NCT06881407

Brief Summary

About 60% of children with cerebral palsy (CP) have impaired arm function. Improving arm function requires hundreds of repetitions per day, which is impossible in a single clinical visit. Thus, therapeutic exercises should be sustained in the home environment; however, the compliance in performing home exercise is low due to poor motivation, boredom, and forgetfulness. A better home program is needed. The objective of this project is to examine the effect of our developed "THRIVE" system (Therapeutic Humanoid Robot In Virtual Environment: the combination of robot with virtual reality games), which can provide a motivating and tailored upper-extremity intervention program with instant feedback, to improve arm function in children with CP at their home. The investigators believe the newly developed "THRIVE" system can increase children's engagement and motivation in home exercises as the robot is their playmate to demonstrate and correct their movements. The investigators will also interview parents and children with CP to understand their impression of using technology at home to shape the intervention. The expected outcome is that children with CP receiving "THRIVE" will improve their arm function more and have better engagement than those who receive VR alone immediately after intervention and at follow-up. The long-term goal is to have the "THRIVE" system be the optimal home exercise platform as it can provide challenging but motivating exercises to improve children's arm function while assisting parents in supervising their children with CP to complete home exercises.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
42

participants targeted

Target at P25-P50 for not_applicable

Timeline
16mo left

Started Feb 2025

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress48%
Feb 2025Aug 2027

Study Start

First participant enrolled

February 25, 2025

Completed
2 days until next milestone

First Submitted

Initial submission to the registry

February 27, 2025

Completed
19 days until next milestone

First Posted

Study publicly available on registry

March 18, 2025

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2026

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2027

Last Updated

March 18, 2025

Status Verified

March 1, 2025

Enrollment Period

1.5 years

First QC Date

February 27, 2025

Last Update Submit

March 11, 2025

Conditions

Keywords

Cerebral palsyVirtual RealityHumanoid RobotHome-based InterventionArm Function

Outcome Measures

Primary Outcomes (3)

  • Reaching kinematics

    Reaching kinematics will be assessed while the child is interacting with Super Pop VR, wherein virtual bubbles are projected onto the standard projecting screen in randomly dispersed locations using the Kinect system. Three testing bubbles will be situated in the location where children need to reach about arm length overhead at 180°, 135°, and 90° of shoulder abduction, with instructions for children to reach in two conditions: (1) as fast as possible and (2) as accurate as possible. Children's reaching kinematics will also be assessed while playing the real-life functional activity using the Kinect camera. All children will be seated in an adjustable chair with a testing table in front of them at waist height with trunk support. Data will be collected for a minimum of six reaches for each direction of virtual and real-life tasks.

    Baseline, at 9th week, and at 13th week.

  • Standardized fine motor assessment score

    The fine motor domain of the Peabody Developmental Motor Scales, 2nd edition (PDMS-2), including grasping and visual-motor integration will be used.

    Baseline, at 9th week, and at 13th week.

  • Daily use of affected hand

    Daily use of affected hand will be evaluated using the Revised Pediatric Motor Activity Log (R-PMAL), which is filled out by primary caregivers about how often and how well their child uses the affected arm in daily activities.

    Baseline, at 9th week, and at 13th week.

Secondary Outcomes (3)

  • Muscle strength

    Baseline, at 9th week, and at 13th week.

  • Range of Motion (ROM)

    Baseline, at 9th week, and at 13th week.

  • Spasticity

    Baseline, at 9th week, and at 13th week.

Other Outcomes (1)

  • Qualitative outcome

    Baseline, at 9th week, and at 13th week.

Study Arms (2)

THRIVE (Combination of Virtual Reality and Humanoid Robot)

EXPERIMENTAL

Participants will receive the home-based intervention using the combination of virtual reality and a humanoid robot, "who" serves as a cheerleader and coach, for 8 weeks. During each week, participants will need to exercise 3 sessions per week, for around 60 minutes per session.

Device: RobotDevice: Virtual Reality

Virtual Reality Alone

ACTIVE COMPARATOR

Participants will receive the home-based virtual reality intervention for 8 weeks. During each week, participants will need to exercise 3 sessions per week, for around 60 minutes per session.

Device: Virtual Reality

Interventions

RobotDEVICE

This robot will serve as a cheerleader and coach to provide encouragement and feedback.

Also known as: Humanoid Robot
THRIVE (Combination of Virtual Reality and Humanoid Robot)

Our developed Super Pop VR system will be used to provide virtual reality intervention.

Also known as: VR
THRIVE (Combination of Virtual Reality and Humanoid Robot)Virtual Reality Alone

Eligibility Criteria

Age5 Years - 21 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Participants are between the ages of 5 and 21 years;
  • diagnosed with spastic CP;
  • have a manual ability classification system (MACs) level I-III;
  • able to sit with trunk supported;
  • are able to reach forward for more than half of their arm length;
  • are able to comprehend and complete a three-steps commands;
  • are able to see a TV screen (with or without corrected vision); and
  • their primary caregiver is willing to follow the desired intervention dosing and all evaluation measurements.

You may not qualify if:

  • they have received surgery or botulinum toxin type A injection in the training arm within the preceding 4 months or are scheduled to receive it during the planned intervention period, or
  • if they have a severe attention deficit or uncontrolled epilepsy, which may possibly be triggered by the light or sound of the video games.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Physical Therapy, Georgia State University

Atlanta, Georgia, 30302, United States

RECRUITING

Related Publications (4)

  • Chen Y, Garcia-Vergara S, Howard AM. Effect of feedback from a socially interactive humanoid robot on reaching kinematics in children with and without cerebral palsy: A pilot study. Dev Neurorehabil. 2018 Nov;21(8):490-496. doi: 10.1080/17518423.2017.1360962. Epub 2017 Aug 17.

    PMID: 28816558BACKGROUND
  • Howard A, Chen Y, Park CH. From Autism Spectrum Disorder to Cerebral Palsy: State-of-the-Art in Pediatric Therapy Robots. In Encyclopedia of Medical Robotics, J. P. Desai (Ed.), World Scientific Publishing Company, 2018, pp241-261

    BACKGROUND
  • Chen YP, Howard AM. Effects of robotic therapy on upper-extremity function in children with cerebral palsy: A systematic review. Dev Neurorehabil. 2016;19(1):64-71. doi: 10.3109/17518423.2014.899648. Epub 2014 Apr 11.

    PMID: 24724587BACKGROUND
  • Chen Y, Fanchiang HD, Howard A. Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Phys Ther. 2018 Jan 1;98(1):63-77. doi: 10.1093/ptj/pzx107.

    PMID: 29088476BACKGROUND

MeSH Terms

Conditions

Cerebral Palsy

Interventions

Robotic Surgical Procedures

Condition Hierarchy (Ancestors)

Brain Damage, ChronicBrain DiseasesCentral Nervous System DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Surgery, Computer-AssistedSurgical Procedures, OperativeRoboticsAutomationTechnologyTechnology, Industry, and Agriculture

Central Study Contacts

Yuping Chen, ScD, PT

CONTACT

Bruna de Souza da Silva, BS, PT

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

February 27, 2025

First Posted

March 18, 2025

Study Start

February 25, 2025

Primary Completion (Estimated)

August 31, 2026

Study Completion (Estimated)

August 31, 2027

Last Updated

March 18, 2025

Record last verified: 2025-03

Data Sharing

IPD Sharing
Will share

Real user therapy assessment and outcome data and intervention log will be possibility shared to a NIH-funded open video-based data-sharing system for developmental science (i.e., Databrary). Databrary is one of the first large-scale repository for sharing video data and related information so the researchers can share and view on another's databases to promote greater transparency and peer oversight into data collection methods and measurement. All the videos collected through Kinect camera during interventions and evaluations will be de-identified first before sharing to Databrary. A new written permission will be obtained from the parents of children with CP before initiating the data sharing process. PI, Co-PI, and research team members will contact the parents to explain the purpose of data sharing. If parents show their initial agreement, a de-identified video will send it to the parents for review before uploading and sharing to Databrary.

Shared Documents
CSR
Time Frame
9/1/2027 - after the data collection is completed and data have been analyzed and disseminated. Data will be available until 12/31/2035.
Access Criteria
Reserachers who also sign up to participate in datasharing in Databrary.

Locations