Evaluation of Robotic Exoskeletons Therapy for Gait Rehabilitation in Patients With Incomplete Spinal Cord Injury.

NCT ID: NCT03477123

Last Updated: 2020-07-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-01

Study Completion Date

2020-07-03

Brief Summary

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The objective of the study is to assess the efficacy of the Exo-H2 robotic exoskeleton for walking rehabilitation of people with incomplete spinal cord injury.

Detailed Description

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The recovery of walking ability is a primary concern of rehabilitation programs for people who have suffered anincomplete spinal cord injury. Robotic therapy arises from the new concepts of neuroplasticity. One of the most novel contributions in this field is robotic exoskeletons. However, there is still not enough scientific evidence to support the clinical use of this technology.

The aim of this proposal is to assess the efficacy of a new model of robotic exoskeleton (Exo H2) developed by the CSIC with HNP involvement in the context of HYPER project (Consolider 2009 call) in gait rehabilitation for people with incomplete spinal cord injury. A multicenter study is proposed here, involving the National Hospital of Paraplegics and the Institut Guttmann. Two randomized groups of patients with subacute incomplete spinal cord injury will be defined. In one group, protocol gait rehabilitation based on the Exo H2 will be established and traditional gait therapy will be adapted for control group. Both groups of patients were assessed performing a physical exam including functional gait scales (10 MWT, 6MWT, WISCI II score, SCIM) and a biomechanical gait analysis with kinetic and kinematic techniques. Functional assessment will be carried out before intervention, at the end of the intervention and a follow up six weeks later.

Conditions

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Spinal Cord Injury Incomplete Spinal Cord Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The evaluator does not have information on the group the patient was enrolled.

Study Groups

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Intervention

Walking therapy with Exo-H2 exoskeleton

Group Type EXPERIMENTAL

Walking therapy with Exo-H2 exoskeleton

Intervention Type DEVICE

Control

Group receiving conventional walking therapy without robotic exoskeleton

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Walking therapy with Exo-H2 exoskeleton

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Incomplete Spinal Cord Syndrome, ASIA scale C or D
* enough strength in the upper extremities to handle a walker or crutches (triceps brachial muscle balance ≥ 3)
* Age between 16 and 70 y.o.
* Heigth: 1.6-1.9m
* Weigth less than 120Kg
* Stable medical condition between 6 weeks and 18 months since injury.
* Subjects must tolerate standing and be included in walking rehabilitation program in the center.
* Lower limb spasticity should be lower than 3 as measyred by Ashworth scale.

Exclusion Criteria

* Cardiovascular diseases.
* Upper limb pathology of any kind.
* irreducible flexo or arthrodesis in lower limb joints, 2 or more osteoporotic fractures in the lower limbs in the last 2 years
* Uncontrolled epilepsy.
* Ulcers sores at the contact points with the exoskeleton.
* Refuse to participate.
Minimum Eligible Age

16 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Guttmann

OTHER

Sponsor Role collaborator

Hospital Nacional de Parapléjicos de Toledo

OTHER

Sponsor Role lead

Responsible Party

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Angel Gil-Agudo

PhD, MD, Head of Rehabilitation

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Angel Gil-Agudo, PhD, MD

Role: STUDY_CHAIR

Head of Rehabilitation Department

Locations

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National Hospital for Paraplegics

Toledo, , Spain

Site Status

Countries

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Spain

References

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Ditunno PL, Patrick M, Stineman M, Ditunno JF. Who wants to walk? Preferences for recovery after SCI: a longitudinal and cross-sectional study. Spinal Cord. 2008 Jul;46(7):500-6. doi: 10.1038/sj.sc.3102172. Epub 2008 Jan 22.

Reference Type BACKGROUND
PMID: 18209742 (View on PubMed)

Esquenazi A, Packel A. Robotic-assisted gait training and restoration. Am J Phys Med Rehabil. 2012 Nov;91(11 Suppl 3):S217-27; quiz S228-31. doi: 10.1097/PHM.0b013e31826bce18.

Reference Type BACKGROUND
PMID: 23080038 (View on PubMed)

Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci. 2004;22(3-5):281-99.

Reference Type BACKGROUND
PMID: 15502272 (View on PubMed)

Chen G, Patten C. Treadmill training with harness support: selection of parameters for individuals with poststroke hemiparesis. J Rehabil Res Dev. 2006 Jul-Aug;43(4):485-98. doi: 10.1682/jrrd.2005.04.0063.

Reference Type BACKGROUND
PMID: 17123188 (View on PubMed)

Colombo G, Joerg M, Schreier R, Dietz V. Treadmill training of paraplegic patients using a robotic orthosis. J Rehabil Res Dev. 2000 Nov-Dec;37(6):693-700.

Reference Type BACKGROUND
PMID: 11321005 (View on PubMed)

Mantone J. Getting a leg up? Rehab patients get an assist from devices such as HealthSouth's AutoAmbulator, but the robots' clinical benefits are still in doubt. Mod Healthc. 2006 Feb 13;36(7):58-60. No abstract available.

Reference Type BACKGROUND
PMID: 16515076 (View on PubMed)

Veneman JF, Kruidhof R, Hekman EE, Ekkelenkamp R, Van Asseldonk EH, van der Kooij H. Design and evaluation of the LOPES exoskeleton robot for interactive gait rehabilitation. IEEE Trans Neural Syst Rehabil Eng. 2007 Sep;15(3):379-86. doi: 10.1109/tnsre.2007.903919.

Reference Type BACKGROUND
PMID: 17894270 (View on PubMed)

Tefertiller C, Pharo B, Evans N, Winchester P. Efficacy of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011;48(4):387-416. doi: 10.1682/jrrd.2010.04.0055.

Reference Type BACKGROUND
PMID: 21674390 (View on PubMed)

Zeilig G, Weingarden H, Zwecker M, Dudkiewicz I, Bloch A, Esquenazi A. Safety and tolerance of the ReWalk exoskeleton suit for ambulation by people with complete spinal cord injury: a pilot study. J Spinal Cord Med. 2012 Mar;35(2):96-101. doi: 10.1179/2045772312Y.0000000003. Epub 2012 Feb 7.

Reference Type BACKGROUND
PMID: 22333043 (View on PubMed)

Aach M, Cruciger O, Sczesny-Kaiser M, Hoffken O, Meindl RCh, Tegenthoff M, Schwenkreis P, Sankai Y, Schildhauer TA. Voluntary driven exoskeleton as a new tool for rehabilitation in chronic spinal cord injury: a pilot study. Spine J. 2014 Dec 1;14(12):2847-53. doi: 10.1016/j.spinee.2014.03.042. Epub 2014 Apr 4.

Reference Type BACKGROUND
PMID: 24704677 (View on PubMed)

Jackson AB, Carnel CT, Ditunno JF, Read MS, Boninger ML, Schmeler MR, Williams SR, Donovan WH; Gait and Ambulation Subcommittee. Outcome measures for gait and ambulation in the spinal cord injury population. J Spinal Cord Med. 2008;31(5):487-99. doi: 10.1080/10790268.2008.11753644.

Reference Type BACKGROUND
PMID: 19086706 (View on PubMed)

Ditunno J, Scivoletto G. Clinical relevance of gait research applied to clinical trials in spinal cord injury. Brain Res Bull. 2009 Jan 15;78(1):35-42. doi: 10.1016/j.brainresbull.2008.09.003. Epub 2008 Oct 9.

Reference Type BACKGROUND
PMID: 18848865 (View on PubMed)

Other Identifiers

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PI15/01437

Identifier Type: -

Identifier Source: org_study_id

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