeleton with four actuated degrees of freedom (shoulder horizontal adduction/abduction, shoulder flexion/extension, humeral rotation, elbow flexion/extension), and one passive degree of freedom (wrist pronation/supination), implementing different rehabilitative strategies. The intervention consists of the execution of different exercises with the affected arm supported by the AGREE device. The subject is actively involved in the exercises and the system provides different kinds of assistance that can be tailored according to the patient's status. The following exercises can be performed: * anterior reaching (in a plane or in the space) * lateral elevation of the arm * hand to mouth movements with or without an object in the hand * moving objects (on a plane or in the space) * exergames. A subset of exercises is defined based on the patient's capability.

  • DeviceFEXO exoskeleton

    After patient's preparation (tDCS and FES) the FEXO assessment is conducted. The subject performs FEXO assessment games. This stage is also used to calibrate the reach and grasp movement intention EEG patterns. The movement is recorded using internal kinematic sensors; therefore, these measures can be extracted for both reaching and lifting movements. Trunk forward bending is measured to avoid compensatory movements when doing reaching assessment. The clinician then reviews the plan for today's session: game selection, number of repetitions and assistance levels. The patient gets ready to play the games and the clinician starts the first activity of the active stage of FEXO therapy. The patient plays the game and sees his own results. The clinician monitors patient activity, assistance levels, effort and signs of discomfort. The patient plays the next game and sees his own results, and the clinician checks the patient's progress with the results overview.

  • OtherConventional therapy

    It consists of a combination of different treatment modalities among the following, based on the patient's specific needs: * Upper limb passive motion * Occupational therapy exercises * Constraint-induced movement therapy * Upper limb active movement (reaching, grasping, elevation, spatial orientation) * Repetitive task training

06

What researchers measure

Primary outcomes

  1. System Usability Scale (SUS)

    SUS is used to measure how easy or difficult the proposed system is to use

    Time frame: up to 5 weeks

Secondary outcomes

  1. Technology Assessment Methods (TAM)

    TAM is an information systems theory that models how users come to accept and use a technology

    Time frame: up to 5 weeks

  2. Virtual Reality Questionnaire (VR)

    VR is used to measure how easy or difficult the virtual reality interface is to use

    Time frame: up to 5 weeks

  3. Fugl-Meyer Assessment Scale (FMA-UE)

    FMA-UE assesses sensorimotor status including items assessing upper extremity motion, balance, sensation and range of movement

    Time frame: up to 5 weeks

  4. Action Research Arm Test (ARAT)

    ARAT is used to assess upper extremity performance (coordination, dexterity and functioning)

    Time frame: up to 5 weeks

  5. Modified Ashworth Scale (MAS)

    MAS is used to muscle quantified spasticity

    Time frame: up to 5 weeks

  6. Motricity Index (MI)

    MI is used to grade motor activity in muscles of the upper limb

    Time frame: up to 5 weeks

  7. Visual Analogue Scale (VAS)

    VAS is a psychometric response scales used to measure subjective pain

    Time frame: up to 5 weeks

  8. Box and Block Test (BBT)

    BBT measures unilateral gross manual dexterity. The BBT administration consists of asking the subject to move, one by one, the maximum number of blocks from one compartment of a box to another of equal size, within 60 seconds

    Time frame: up to 5 weeks

  9. Nine Hole Peg Test (9HPT)

    9HPT is used to measure finger dexterity in patients. The 9HPT administration consist of asking the subject to take the pegs from a container, one by one, and place them into the holes on the board, as quickly as possible

    Time frame: up to 5 weeks

  10. Number of Peaks (#Peaks) of the speed profile

    If a point-to-point reaching movement has a low number of peaks, it means that few acceleration and deceleration periods are present

    Time frame: up to 5 weeks

  11. Smoothness described by the Teulings's index (TI)

    TI s the rate of change of the acceleration in a movement; a lower value of TI indicates a smoother movement

    Time frame: up to 5 weeks

  12. The absolute hand path error (e)

    e is the area between the actual movement path and the straight line; this was considered an index of learning and a reduction of e indicates a better adaptation to the required task.

    Time frame: up to 5 weeks

  13. Event-Related Desynchronization and Synchronization (ERD/ERS) of the μ and β rhythms

    Motor processing can result in changes of the ongoing EEG in form of an event-related desynchronization (ERD) or event-related synchronization (ERS). Spatial mapping of ERD/ERS can be used to study the dynamics of cortical activation patterns

    Time frame: up to 5 weeks

07

Study locations

1 site
  • Casa di Cura del Policlinico
    Milan, MI 20144, Italy
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jan 2022 to primary completion in Mar 2023, 14 months.

Of 3,111 non-industry interventional studies with no phase under Stroke, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 46. This study's 14 months is below that.

Counting every sponsor, half of 3,255 studies reached it within 23 months; a quarter within 10 and three quarters within 46.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 10, 2022
First posted
Mar 15, 2022
StartActual
Jan 25, 2022
Primary completionActual
Mar 31, 2023
CompletionActual
Mar 31, 2023
Last update
Aug 30, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 30, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05280431
Lead sponsor
Casa di Cura Privata del Policlinico SpA
Collaborators
Politecnico di Milano, Fundación Tecnalia Research & Innovation
Responsible party
Sponsor
First posted
Mar 15, 2022
Start date
Jan 25, 2022
Primary completion
Mar 31, 2023
Completion
Mar 31, 2023
Last update
Aug 30, 2023

Oversight

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

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This study is completed, as verified in Feb 2023. You cannot join it, but the record below documents what was studied.

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