Trial Outcomes & Findings for Combined Application of Electrical Stimulated Antagonist Contraction During Walking (Walking Study) (NCT NCT02730598)

NCT ID: NCT02730598

Last Updated: 2018-06-15

Results Overview

Participants will be familiarized with strength testing equipment and counseled on proper lifting technique. They will undergo testing to determine their peak isokinetic knee extensor torque, using an isokinetic dynamometer.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

28 participants

Primary outcome timeframe

Baseline and 12-week follow-up

Results posted on

2018-06-15

Participant Flow

Participant milestones

Participant milestones
Measure
Hybrid Training System (HTS)
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Overall Study
STARTED
14
14
Overall Study
COMPLETED
10
10
Overall Study
NOT COMPLETED
4
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Hybrid Training System (HTS)
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Overall Study
Withdrawal by Subject
3
3
Overall Study
Protocol Violation
0
1
Overall Study
Unrelated Injury affecting outcomes.
1
0

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Hybrid Training System (HTS)
n=14 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=14 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Total
n=28 Participants
Total of all reporting groups
Age, Continuous
59.21 years
STANDARD_DEVIATION 10.02 • n=14 Participants
58.29 years
STANDARD_DEVIATION 6.35 • n=14 Participants
58.75 years
STANDARD_DEVIATION 8.19 • n=28 Participants
Sex: Female, Male
Female
14 Participants
n=14 Participants
14 Participants
n=14 Participants
28 Participants
n=28 Participants
Sex: Female, Male
Male
0 Participants
n=14 Participants
0 Participants
n=14 Participants
0 Participants
n=28 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Weight
97.1 kilograms (kg)
STANDARD_DEVIATION 9.6 • n=14 Participants
95.6 kilograms (kg)
STANDARD_DEVIATION 12.6 • n=14 Participants
96.4 kilograms (kg)
STANDARD_DEVIATION 11.1 • n=28 Participants
Height
161.5 centimeters (cm)
STANDARD_DEVIATION 6.6 • n=14 Participants
163.5 centimeters (cm)
STANDARD_DEVIATION 8.6 • n=14 Participants
162.5 centimeters (cm)
STANDARD_DEVIATION 7.6 • n=28 Participants
Body Mass Index (BMI)
37.4 kilograms per meters squared (kg/m2)
STANDARD_DEVIATION 4.2 • n=14 Participants
35.8 kilograms per meters squared (kg/m2)
STANDARD_DEVIATION 2.9 • n=14 Participants
36.6 kilograms per meters squared (kg/m2)
STANDARD_DEVIATION 3.6 • n=28 Participants
20-Meter Walk Time
12.5 seconds
STANDARD_DEVIATION 2.0 • n=14 Participants
12.9 seconds
STANDARD_DEVIATION 2.0 • n=14 Participants
12.7 seconds
STANDARD_DEVIATION 2.0 • n=28 Participants
5-Chair Stand Time
11.9 seconds
STANDARD_DEVIATION 3.1 • n=14 Participants
15.2 seconds
STANDARD_DEVIATION 4.6 • n=14 Participants
13.6 seconds
STANDARD_DEVIATION 3.8 • n=28 Participants
Stair Climb Time
6.4 seconds
STANDARD_DEVIATION 1.3 • n=14 Participants
6.7 seconds
STANDARD_DEVIATION 2.5 • n=14 Participants
6.5 seconds
STANDARD_DEVIATION 1.9 • n=28 Participants
Knee Extension Torque
79.6 Newton-meters (Nm)
STANDARD_DEVIATION 35.9 • n=14 Participants
71.7 Newton-meters (Nm)
STANDARD_DEVIATION 42.2 • n=14 Participants
75.6 Newton-meters (Nm)
STANDARD_DEVIATION 39.1 • n=28 Participants
Knee Flexion Torque
36.8 Newton-meters (Nm)
STANDARD_DEVIATION 22.0 • n=14 Participants
26.3 Newton-meters (Nm)
STANDARD_DEVIATION 19.2 • n=14 Participants
31.6 Newton-meters (Nm)
STANDARD_DEVIATION 20.6 • n=28 Participants
Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain Subscale
14.7 units on a scale
STANDARD_DEVIATION 4.7 • n=14 Participants
17.1 units on a scale
STANDARD_DEVIATION 4.0 • n=14 Participants
15.9 units on a scale
STANDARD_DEVIATION 4.4 • n=28 Participants
Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QOL) sub scale
9.1 units on a scale
STANDARD_DEVIATION 2.6 • n=14 Participants
10.4 units on a scale
STANDARD_DEVIATION 3.0 • n=14 Participants
9.8 units on a scale
STANDARD_DEVIATION 2.8 • n=28 Participants
Knee Pain by Visual Analog Scale
31.6 millimeters (mm)
STANDARD_DEVIATION 23.4 • n=14 Participants
43.6 millimeters (mm)
STANDARD_DEVIATION 22.2 • n=14 Participants
37.6 millimeters (mm)
STANDARD_DEVIATION 22.8 • n=28 Participants

PRIMARY outcome

Timeframe: Baseline and 12-week follow-up

Participants will be familiarized with strength testing equipment and counseled on proper lifting technique. They will undergo testing to determine their peak isokinetic knee extensor torque, using an isokinetic dynamometer.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Knee Extensor Strength Assessed by Isokinetic Dynamometer.
9.6 Newton-meters (Nm)
Standard Error 10.8
3.8 Newton-meters (Nm)
Standard Error 28.9

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

Participants will be familiarized with strength testing equipment and counseled on proper lifting technique. They will undergo testing to determine their peak isokinetic knee flexor torque, using an isokinetic dynamometer.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Knee Flexor Strength Assessed by Isokinetic Dynamometer
9.3 Newton-meters (Nm)
Standard Deviation 9.7
6.3 Newton-meters (Nm)
Standard Deviation 15.1

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

Knee pain will be evaluated using a visual analog scale (VAS) of 100 mm from no pain (0 mm) to the worst imaginable pain (100 mm). Participants will be asked to record their pain levels of the past one week.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Knee Pain Assessed by a Visual Analog Scale (VAS)
-14.9 millimeters (mm)
Standard Error 27.1
-11.9 millimeters (mm)
Standard Error 23.1

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

The Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain subscale was used at baseline and follow-up to assess participant outcomes. The pain subscale is made up of 9 questions and was scored from zero to 100, with zero corresponding to extreme knee problems and 100 corresponding to no knee problems.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Knee Pain Assessed by Knee Injury and Osteoarthritis Outcome Score (KOOS)
-5.4 units on a scale
Standard Deviation 4.0
-5.3 units on a scale
Standard Deviation 4.9

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

The Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QOL) subscale was used at baseline and follow-up to assess participant outcomes. The QOL subscale is made up of 4 questions and was scored from zero to 100, with zero corresponding to extreme knee problems and 100 corresponding to no knee problems.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Quality of Life (QOL) Assessed by Knee Injury and Osteoarthritis Outcome Score (KOOS)
-2.6 units on a scale
Standard Deviation 1.9
-2.4 units on a scale
Standard Deviation 3.0

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

Average time of two trials used for each participant.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in 20-meter Walk Time.
-0.53 seconds
Standard Deviation 0.9
-0.52 seconds
Standard Deviation 1.5

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

Average time of two trials used for each participant.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in 5-chair Stand Time.
-1.5 seconds
Standard Deviation 1.5
-2.4 seconds
Standard Deviation 2.9

SECONDARY outcome

Timeframe: Baseline and 12-week follow-up

Average time of two trials used for each participant.

Outcome measures

Outcome measures
Measure
Hybrid Training System (HTS)
n=10 Participants
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=10 Participants
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Change in Stair Climb Time.
-0.8 seconds
Standard Deviation 0.5
-1.4 seconds
Standard Deviation 1.4

Adverse Events

Hybrid Training System (HTS)

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Transcutaneous Electrical Nerve Stimulation (TENS)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Hybrid Training System (HTS)
n=14 participants at risk
HTS stimulation while walking at a comfortable pace for 30 minutes. Hybrid Training System (HTS): Electrodes will be placed over the quadriceps and hamstrings. Electrical stimulation parameters will be based on a standard Russian waveform in which a 5000 Hz carrier frequency is modulated at 40 Hz (2.4 ms on, 22.6 ms off) to deliver a rectangular voltage biphasic pulse. Acceleration sensors as a joint motion sensor is placed on the front of each leg 88mm above the patellar edge. It analyzes the algorithm of each exercise pattern, and stimulates the antagonist of the motion of each bilateral knee joint during exercise. Electrical stimulation intensity will be set to \~50-60% of 1RM based on the subject's tolerance. The subject's tolerance gradually increases, and electrical stimulation intensity is reset every 2 weeks.
Transcutaneous Electrical Nerve Stimulation (TENS)
n=14 participants at risk
Sensory TENS while walking at a comfortable pace for 30 minutes. Sensory TENS: The electrical stimulation intensity will be set under the muscle contraction threshold (but at a level at which the subject can perceive as sensory TENS). Electrical stimulation parameters (i.e. waveform and pulse duration) will be the same of HTS, while the amplitude will be lower. The subject will be stimulated using the same device as for HTS.
Musculoskeletal and connective tissue disorders
Increased Knee Pain during Intervention
14.3%
2/14 • Adverse event data was collected over the duration of the study from baseline to 12-week follow-up.
7.1%
1/14 • Adverse event data was collected over the duration of the study from baseline to 12-week follow-up.

Additional Information

Neil Segal

University of Kansas Medical Center

Phone: (913) 945-8985

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place