Proof of Concept of Hybrid Robotics for Gait Rehabilitation of Persons Post-stroke

NCT ID: NCT06436898

Last Updated: 2024-05-31

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2025-11-01

Brief Summary

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Persons post-stroke suffer from hemiparesis affecting the functional abilities of the controlesional lower limb. Improving walking is therefore a primary rehabilitation goal for such patients. Robotic-Assisted Rehabilitation (RAR, e.g. exoskeletons) and Functional Electrical Stimulation (FES) are promising techniques to facilitate the functional recovery after stroke. allowing benefits to be maintained over long term.

Detailed Description

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Exoskeletons were originally developed for subjects with spinal cord injury where they demonstrated a positive impact on rehabilitation and relative costs. The investigators expect the same trend also for stroke. Based on prior exploratory activities using an overgorund exoskeleton (TWIN\_Acta) in gait rehabilitation post stroke, in this project the aim is to merge the potential of an overground exoskeleton and FES to treat the lower limb motor deficits in persons post-stroke, strengthening their residual abilities. Synchronized pairing of the two devices might boost the functional recovery of gait post-stroke by promoting neural reorganization The persons post stroke will undergo 20 gait rehabiliation sessions with the exoskeleton and with FES applied to the lower limb muscles during execution of gait with the aim of improving various gait and quality of life parameters. This experimental intervention will be compared to a control intervention using an exoskeleton alone for gait rehabiltation post stroke.

Conditions

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Stroke Sequelae Gait, Hemiplegic

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Assessor blind to treatment arm

Study Groups

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Exoskeleton plus FES

Participants will train gait with an overground exoskeleton and a combined myoelectrically controlled Functional Electrostimulation System (FES) applied to lower limb muscles during execution of gait.

Group Type EXPERIMENTAL

Combined overground gait exoskeleton and FES applied to lower limb

Intervention Type DEVICE

Gait rehabilitation for persons with stroke, with an overground exoskeleton combined with an electromyographically controlled FES applied to lower limb muscles during gait.

Exoskeleton

Participants will train gait with an overground exoskeleton.

Group Type ACTIVE_COMPARATOR

Overground gait exoskeleton

Intervention Type DEVICE

Gait rehabilitation for persons with stroke, with an overground exoskeleton.

Interventions

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Combined overground gait exoskeleton and FES applied to lower limb

Gait rehabilitation for persons with stroke, with an overground exoskeleton combined with an electromyographically controlled FES applied to lower limb muscles during gait.

Intervention Type DEVICE

Overground gait exoskeleton

Gait rehabilitation for persons with stroke, with an overground exoskeleton.

Intervention Type DEVICE

Other Intervention Names

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TWIN_Acta and FITFES TWIN_Acta

Eligibility Criteria

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Inclusion Criteria

18 years or older

* Diagnosis of first unilateral ischemic or hemorrhagic ictus, at least two weeks from the event, ischemic or hemorrhagic
* diagnosis confermed with Computer Tomography or Magnetic Resonance Imaging
* 1 ≤ FAC (Functional ambulation category) ≤ 3
* 50 kg ≤ weight ≤ 90 kg
* 150 cm ≤ height ≤ 192 cm
* Femor length: 355-475 mm
* Tibia length: 405-485 mm
* Pelvic width 690-990 mm
* shoe size 36-45
* Capable of standing unsupported for at least one minute

Exclusion Criteria

* Mini Mental State Examination score (corrected for age and education) \< 24
* Clinical evidence in the medical records of visuospatial and ideomotor apraxia, behavioral disorders, neglect, severe visual and auditory sensory disorders or those which prevent use of the device
* patients at risk of fractures or with strategic fractures (unstabilized fractures or spinal instability)
* Major head trauma
* Subarachnoid hemorrhage, cerebral thrombosis
* Cardio-respiratory or internal clinical instability
* Pregnant or breastfeeding status;
* Recent malignant neoplasm
* Chronic inflammatory diseases with joint involvement of the lower limbs;
* Severe spasticity (Ashworth\>3)
* Significant limitations in passive ROM of the hips and knees
* Problems with the integrity of the skin at the interface surfaces with the device or which would prevent sitting.
* Implanted electronic devices
* Epilepsy
* Severe peripheral neuropathies
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Istituto Italiano di Tecnologia

OTHER

Sponsor Role collaborator

Istituto Nazionale di Ricovero e Cura per Anziani

OTHER

Sponsor Role collaborator

Fondazione Don Carlo Gnocchi Onlus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Maurizio Ferrarin, PhD

Role: PRINCIPAL_INVESTIGATOR

Research Head of Biomedical Technology Department

Andrea Corsonello, PhD

Role: STUDY_DIRECTOR

Research Head of the Neurological Unit

Locations

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Fondazione Don Carlo Gnocchi IRCCS

Milan, , Italy

Site Status

Countries

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Italy

Central Contacts

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Tiziana Lencioni, PhD

Role: CONTACT

024030 ext. 8547

Johanna Jonsdottir, PhD

Role: CONTACT

024030 ext. 8840

Other Identifiers

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PoCH-Rehab

Identifier Type: -

Identifier Source: org_study_id

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