ClinicalTrials.gg
Not yet recruitingNCT07794072PSY-NeT-EngageUpdated Sep 15, 2026

Digital Patient Engagement in Technology-Supported Neurorehabilitation

An observational study in Stroke, Parkinson Disease (PD) and Motor Neuron Disease, sponsored by Catholic University, Italy. Not yet recruiting at 3 sites in Italy. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-09-15.

Sponsored by Catholic University, Italy · Observational

Study type
Observational
Model
Other
Time perspective
Cross-sectional
Enrollment
129
Ages
18 Years to 85 Years
Sex
All
01

Study summary

The goal of this observational study is to investigate digital patient engagement and its psychosocial correlates and potential predictors among adults aged 18-85 years with neurological disorders who are undergoing technology-supported neurorehabilitation using robotic systems for upper-limb training and/or virtual reality-based technologies.

Specifically, the study will examine the roles of hope and the quality of the patient-healthcare professional relationship as the potential predictors of engagement with rehabilitation technologies. It will also explore the contribution of disease-management self-efficacy, technology anxiety, and sociodemographic, clinical, functional, and rehabilitation-related characteristics. Finally, the study will examine whether digital patient engagement predicts the perceived psychosocial impact of rehabilitation technologies, behavioural intention to continue using them, and overall satisfaction with the rehabilitation pathway.

Participants will:

  • continue their standard neurorehabilitation pathway without any modification to routine clinical procedures;
  • complete a computerized self-report questionnaire via the Qualtrics digital platform at a single time point after completing at least three rehabilitation sessions using the technologies under study.

No experimental intervention, comparison group, or follow-up assessment is planned.

Read the detailed description

PSY-NeT-Engage is an academic, non-profit, multicentre, cross-sectional observational study designed to characterize digital patient engagement during technology-supported neurorehabilitation and to examine factors associated with differences in engagement. The study will be conducted among patients already receiving standard neurorehabilitation involving robotic systems for upper-limb training and/or virtual reality-based rehabilitation technologies at participating clinical centres. It will not assess the clinical or therapeutic efficacy of these technologies, functional recovery, or the achievement of rehabilitation goals, nor will it introduce any experimental intervention or modification to the standard rehabilitation pathway. Because the data will be collected cross-sectionally, the findings will be interpreted as exploratory associations and predictive relationships within the specified statistical models.

Data will be collected once for each participant during the standard neurorehabilitation pathway, after the participant has completed at least three rehabilitation sessions using the technologies under study. Consequently, participants may be assessed at different stages of rehabilitation and after completing different numbers of technology-supported sessions.

Patient-reported data will be collected through a single computerized self-report questionnaire administered via the Qualtrics digital platform using a password-protected tablet. Questionnaire completion is expected to require approximately 15 minutes. Research staff will be available to provide procedural clarification and technical assistance without influencing participants' responses. Relevant sociodemographic, clinical, functional, and rehabilitation-related variables will be extracted from clinical documentation. Variables not available in the clinical records will be collected directly from participants. No follow-up assessment is planned.

In addition to the primary outcome measure of digital patient engagement, the study includes secondary outcome measures of overall satisfaction with the rehabilitation pathway, behavioural intention to continue using rehabilitation technologies, and the perceived psychosocial impact of rehabilitation technologies. Four other pre-specified exploratory variables will also be assessed: hope, perceived quality of the patient-healthcare professional relationship, technology anxiety, and disease-management self-efficacy. These variables will be examined as potential psychosocial, relational, and individual predictors of digital patient engagement. Disease-management self-efficacy will be evaluated as a potential moderator.

Hope will be assessed using the 2-item Brief Hopelessness Scale with Positive Valence (Brief-H-Pos), which measures positive expectations regarding the future and the perceived attainability of personal goals. Higher scores indicate greater hope.

The perceived quality of the patient-healthcare professional relationship will be assessed using the 8-item Nordic Patient Experiences Questionnaire (NORPEQ). The questionnaire evaluates relevant dimensions of the patient's care experience, including communication with healthcare professionals, perceived care and attention, and trust in the healthcare team. Higher scores indicate a more positive care experience and better perceived relationship quality.

Technology anxiety will be assessed using the 11-item Abbreviated Technology Anxiety Scale (ATAS), which evaluates negative affective responses to technology, including apprehension, confidence, and perceived competence in using technological tools. Higher scores indicate greater technology anxiety.

Disease-management self-efficacy will be assessed using the 10-item Self-Efficacy Self-Care Scale (SCSES), which evaluates participants' confidence in their ability to maintain their health, monitor their condition, and manage symptoms while living with a chronic condition. Higher scores indicate greater disease-management self-efficacy. This variable will be examined as a secondary individual exposure factor and as a potential moderator of the associations between hope, the patient-healthcare professional relationship, and digital patient engagement.

For measures without an available validated Italian version, a research-specific Italian translation will be developed using forward-backward translation followed by review by an expert panel. The translated measures and data-collection procedures will initially be piloted in a subgroup of 15 participants to assess item comprehensibility and the adequacy of questionnaire administration. These translations are intended exclusively for research use and will not constitute validated instruments for routine clinical practice.

The minimum target sample of 129 participants was established through an a priori power analysis for structural equation modelling, assuming a moderate effect size of 0.30, statistical power of 0.80, and a two-sided significance level of α = 0.05. Consecutive non-probability sampling will be used, and data collection may continue beyond the minimum target throughout the planned recruitment period to improve the robustness and generalizability of the findings.

The statistical analysis will include descriptive statistics, assessment of variable distributions and outliers, and evaluation of internal consistency using Cronbach's alpha. Exploratory factor analysis will be used to examine the factor structure of measures without a validated Italian version. Initial associations will be evaluated using Pearson or Spearman correlation coefficients, as appropriate. Structural equation modelling will be applied within a confirmatory-exploratory framework to examine the plausibility, direction, and magnitude of the hypothesized direct, indirect, and total associations. Exploratory moderation analyses will be conducted using regression-based interaction models, and multiple regression models will be used to examine additional associations specified in the protocol. Robust estimators will be considered when non-normality or influential outliers could materially affect the results.

02

Conditions studied

  • Stroke
  • Parkinson Disease (PD)
  • Motor Neuron Disease
  • Spinal Cord Injury
  • Traumatic Brain Injury
  • Neurological Disorders
  • Ataxia

Keywords

  • Neurorehabilitation
  • Digital patient engagement
  • Psychosocial factors
  • Robotic rehabilitation
03

In context

Stroke

8,255 studies on the registry are indexed under Stroke; 2,056 are open to participants now.

This study's planned enrollment of 129 is below the median of 152 across 1,968 observational studies indexed under Stroke.

Browse Stroke studies →

Lead sponsor

Catholic University, Italy is the lead sponsor of 10 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population is adult patients who, from the study start date at each participating ICS Maugeri centre, are enrolled under ordinary inpatient admission, simple outpatient care, or MAC (Macroattività Ambulatoriale Complessa; Complex Outpatient Macro-Activity), in a neurorehabilitation programme involving the support and use of robotic systems for upper-limb rehabilitation training (Gloreha BTL Robotics, Motore Humanware) and/or virtual reality-based rehabilitation technologies (VRRS Khymeia, Prokin Tecnobody).

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

  • Aged between 18 and 85 years.
  • Diagnosed with one of the following neurological conditions: stroke, Parkinson's disease, ataxia, motor neuron disease, spinal cord injury, traumatic brain injury, or post-neurosurgical neurological outcomes.
  • Have completed at least three rehabilitation sessions using the technologies under study, representing the minimum exposure required for participants to become sufficiently familiar with the technology and to provide informed feedback on their experience of use.
  • Have adequate cognitive functioning, defined as the ability to understand study-related information, provide , and reliably complete the planned assessment measures, as determined by the clinical team during routine clinical evaluation.
  • Have sufficient proficiency in Italian to understand the study information and complete the assessment measures reliably.
  • Can use the digital tools required for data collection, e.g., a tablet, either independently or with compensatory aids and/or assistance from the data collection staff.

Exclusion criteria

Exclusion Criteria:

  • Diagnosis of an acute or non-stabilized psychiatric disorder, such as an active psychotic episode or a depressive episode with severe symptoms, that may interfere with informed participation in the study.
  • Severe uncompensated sensory impairment, such as severe visual or hearing impairment, that prevents the use of the digital tools required for data collection.
  • Motor impairment that prevents interaction with a tablet, even with compensatory aids and/or assistance from the data collection staff.
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

Observational model
Other
Time perspective
Cross-sectional
Enrollment
129 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients Undergoing Technology-Supported Neurorehabilitation

    Adult patients with neurological disorders undergoing standard neurorehabilitation involving upper-limb robotic rehabilitation systems and/or virtual reality-based rehabilitation technologies at participating ICS Maugeri centres.

06

What researchers measure

Primary outcomes

  1. Digital patient engagement score assessed using the TWente Engagement with Ehealth Technologies Scale after completion of at least 3 rehabilitation sessions with the technologies

    Digital patient engagement in the use of neurorehabilitation technologies will be measured using the TWente Engagement with Ehealth Technologies Scale (TWEETS), a 9-item self-report scale assessing cognitive, emotional, and behavioral engagement with eHealth technologies. Items are rated on a 4-point Likert scale from 1 = strongly disagree to 4 = strongly agree. A total score is calculated by summing the 9 items, with possible scores ranging from 9 to 36. Higher scores indicate higher digital patient engagement. "Not applicable" responses, if selected, are treated as missing and handled according to the pre-specified scoring plan.

    Time frame: At baseline, single assessment (Day 1)

Secondary outcomes

  1. Overall satisfaction with rehabilitation score assessed using the Overall Satisfaction with Rehabilitation Scale after completion of at least 3 rehabilitation sessions with the technologies

    Overall satisfaction with the rehabilitation pathway will be assessed using the Overall Satisfaction with Rehabilitation Scale (OSWRS), a 5-item self-report measure assessing global patient satisfaction with rehabilitation, including perceived progress, satisfaction with recovery timing, affective response to rehabilitation, and overall satisfaction. Items are rated on a 7-point Likert scale from 1 = strongly disagree to 7 = strongly agree. A total score is calculated by summing the 5 items, with possible scores ranging from 5 to 35. Higher scores indicate higher overall satisfaction with the rehabilitation pathway.

    Time frame: At baseline, single assessment (Day 1)

  2. Behavioral intention to continue using rehabilitation technologies score assessed using adapted UTAUT items after completion of at least 3 rehabilitation sessions with the technologies

    Behavioral intention to continue using rehabilitation technologies will be assessed using 3 items adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT). The items assess the participant's intention and planning to continue using the rehabilitation technologies in the near future. Items are rated on a 7-point Likert scale from 1 = strongly disagree to 7 = strongly agree. A total score is calculated by summing the 3 items, with possible scores ranging from 3 to 21. Higher scores indicate stronger behavioral intention to continue using rehabilitation technologies.

    Time frame: At baseline, single assessment (Day 1)

  3. Perceived psychosocial impact of rehabilitation technologies score assessed using the Psychosocial Impact of Assistive Devices Scale short form after completion of at least 3 rehabilitation sessions with the technologies

    The perceived psychosocial impact of rehabilitation technologies will be measured using the short version of the Psychosocial Impact of Assistive Devices Scale (PIADS-10). The scale includes 10 items assessing the perceived impact of the device on competence, adaptability, and self-esteem. Items are rated on a 7-point scale from -3 = has decreased to +3 = has increased. A total score is calculated by summing the 10 items, with possible scores ranging from -30 to +30. Higher positive scores indicate greater perceived positive psychosocial impact of the rehabilitation technologies, while negative scores indicate perceived negative psychosocial impact.

    Time frame: At baseline, single assessment (Day 1)

07

Study locations

3 sites
  • ICS Maugeri IRCCS - Istituto Scientifico di Milano
    Milan, 20138, Italy
  • ICS Maugeri IRCCS - Istituto Scientifico di Montescano
    Montescano, Italy
  • ICS Maugeri IRCCS - Istituto Scientifico di Pavia
    Pavia, Italy
08

References and documents

Publications

  • Klaic M, Galea MP. Using the Technology Acceptance Model to Identify Factors That Predict Likelihood to Adopt Tele-Neurorehabilitation. Front Neurol. 2020 Dec 2;11:580832. doi: 10.3389/fneur.2020.580832. eCollection 2020. PubMed 33343488 ↗
  • Warraich Z, Kleim JA. Neural plasticity: the biological substrate for neurorehabilitation. PM R. 2010 Dec;2(12 Suppl 2):S208-19. doi: 10.1016/j.pmrj.2010.10.016. PubMed 21172683 ↗
  • Danzl MM, Etter NM, Andreatta RD, Kitzman PH. Facilitating neurorehabilitation through principles of engagement. J Allied Health. 2012 Spring;41(1):35-41. PubMed 22544406 ↗
  • Kelders SM, Kip H, Greeff J. Psychometric Evaluation of the TWente Engagement with Ehealth Technologies Scale (TWEETS): Evaluation Study. J Med Internet Res. 2020 Oct 9;22(10):e17757. doi: 10.2196/17757. PubMed 33021487 ↗
  • Di Nitto M, Durante A, Torino F, Bolgeo T, Damico V, Ghizzardi G, Zerulo SR, Alvaro R, Vellone E, Biagioli V. Validity and Reliability of the Self-Care of Chronic Illness Inventory and Self-Care Self-Efficacy Scale in Patients Living With Cancer. J Adv Nurs. 2025 Dec;81(12):8620-8632. doi: 10.1111/jan.16823. Epub 2025 Feb 19. PubMed 39968728 ↗
  • Ritter PL, Lorig K. The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies. J Clin Epidemiol. 2014 Nov;67(11):1265-73. doi: 10.1016/j.jclinepi.2014.06.009. Epub 2014 Aug 3. PubMed 25091546 ↗
  • Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P; ISPOR Task Force for Translation and Cultural Adaptation. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005 Mar-Apr;8(2):94-104. doi: 10.1111/j.1524-4733.2005.04054.x. PubMed 15804318 ↗
  • Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91. doi: 10.1097/00007632-200012150-00014. No abstract available. PubMed 11124735 ↗
  • Fraser L, Burnell M, Salter LC, Fourkala EO, Kalsi J, Ryan A, Gessler S, Gidron Y, Steptoe A, Menon U. Identifying hopelessness in population research: a validation study of two brief measures of hopelessness. BMJ Open. 2014 May 30;4(5):e005093. doi: 10.1136/bmjopen-2014-005093. PubMed 24879829 ↗
  • Andrich, R., Pedroni, F., & Vanni, G. (2003). Psychosocial impact of assistive devices: Italian localization of the PIADS instrument. Assistive Technology-Shaping the Future, GM Craddock, LP McCormack, RB Reilly, and HTP Knops, Eds, 917-921.
  • Yang, C., Wu, C. F., Wang, J., Chen, W. C., Chang, H., & Xu, D. D. (2024). A study on the intention of upper limb hemiplegic patients to use interactive gaming devices for hand rehabilitation. The Design Journal, 27(3), 470-492. https://doi.org/10.1080/14606925.2024.2334139
  • Venkatesh, V., Morris, M. G., Davis, G. B., & Davis, F. D. (2003). User Acceptance of Information Technology: Toward a Unified View. MIS Quarterly, 27(3), 425-478. https://doi.org/10.2307/30036540
  • Cressman, J. M., & Dawson, K. A. (2011). Evaluation of the Use of Healing Imagery in Athletic Injury Rehabilitation. Journal of Imagery Research in Sport and Physical Activity, 6(1). https://doi.org/10.2202/1932-0191.1060
  • Matamala-Gomez M, Maisto M, Montana JI, Mavrodiev PA, Baglio F, Rossetto F, Mantovani F, Riva G, Realdon O. The Role of Engagement in Teleneurorehabilitation: A Systematic Review. Front Neurol. 2020 May 6;11:354. doi: 10.3389/fneur.2020.00354. eCollection 2020. PubMed 32435227 ↗
  • Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res. 2022 Apr 20;22(1):523. doi: 10.1186/s12913-022-07821-w. PubMed 35443710 ↗
  • Yu DS, De Maria M, Barbaranelli C, Vellone E, Matarese M, Ausili D, Rejane RE, Osokpo OH, Riegel B. Cross-cultural applicability of the Self-Care Self-Efficacy Scale in a multi-national study. J Adv Nurs. 2021 Feb;77(2):681-692. doi: 10.1111/jan.14617. Epub 2020 Dec 9. PubMed 33295675 ↗
  • Wilson ML, Huggins-Manley AC, Ritzhaupt AD, Ruggles K. Development of the Abbreviated Technology Anxiety Scale (ATAS). Behav Res Methods. 2023 Jan;55(1):185-199. doi: 10.3758/s13428-022-01820-9. Epub 2022 Mar 25. PubMed 35338456 ↗
  • Oltedal S, Garratt A, Bjertnaes O, Bjornsdottir M, Freil M, Sachs M. The NORPEQ patient experiences questionnaire: data quality, internal consistency and validity following a Norwegian inpatient survey. Scand J Public Health. 2007;35(5):540-7. doi: 10.1080/14034940701291724. PubMed 17852989 ↗
  • Day H, Jutai J, Campbell KA. Development of a scale to measure the psychosocial impact of assistive devices: lessons learned and the road ahead. Disabil Rehabil. 2002 Jan 10-Feb 15;24(1-3):31-7. doi: 10.1080/09638280110066343. PubMed 11827152 ↗
  • Rosa D, Villa G, Marcomini I, Nardin E, Gianfranceschi E, Faini A, Pengo MF, Bilo G, Croce A, Manara DF, Parati G. Psychometric Properties of the TWente Engagement with Ehealth Technologies Scale (TWEETS) Among Patients with Hypertension in Italy. High Blood Press Cardiovasc Prev. 2025 Jan;32(1):61-68. doi: 10.1007/s40292-024-00688-4. Epub 2024 Oct 29. PubMed 39472407 ↗

Individual participant data

Plan to share: No — Individual participant data will not be shared because the study involves clinical and psychosocial data from a vulnerable neurological rehabilitation population. Data will be processed in pseudonymized/anonymized form, and access will be limited to authorized study personnel in accordance with the approved protocol and applicable data protection regulations.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Oct 2026; primary completion for Jul 2027, 9 months later.

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

Registered
Aug 26, 2026
First posted
Aug 31, 2026
StartEst.
Oct 1, 2026
Primary completionEst.
Jul 1, 2027
CompletionEst.
Jul 1, 2027
Last update
Sep 15, 2026
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 Sep 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07794072
Lead sponsor
Catholic University, Italy
Responsible party
Patrizia Catellani (Full Professor, Catholic University, Italy) — Principal investigator
First posted
Aug 31, 2026
Start date
Oct 1, 2026 (estimated)
Primary completion
Jul 1, 2027 (estimated)
Completion
Jul 1, 2027 (estimated)
Last update
Sep 15, 2026

Study contacts

Patrizia Catellani, PhD in Social Psychology
Contact
patrizia.catellani@unicatt.it
393356741468
Valentina Carfora, PhD in Social Psychology
Contact
valentina.carfora@unicatt.it
393338569908
Patrizia Catellani, PhD in Social Psychology
principal investigator · Catholic University, Italy

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion