About this trial
The present investigation is configured as a multicenter clinical study in a within-group pilot phase.
This study aims to investigate primarily the feasibility of use and effectiveness of a treatment for upper limb function in children aged 4 to 18 years with congenital and acquired neuromotor disorders through a new portable robotic system, called PhiCube, designed for bilateral neuromotor rehabilitation of the upper limbs in subjects with neuromotor disorders.
In order to specifically investigate also the potential impact of PhiCube on movement planning aspects, the study will also involve a small group of children aged 4 to 18 years with Developmental Coordination Disorder (DCD).
Before (PreT0 and T0) and after (T1 and T2) treatment, standardized assessment tests will be administered. Regarding the investigation objectives reported above, the primary outcome measure will be the Melbourne Assessment-2 (MA2), a standardized, valid and reliable instrument for evaluating the quality of upper limb movement in children with neurological deficits, capable of measuring four elements of movement quality: range of motion, accuracy, dexterity and fluency. As secondary outcome measures, Abilhand-Kids has been chosen, a brief questionnaire that measures 21 main daily bimanual activities completed by the parent or caregiver, and various subtests and questionnaires aimed at evaluating the neuropsychological processes involved and the effects related to auditory feedback perception.
The treatment will have a total duration of approximately 3 months and will be organized in 3 weekly sessions lasting 45 minutes each, to reach a total of 30.
Descriptive statistics of the clinical and technological variables obtained in the evaluation and rehabilitation phases will be calculated. Subsequently, treatment efficacy analyses through the robotic device are planned, comparing pre-post clinical variables. All collected data will finally be analyzed in order to compare the rehabilitative efficacy of the device with respect to the different groups of participants identified based on diagnostic profile.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Diagnosis of congenital and acquired neuromotor disorders
Age between 4 and 18 years at the time of recruitment
Modified Ashworth Scale (MAS) less than 3
MACS level I-IV
Disqualifiers
Severe sensory deficits
Onset of pathologies that prevent participation
Worsening of pre-existing comorbidities
Severe sensory deficits
Trial design
Single group
Treatments tested in this trial
Robotic bilateral upper limb rehabilitation training
DeviceBilateral upper limb rehabilitation using PhiCube, a modular robotic end-effector device with two motorized axes that can assist or resist patient movements. Treatment consists of 30 sessions over 3 months (3 sessions/week, 45 minutes each) combining motor training with gaming elements specifically designed for pediatric populations. The device's modular design allows customization for individual patient needs and bilateral coordination training. Sessions focus on improving range of motion, precision, dexterity, and movement fluidity through controlled, repetitive, high-intensity exercises in children aged 4-18 years with neuromotor disorders and developmental coordination disorder.
Treatment groups
Trial outcomes
Primary outcomes
Upper limb movement quality in children with neurological deficits
Quality of upper limb movement in children with neurological deficits, measured through Melbourne Assessment-2 (MA2), which is able to measure four elements of movement quality: range of motion, precision, dexterity and fluidity.
Secondary outcomes
ABILHAND-Kids Questionnaire
A brief questionnaire measuring 21 main bimanual daily activities. Scores are assigned by parents based on the child's difficulty in performing daily activities, with a 3-point scale (impossible, difficult, easy).
Leiter-3 Sustained Attention Subtest
A subtest of the Leiter-3 non-verbal cognitive scale that evaluates sustained visual attention through tasks of increasing complexity within a specific time period. The number of correctly selected target elements is recorded.
NEPSY-II Inhibition Subtest
Evaluates inhibitory control abilities of automatic verbal responses through administration of 3 different conditions for two different stimulus sets, requiring naming, inhibition with reversal, and alternating responses based on color.
NEPSY-II Auditory Attention Subtest
Assesses the ability to maintain sustained attention to auditory stimuli performance and inhibit automatic motor responses in two tasks of increasing complexity with incremental executive control demands.
Sponsors and contacts
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Istituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato
Lead sponsor
IRCCS Fondazione Stella Maris
Collaborator
IRCCS Eugenio Medea
Collaborator
Fondazione Don Carlo Gnocchi Onlus
Collaborator
IRCCS Fondazione Istituto Neurologico Mondino Pavia
Collaborator
Ospedale IRCCS G. Gaslini di Genova
Collaborator