Pediatric Upper-Limb Rehabilitation With PhiCube, a Modular Bilateral End-Effector Device

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age4-18
SponsorIstituto di Sistemi e Tecnologie Industriali Intelligenti per il Manifatturiero Avanzato

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 volunteers

Qualifiers

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

Design model

Single group

Treatments tested in this trial

  • Robotic bilateral upper limb rehabilitation training

    Device

    Bilateral 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

54 Participants
are divided into 1 treatment group
Group A: PhiCube Bilateral Upper Limb RehabilitationExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

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.

Time frame
Assessed at 4 time points: - PreT0: 2 months before treatment initiation - T0: Immediately before starting PhiCube treatment - T1: Immediately after completing the treatment period - T2: 1 month after treatment completion

Secondary outcomes

1

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).

Time frame
Assessed at 4 time points: - PreT0: 2 months before treatment initiation - T0: Immediately before starting PhiCube treatment - T1: Immediately after completing the treatment period - T2: 1 month after treatment completion
2

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.

Time frame
Assessed at 4 time points: - PreT0: 2 months before treatment initiation - T0: Immediately before starting PhiCube treatment - T1: Immediately after completing the treatment period - T2: 1 month after treatment completion
3

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.

Time frame
Assessed at 4 time points: - PreT0: 2 months before treatment initiation - T0: Immediately before starting PhiCube treatment - T1: Immediately after completing the treatment period - T2: 1 month after treatment completion
4

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.

Time frame
Assessed at 4 time points: - PreT0: 2 months before treatment initiation - T0: Immediately before starting PhiCube treatment - T1: Immediately after completing the treatment period - T2: 1 month after treatment completion

Other outcomes

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