Clinical Study of the L300 Versus Ankle-foot Orthosis (AFO) on Post-Stroke Subjects With Foot Drop

NCT ID: NCT01138995

Last Updated: 2016-04-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

197 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2013-02-28

Brief Summary

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The objective of this study is to determine the effectiveness of the NESS L300 (L300) in improving gait parameters, function, and quality of life among stroke subjects (greater than or equal to 3 months post stroke)with drop foot.

Detailed Description

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Approximately 176 subjects with stroke that have drop foot will be enrolled from approximately 10 different sites in the United States depending on the rate of enrollment. This clinical study is proposed to show that the functional electrical stimulation (FES) delivered via the Ness L300 improves gait function, stroke-specific quality of life, and safety for persons with stroke.

Conditions

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Sensorimotor Gait Disorder Neurologic Ambulation Disorder Gait, Drop Foot Poststroke Hemiparesis Post-Cerebrovascular Accident (CVA) Hemiparesis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Ankle-foot orthosis (AFO) Control Group

The Control Group will walk with the a "usual" ankle-foot orthosis (AFO) for 30 weeks.

Group Type ACTIVE_COMPARATOR

Ankle-foot orthosis

Intervention Type DEVICE

The Control Group will walk with a "usual" ankle-foot orthosis (AFO).

Ness L300 Treatment Group

The Original Treatment Group will walk with the Ness L300 for 30 weeks.

Group Type EXPERIMENTAL

Ness L300

Intervention Type DEVICE

The Ness L300 delivers functional electrical stimulation (FES), which improves gait function, stroke-specific quality of life, functionality, and safety for persons with stroke.

Interventions

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Ness L300

The Ness L300 delivers functional electrical stimulation (FES), which improves gait function, stroke-specific quality of life, functionality, and safety for persons with stroke.

Intervention Type DEVICE

Ankle-foot orthosis

The Control Group will walk with a "usual" ankle-foot orthosis (AFO).

Intervention Type DEVICE

Other Intervention Names

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Leg Stimulator drop foot orthotic

Eligibility Criteria

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Inclusion Criteria

* Have ankle dorsiflexion range of motion greater than or equal to neutral when assessed concurrent with test stimulation in sitting and standing and demonstrate adequate ankle and knee stability during gait at the time of screening
* Have had at least one stroke of any etiology (e.g., ischemic, hemorrhagic,etc.) experienced greater than or equal to 3 months prior to study enrollment, as confirmed by independent medical records, and result in drop foot sufficient to require prior or current prescription for and/or use of an AFO
* Have adequate cognition and communication abilities for informed consent, training and instructions, use of the L300, and provide feedback, to be demonstrated by either the subjects scoring greater than or equal to 24 (out of a possible 30) on the Mini Mental State Examination, or having a competent caregiver for these purposes
* Must be 18 years or older
* Have the ability to safely walk at least 10-meters with a maximum of 1 person assist
* Have a self-selected 10-meter gait speed of less than or equal to 0.8m/s at the time of assessment
* Have inadequate dorsiflexion/limb clearance or unable to achieve normal heel strike on ambulation without AFO
* Be medically stable

Exclusion Criteria

* Have fixed ankle contracture at greater than or equal to 5 degrees of plantar flexion in the hemiplegic leg with the knee extended
* Have excessive pain in the affected leg, as measured by a score greater than or equal to 4 on a 10-point visual analog scale
* Participation, within the past 3 months, currently, or during the course of the study in any interventional clinical studies without the Sponsor's approval
* Have a demand-type cardiac pacemaker, defibrillator, or any electrical or metallic implant
* Have a lower motor neuron disease or injury with inadequate response to stimulation
* Have significant swelling/edema in the leg extending up to the knee
* Have a history of chronic skin problems/conditions or cancerous lesion present or suspected in close proximity ot the expected site for L300 stimulation
* Are pregnant or plan on becoming pregnant in the next 45 weeks
* Have had botulinum toxin(type a or b) to the hemiplegic leg or arm within the past six weeks or plan to have botulinum toxin treatments during the course of the study
* Expectation of a significant change in the subject's spasticity medications during the course of the study for the effected leg
* Have unstable seizure disorder (average of greater or equal to 2 seizures per month)
* Have a pre-existing significant orthopedic conditions that are, a that investigator's discretion, determined as likely to limit ambulatory progress (e.g., total hip replacement \[non-metallic\], total knee replacement \[non-metallic\], limited lower extremity (LE) range of motion (ROM), rheumatoid arthritis, osteoarthritis, or other fracture or dislocation that underlies the expected site for L300 stimulation)
* Have a complete hemisensory loss ipsilateral to foot drop
* Used the L300 or other FES device for foot drop (e.g., Odstock Drop Foot System (ODFS), WalkAide by Innovation Neurotronics, etc.) for greater than or equal to 3 hours within the last 6 months prior to study enrollment
* Have major post-stroke depression (PHQ-9 greater than or equal to 10) that is not medically managed with antidepression medication and/or psychotherapy
* Currently or planning on participating in a neuro-rehabilitation physical therapy (PT) or occupational therapy (OT) program or new independent exercise programs with enrolled in the study. However, injury or a change in condition requiring PT or OT that would not affect gait outcomes maybe assessed by an off-site study committee, on a case-by-case basis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medidata Solutions

INDUSTRY

Sponsor Role collaborator

University of Cincinnati

OTHER

Sponsor Role collaborator

Bioness Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kari Dunning, PT, Ph.D

Role: STUDY_CHAIR

The Drake Center/University of Cincinnati

Michael O'Dell, MD

Role: STUDY_CHAIR

Weill Medical College of Cornell University

Patricia Kluding, PT, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Kansas

Steven R. Edgley, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Kathaleen P Brady, PT, NCS

Role: PRINCIPAL_INVESTIGATOR

MedStar National Rehabilitation Network

Trevor Paris, MD

Role: PRINCIPAL_INVESTIGATOR

Brooks Rehabilitation

Jerome Stenehjem, MD

Role: PRINCIPAL_INVESTIGATOR

Sharp Rehabilitation Center

John Thottakara, MD

Role: PRINCIPAL_INVESTIGATOR

UT Southwestern

Jun Zhang, MD

Role: PRINCIPAL_INVESTIGATOR

St. Charles Hospital & Rehabilitation

Ziyad Ayyoub, MD

Role: PRINCIPAL_INVESTIGATOR

Rancho Los Amigos National Rehabilitation

Diemha Hoang, MD

Role: PRINCIPAL_INVESTIGATOR

Long Beach Memorial Medical Center

Locations

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Rancho Los Amigos National Rehabilitation Center

Downey, California, United States

Site Status

Long Beach Memorial Medical Center

Long Beach, California, United States

Site Status

Sharp Rehabilitation Center

San Diego, California, United States

Site Status

National Rehabilitation Hospital

Washington D.C., District of Columbia, United States

Site Status

Brooks Center for Rehabilitation Studies

Jacksonville, Florida, United States

Site Status

Kansas University Medical Center

Kansas City, Kansas, United States

Site Status

Weill Cornell Medical Center

New York, New York, United States

Site Status

St.Charles Hospital & Rehabilitation

Port Jefferson, New York, United States

Site Status

The Drake Center /University of Cincinnati

Cincinnati, Ohio, United States

Site Status

UT Southwestern

Dallas, Texas, United States

Site Status

University of Utah, School of Medicine

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Alenazi AM, Alshehri MM, Alothman S, Rucker J, Dunning K, D'Silva LJ, Kluding PM. Functional Reach, Depression Scores, and Number of Medications Are Associated With Number of Falls in People With Chronic Stroke. PM R. 2018 Aug;10(8):806-816. doi: 10.1016/j.pmrj.2017.12.005. Epub 2017 Dec 26.

Reference Type DERIVED
PMID: 29288141 (View on PubMed)

O'Dell MW, Dunning K, Kluding P, Wu SS, Feld J, Ginosian J, McBride K. Response and prediction of improvement in gait speed from functional electrical stimulation in persons with poststroke drop foot. PM R. 2014 Jul;6(7):587-601; quiz 601. doi: 10.1016/j.pmrj.2014.01.001. Epub 2014 Jan 9.

Reference Type DERIVED
PMID: 24412265 (View on PubMed)

Kluding PM, Dunning K, O'Dell MW, Wu SS, Ginosian J, Feld J, McBride K. Foot drop stimulation versus ankle foot orthosis after stroke: 30-week outcomes. Stroke. 2013 Jun;44(6):1660-9. doi: 10.1161/STROKEAHA.111.000334. Epub 2013 May 2.

Reference Type DERIVED
PMID: 23640829 (View on PubMed)

Other Identifiers

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CP-L300-0801, Rev. B

Identifier Type: -

Identifier Source: org_study_id

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