The challenge of stroke rehab
The Wyss Center is supporting a clinical trial to assess the effect of personalized robotic therapy to improve upper limb rehabilitation after stroke.
The trial aims to test the safety and clinical efficacy of an upper limb exoskeleton designed by industrial partner Wearable Robotics, as well as design and test an automated algorithm developed by the team to optimize movements based on kinematic feedback from participants.
It is hoped that by using personalized robot-aided rehabilitation to promote brain plasticity in this way, people recovering from a stroke will experience improvements in both the speed and quality of their recovery compared to those who train with a human therapist.
The exoskeleton has previously been tested with healthy participants in a pilot study and the results showed that it produced natural movements and could help the subjects complete a range of tasks.
It is hoped that people recovering from a stroke will experience improvements in both the speed and quality of their recovery.
The intelligent robotic therapy selects the movements based on how well the person previously reached the targets. If a particular movement is easy for the subject, a more challenging one will be proposed in order to match the difficulty of the exercise to the ability of the person.
By contrast, the standard robotic exoskeleton, without the intelligent add-on, asks the person to perform a standard series of reaching tasks regardless of their capability.
The clinical trial in acute and subacute stroke patients is now underway at the two participating hospitals – HUG (Geneva) and Pisa University Hospital. The start of the trial follows close collaboration between Wyss Center regulatory experts and the research team to gain the necessary study approvals from authorities.
The trial will evaluate the effectiveness of personalized robot-assisted rehabilitation on cortical organization and muscle activity after a stroke. Clinical information, including kinematic, EMG and EEG data, will be collected during treatment in order to investigate possible biomarkers of neural recovery.
The clinical trial, known as the NeuroPRoBES project, is a collaboration between the Wyss Center, Wearable Robotics (robot manufacturer and study sponsor), the group of the Bertarelli Foundation Chair in Translational NeuroEngineering at the École polytechnique fédérale de Lausanne (EPFL), the Swiss National Centre of Competence in research (NCCR) Robotics and two participating hospitals – HUG (Geneva) and Pisa University Hospital.