Robotic Therapy and Brain Stimulation in the Early Phase After Stroke

Recruiting

Phase N/A Results N/A

Trial Description

Stroke is the second cause of death worldwide and the majority of the survivors remain with motor impairments. Inhibition of the motor cortex of the unaffected hemisphere has emerged as a potential intervention to enhance effects of other rehabilitation strategies on improvement of motor performance of the paretic upper limb. In this proof-of-concept study we will evaluate the effects of inhibition of the motor cortex of the unaffected hemisphere associated with robotic therapy on improvement of motor performance of the paretic upper limb in the early phase post-stroke.

Detailed Description

The main goal of this study is to test the proof of concept of benefits of inhibition of the motor cortex of the unaffected hemisphere on learning evaluated by improvement in kinematics of motor performance, in patients with upper limb paresis in the early phase post-stroke. For this purpose, patients will be randomized to receive real or sham transcranial direct current stimulation before a session of robotic therapy. Data will be collected by kinematic assessment performed automatically by the robot at baseline, immediately after and 24h after the intervention.
The working hypothesis is that one session of upper limb motor training will lead to improvement of performance in metrics of kinematics, and this improvement will be maintained up to 24h after the end of the training.

Conditions

Interventions

  • Sham stimulation Device
    Intervention Desc: In sham transcranial direct current stimulation, no current will be delivered through the transcranial direct current stimulation device after the first 30 seconds.
    ARM 1: Kind: Experimental
    Label: Sham stimulation + robotic therapy
    Description: Sham transcranial direct current stimulation will be applied during 20 minutes prior to robotic training. Number of interventions sessions: 1
  • Robotic therapy Device
    Intervention Desc: Robotic therapy (MIT - Manus, Interactive Motion Technologies) will be administered for 40 minutes to the paretic upper limb.
    ARM 1: Kind: Experimental
    Label: Active stimulation + robotic therapy
    Description: Active transcranial direct current stimulation will be applied during 20 minutes prior to robotic training. Number of interventions sessions: 1
    ARM 2: Kind: Experimental
    Label: Sham stimulation + robotic therapy
    Description: Sham transcranial direct current stimulation will be applied during 20 minutes prior to robotic training. Number of interventions sessions: 1
  • Active stimulation Device
    Intervention Desc: Active transcranial direct current stimulation will be applied with the cathode positioned over the ipsilesional primary motor cortex and the anode over the contralateral supraorbital region for 20 minutes (1mA).
    ARM 1: Kind: Experimental
    Label: Active stimulation + robotic therapy
    Description: Active transcranial direct current stimulation will be applied during 20 minutes prior to robotic training. Number of interventions sessions: 1

Outcomes

Type Measure Time Frame Safety Issue
Primary Movement Smoothness Kinematic assessment at baseline, immediately after intervention; and 24h after.
Secondary Number of peaks of the movement kinematic assessment at baseline, immediately after intervention; and 24h after.
Secondary Jerk metric of the movement kinematic assessment at baseline, immediately after intervention; and 24h after

Sponsors