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Evaluation of a Wearable Exoskeleton for Functional Arm Training

Primary Purpose

Stroke, Post-Stroke Hemiparesis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Gravity Elimination Alone
Path Assistance Alone
Path Assistance and Gravity Elimination
Sponsored by
NYU Langone Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Stroke

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria for stroke population:

  • Radiologically verified unilateral stroke at least 4 months previously.
  • Right-handed subjects with or without right hemiparesis (as robot is built for right arm alone).
  • Preserved passive range of motion at all upper limb joints.
  • Spasticity <3 on the modified Ashworth Scale (MAS).
  • Ability to follow study instructions and likely to complete the protocol; ability to comply with the protocol as assessed by the investigator; must be English speaking since the assessments are in English.

Exclusion Criteria for stroke population.

  • History of surgery or other significant injury to either upper extremity causing mechanical limitations that preclude task performance.
  • Previous neurological illness such as head trauma, prior stroke ( as we are recruiting subjects with first unilateral stroke), epilepsy, or demyelinating disease.
  • Complicating medical problems such as uncontrolled hypertension, diabetes with signs of polyneuropathy, severe renal, cardiac or pulmonary disease, or evidence of other concurrent neurologic or orthopedic conditions precluding the subject from complying with the study protocol.
  • Severe upper extremity spasticity suggested by an Ashworth score of >3 at any joint, or restriction of full passive range of motion.
  • Evidence of alcohol, drug abuse or other relevant neuropsychiatric condition such as psychotic illness or severe depression.

Inclusion Criteria for control population.

  • No previous stroke or any other previous neurological injury.
  • Right-handed subjects without any weakness or hemiparesis (as robot is built for right arm alone).
  • Preserved passive and active range of motion at all upper limb joints.
  • No increase in muscle tone in response to passive range of motion. A score of zero on Ashworth Scale (MAS).
  • Able to achieve full score on upper extremity Fugl-Meyer Scale (66/66)
  • Ability to follow study instructions and likely to complete the protocol; ability to comply with the protocol as assessed by the investigator; must be English speaking since the assessments are in English.

Exclusion Criteria for control population.

  • History of surgery or other significant injury to either upper extremity causing mechanical limitations that preclude task performance.
  • Previous neurological illness such as head trauma, prior stroke, epilepsy, or demyelinating disease.
  • Complicating medical problems such as uncontrolled hypertension, diabetes with signs of polyneuropathy, severe renal, cardiac or pulmonary disease, or evidence of other concurrent neurologic or orthopedic conditions precluding the subject from complying with the study protocol.
  • Any condition or situation that, in the investigator's opinion, may put the subject at significant risk, confound the study results, or interfere significantly with the subject's participation in the study.
  • Severe upper extremity spasticity suggested by an Ashworth score of >3 at any joint, or restriction of full passive range of motion.
  • Evidence of alcohol, drug abuse or other relevant neuropsychiatric condition such as psychotic illness or severe depression.

Sites / Locations

  • New York University School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Healthy Subjects

Chronic Post Stroke Right Side Hemiparesis

Arm Description

Seven healthy patients will serve as controls based on preliminary data in healthy volunteers using CAREX with gravity elimination alone versus gravity elimination plus path assistance.

Radiologically verified unilateral stroke patients with at least 4 months previously.

Outcomes

Primary Outcome Measures

Passive range of motion measured by goniometry
Active range of motion measured by goniometry
Upper extremity motor impairment measured by performance on the 33 tasks of the Fugl-Meyer Scale (FMS)
Spasticity measured by the Modified Ashworth Scale (MAS)

Secondary Outcome Measures

Full Information

First Posted
March 17, 2016
Last Updated
December 21, 2018
Sponsor
NYU Langone Health
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1. Study Identification

Unique Protocol Identification Number
NCT02726204
Brief Title
Evaluation of a Wearable Exoskeleton for Functional Arm Training
Official Title
Evaluation of a Wearable Exoskeleton for Functional Arm Training (CAREX)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
June 1, 2015 (Actual)
Primary Completion Date
May 5, 2016 (Actual)
Study Completion Date
May 5, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
NYU Langone Health

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to investigate how the cable-driven arm exoskeleton (CAREX) can assist task performance during 3D arm movement tasks under various experimental conditions in healthy individuals and patients with stroke. This study is designed to test motor learning with the robotic rehabilitative device CAREX under three conditions in healthy subjects and subjects with post-stroke hemiparesis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, Post-Stroke Hemiparesis

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Healthy Subjects
Arm Type
Active Comparator
Arm Description
Seven healthy patients will serve as controls based on preliminary data in healthy volunteers using CAREX with gravity elimination alone versus gravity elimination plus path assistance.
Arm Title
Chronic Post Stroke Right Side Hemiparesis
Arm Type
Active Comparator
Arm Description
Radiologically verified unilateral stroke patients with at least 4 months previously.
Intervention Type
Other
Intervention Name(s)
Gravity Elimination Alone
Intervention Description
CAREX will compensate for the gravity of the subject's arm, i.e. subject can move their arm to a specific position and relax all the arm muscles, CAREX will hold the arm in that configuration
Intervention Type
Other
Intervention Name(s)
Path Assistance Alone
Intervention Description
CAREX will push subject's arm to a pre-specified path. If the arm is not in the path, CAREX will generate some force that is proportional to the distance between the hand and the path. The subject will feel like having a spring connected between his hand and the path
Intervention Type
Other
Intervention Name(s)
Path Assistance and Gravity Elimination
Primary Outcome Measure Information:
Title
Passive range of motion measured by goniometry
Time Frame
1 Day
Title
Active range of motion measured by goniometry
Time Frame
1 Day
Title
Upper extremity motor impairment measured by performance on the 33 tasks of the Fugl-Meyer Scale (FMS)
Time Frame
1 Day
Title
Spasticity measured by the Modified Ashworth Scale (MAS)
Time Frame
1 Day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria for stroke population: Radiologically verified unilateral stroke at least 4 months previously. Right-handed subjects with or without right hemiparesis (as robot is built for right arm alone). Preserved passive range of motion at all upper limb joints. Spasticity <3 on the modified Ashworth Scale (MAS). Ability to follow study instructions and likely to complete the protocol; ability to comply with the protocol as assessed by the investigator; must be English speaking since the assessments are in English. Exclusion Criteria for stroke population. History of surgery or other significant injury to either upper extremity causing mechanical limitations that preclude task performance. Previous neurological illness such as head trauma, prior stroke ( as we are recruiting subjects with first unilateral stroke), epilepsy, or demyelinating disease. Complicating medical problems such as uncontrolled hypertension, diabetes with signs of polyneuropathy, severe renal, cardiac or pulmonary disease, or evidence of other concurrent neurologic or orthopedic conditions precluding the subject from complying with the study protocol. Severe upper extremity spasticity suggested by an Ashworth score of >3 at any joint, or restriction of full passive range of motion. Evidence of alcohol, drug abuse or other relevant neuropsychiatric condition such as psychotic illness or severe depression. Inclusion Criteria for control population. No previous stroke or any other previous neurological injury. Right-handed subjects without any weakness or hemiparesis (as robot is built for right arm alone). Preserved passive and active range of motion at all upper limb joints. No increase in muscle tone in response to passive range of motion. A score of zero on Ashworth Scale (MAS). Able to achieve full score on upper extremity Fugl-Meyer Scale (66/66) Ability to follow study instructions and likely to complete the protocol; ability to comply with the protocol as assessed by the investigator; must be English speaking since the assessments are in English. Exclusion Criteria for control population. History of surgery or other significant injury to either upper extremity causing mechanical limitations that preclude task performance. Previous neurological illness such as head trauma, prior stroke, epilepsy, or demyelinating disease. Complicating medical problems such as uncontrolled hypertension, diabetes with signs of polyneuropathy, severe renal, cardiac or pulmonary disease, or evidence of other concurrent neurologic or orthopedic conditions precluding the subject from complying with the study protocol. Any condition or situation that, in the investigator's opinion, may put the subject at significant risk, confound the study results, or interfere significantly with the subject's participation in the study. Severe upper extremity spasticity suggested by an Ashworth score of >3 at any joint, or restriction of full passive range of motion. Evidence of alcohol, drug abuse or other relevant neuropsychiatric condition such as psychotic illness or severe depression.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Preeti Raghavan, MD
Organizational Affiliation
New York University Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
New York University School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States

12. IPD Sharing Statement

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Evaluation of a Wearable Exoskeleton for Functional Arm Training

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