Exercises on a stationary robot in the rehabilitation of people after stroke

ISRCTN ISRCTN15913162
DOI https://doi.org/10.1186/ISRCTN15913162
Submission date
15/03/2024
Registration date
21/05/2024
Last edited
21/05/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Strokes are a global burden. People of all ages suffer from strokes, including relatively young and professionally active people. Post-stroke rehabilitation is multi-directional and long-lasting. There is still a need to search for new methods of rehabilitation of post-stroke therapy that will ensure effective and quick recovery of patients.
In recent years, attempts have been made to implement modern technologies in post-stroke rehabilitation, including rehabilitation robots. It is assumed that robots enable precise repetition of movements, which enables the training of movement patterns, including gait. However, there are still few scientific studies, the results of which would allow for unequivocal determination of the effectiveness of robotic rehabilitation in training movement patterns in patients at different times from the onset of stroke and with dysfunctions of varying severity. The results of these studies would also enable the development of a methodology for robotic post-stroke rehabilitation.
The aim of the study is to obtain knowledge on the effectiveness of rehabilitation carried out with the use of a stationary robot in patients with subacute stroke (minimum 1 month after stroke).

Who can participate?
Sub-acute stroke survivors over 18 years of age

What does the study involve?
The study will include stroke patients treated in the Medical and Rehabilitation Center ''Solanki'' in Inowroclaw (Poland). Participants will be randomly divided into two groups. In the experimental group, participants will perform gait exercises on a stationary robot once a day for a minimum of 3 days a week (Monday - Saturday) and a maximum of 6 days a week for 3 weeks. In the first control group, participants will perform traditional ground gait exercises once a day for a minimum of 3 days a week (Monday - Saturday) and a maximum of 6 days a week for 3 weeks. The duration of all exercises will be from 20 to 40 minutes, depending on the patient's condition. In addition, patients in both groups will undergo typical post-stroke rehabilitation for 2.5 hours a day, 6 days a week (Monday-Saturday), based on the principles of best clinical practices. The aim of the exercises will be to normalize muscle tone and improve movement patterns.

What are the possible benefits and risks of participating?
It is hoped that the treatment will contribute to the improvement of static and dynamic body balance, quality of gait and postural control of stroke patients.
The exercises will be conducted and supervised by physiotherapists. During the exercises, patients will be provided with protection against falls and injuries. The methodology of individual exercises will be planned on the basis of scientific publications in which modern technologies were used safely in post-stroke rehabilitation. Therefore, no adverse events except fatigue are expected in patients. Possible side effects will be noted and, if necessary, the studies will be modified and discontinued, with appropriate notification to the Bioethics Committee.

Where is the study run from?
1. Academy of Physical Education in Katowice (Poland)
2. The Medical and Rehabilitation Center ''Solanki'' in Inowroclaw (Poland)

When is the study starting and how long is it expected to run for?
July 2020 to September 2024

Who is funding the study?
1. The Medical and Rehabilitation Center ''Solanki'' in Inowroclaw (Poland)
2. European Regional Development Fund for the Kuyavian-Pomeranian Voivodeship (Poland) (No. RPKK.01.02.01-04-0016/18)

Who is the main contact?
1. Anna Polak
a.polak@awf.katowice.pl
2. Laura Piejko
l.piejko@awf.katowice.pl

Contact information

Prof Anna Polak
Public, Scientific, Principal Investigator

72a Mikolowska Street
Katowice
40-065
Poland

ORCiD logoORCID ID 0000-0001-6932-5047
Phone +48 (0)32 2075129
Email a.polak@awf.katowice.pl
Dr Laura Piejko
Scientific

72a Mikolowska Street
Katowice
40-065
Poland

ORCiD logoORCID ID 0000-0002-5338-1842
Phone +48 (0)32 207 5110
Email l.piejko@awf.katowice.pl

Study information

Study designSingle-center interventional randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment, Efficacy
Participant information sheet Not available in web format, please use contact details to request a participant information sheet
Scientific titleThe effectiveness of exercises on a stationary robot in the rehabilitation of people after stroke - a randomized clinical trial
Study objectives1. Training performed once a day, for 3-6 days a week, for 3 weeks with the use of the stationary robot (GEOSYSTEM TM, RehaTechnology, Germany) will improve the quality of gait of post-acute stroke patients.
2. Training performed once a day, for 3-6 days a week, for 3 weeks with the use of the stationary robot (GEOSYSTEM TM, RehaTechnology, Germany) will improve static and dynamic body balance of post-acute stroke patients.
Ethics approval(s)

Approved 09/07/2020, Bioethics Commission for Scientific Research at The Jerzy Kukuczka Academy of Physical Education in Katowice (Poland) (Mikolowska 72a Street, Katowice, 40-065, Poland; +48 (0)32 2075152; komisjabioetyczna@awf.katowice.pl), ref: 5/2020

Health condition(s) or problem(s) studiedStroke
InterventionAfter the medical examination and meeting the inclusion criteria, patients will be randomly assigned by the attending physician to participate in the study in one of the following groups. Patients will be randomly assigned to groups based on the group symbol in an opaque and sealed envelope. Randomization will take place after the medical examination and meeting the inclusion criteria by the attending physician.
1. In the experimental group patients will receive rehabilitation with the use of the stationary robot G-EOSYSTEM TM (RehaTechnology, Germany) once a day, a minimum of 3 days a week (Monday - Saturday) and a maximum of 6 days a week, for 20 - 40 minutes a day, depending on the condition of the patient.
2. In the control group patients will receive overground gait training once a day, a minimum of 3 and a maximum of 6 days a week (Monday - Saturday), for 20 - 40 minutes a day, depending on the condition of the patient.

The overall treatment duration in both groups will be 3 weeks. In addition, patients in all groups will be subjected to typical post-stroke rehabilitation for 2.5 hours a day, 6 days a week (Monday-Saturday), based on the principles of best clinical practices. The aim of the exercises will be to normalize muscle tone and improve movement patterns.
Intervention typeDevice
Pharmaceutical study type(s)Not Applicable
PhaseNot Applicable
Drug / device / biological / vaccine name(s)G-EOSYSTEM TM (RehaTechnology, Germany)
Primary outcome measure1. Dynamic body balance assessed by Time Up and Go Test (TUG) at baseline and after the 3-week rehabilitation period
2. Gait assessed by 10 Metre Walk Test (10MWT) at baseline and after the 3-week rehabilitation period
Secondary outcome measures1. Static body balance assessed by stabilometric platform (Zebris FDM-T; Rehawalk, MaxxusDaum h/p Cosmos Force) at baseline and after the 3-week rehabilitation period
2. Dynamic body balance assessed by Functional Reach Test (FRT) at baseline and after the 3-week rehabilitation period
3. Static and dynamic body balance assessed by Berg Balance Scale (BBS) at baseline and after the 3-week rehabilitation period
4. Gait assessed by treadmill walking test (Zebris FDM-T; Rehawalk, MaxxusDaum h/p Cosmos Force) at baseline and after the 3-week rehabilitation period
Overall study start date01/07/2020
Completion date29/09/2024

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit80 Years
SexBoth
Target number of participants60
Key inclusion criteria1. Women and men over 18 years of age
2. First history of ischemic or hemorrhagic brain
3. The period min. 1 month after stroke
4. The patient's consent to participate in the study
5. Ability to understand and follow the therapist's instructions
6. Ability to walk independently on a distance of 10 meters (it is allowed to use supporting tools, such as a walking stick, a ball or a walking frame)
Key exclusion criteria1. Contraindications to exercises in the study
2. Subarachnoid hemorrhage
3. Neurological diseases other than stroke affecting body balance and quality of the gait
4. Body structure, articular stiffness and other dysfunctions that are contraindicators to therapy in a stationary gait rehabilitation robot (mainly: body weight over 95 kg, body height below 150 cm and over 199 cm, difference in the length of the lower limbs over 1.5 cm, spasticity over the 3rd degree in Ashworth scale, wounds on the body at fixation sites on stationary rehabilitation robot)
Date of first enrolment29/04/2023
Date of final enrolment08/09/2024

Locations

Countries of recruitment

  • Poland

Study participating centres

The Jerzy Kukuczka Academy of Physical Education in Katowice
Mikolowska 72a Street
Katowice
40-065
Poland
The Medical and Rehabilitation Center ''Solanki''
Sienkiewicza 50 Ave
Inowroclaw
88-100
Poland

Sponsor information

Medical and Rehabilitation Center ''Solanki'' in Inowroclaw, Poland
Hospital/treatment centre

Solankowa 77 Street
Inowroclaw
88-100
Poland

Phone +48 (0)52 35 63 251
Email sekretariat@solanki.pl
Website https://www.solanki.pl/

Funders

Funder type

Hospital/treatment centre

Medical and Rehabilitation Center ''Solanki'' in Inowroclaw, Poland

No information available

European Regional Development Fund for the Kuyavian-Pomeranian Voivodeship, Poland No. RPKK.01.02.01-04-0016/18

No information available

Results and Publications

Intention to publish date31/01/2025
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planPublication in a scientific journal. The research will also be disseminated at Polish and foreign scientific conferences. The study protocol, the statistical analysis plan and the trial database are not planned to be published.
IPD sharing planThe researchers currently do not plan to publish the dataset. The participant-level data will be held in the Medical and Rehabilitation Center ''Solanki'' in Inowroclaw, Poland.

Editorial Notes

15/03/2024: Study's existence confirmed by the Bioethics Commission for Scientific Research at The Jerzy Kukuczka Academy of Physical Education in Katowice (Poland).