Brain Computer Interface integrated HandyRehab platform (BCI-HR)HandyRehab (HR)Standard Treatment of Care
Brain Computer Interface integrated HandyRehab platform (BCI-HR): To test the usability, safety and efficacy of an experimental prototype of a wearable hand robotic glove integrated with brain computer interface system being developed and researched.
HandyRehab (HR): A wearable hand robotic glove approved by Health Sciences Authority, class I commercial device
Standard Treatment of Care: Standard Conventional Occupational Therapy
Study summary
Upper extremity (UE) recovery remains a huge rehabilitation challenge with largely incomplete recovery of the upper limb post stroke. This is due to heavier priorities placed on other stroke competencies such as mobility, activities of daily living training and home integration which results in suboptimal amounts of time spent in upper limb training post stroke.
In this study the investigators plan to pilot brain computer interface (BCI) integrated wearable hand robotic glove (HandyRehab) system for upper limb stroke rehabilitation.
Eligibility
Sex
ALL
Min age
21 Years
Max age
85 Years
Healthy volunteers
No
Inclusion Criteria:
1. Age 21-85 years, males and females
2. First diagnosis of stroke (ischemic or haemorrhagic), confirmed by neurologist/neurosurgeon/CT/MRI imaging
3. \> 16 weeks post stroke
4. Hemiplegic pattern of post-stroke weakness
5. MRC ≥ 2/5 motor power and above for shoulder abduction \& elbow flexion
6. MRC 0 to 4/5 motor power and above for finger flexors \&/or extensors of thumb, index, middle fingers
7. Screening Fugl-Meyer wrist hand sub score \<18/24
8. Spasticity MAS \<3 for thumb, index, and middle fingers
9. Able to discriminate thumb and index sensation to pain
10. Hand sizes within 170-200mm (length) \&75-85mm (width), compatible with HandyRehab robotic glove
11. BCI compatible brain states using a standardised screening protocol
12. Able to understand simple commands with Mini Mental state examination scores MMSE \> 21/30)
13. Able to give informed consent
* Subjects who are unable to clear BCI screening 11. will be randomised to either CT or HR groups.
Exclusion Criteria:
Neurological
* Recurrent stroke
* Diagnosis of neurodegenerative disease; e.g. Parkinson's' disease, Dementia, ALS
Medical:
\- unstable medical or neurological conditions, life expectancy \<6 months, end-organ renal failure on dialysis, severe heart failure, postural hypotension, history of uncontrolled sepsis, epilepsy with seizure within 3 months of informed consent, skin conditions which could potentially be worsened by wearable robot (ulcers, open wounds, eczema, infections etc)
Postural:
* Unable to tolerate upright posture or sit unaided for \< 90min with rest breaks
* Cognitive/behavioural/visual:
* Severe dysphasia/aphasia, severe visual neglect/blindness, untreated severe depression, psychiatric illness, unable to understand study requirements
Upper limb:
* Moderate to severe spasticity (Modified Ashworth scale MAS ≥2)
* Hand/arm related pain (VAS Pain ≥ 5/10),
* Presence of finger contractures, reduced functional range of motion, limiting functional wrist/finger movements, active fractures or arthritis with deformities
* Severe limb ataxia/apraxia
* Severe post stroke hemi-anaesthesia in affected UE
BCI incompatibility:
* Motor imagery EEG signals unable to be detected
* Presence of craniectomy skull defect (affecting BCI cap fit and electrode contact)
* Concomitant participation in other interventional research trials
* Resident of nursing home or overseas country which may compromise attendance at research site
* Pregnant or lactating females will not be allowed to participate
Primary outcome measure(s)
Action Research Arm Test (ARAT) Score — Weeks 0 (baseline), 6 (end training), 12, 24, 52 (follow-up) Functional and dexterity score in the affected arm evaluated using 19 tests of motor function across 4 subsets; minimum score = 0, maximum score = 57, with higher score indicating better function.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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