New Technological Pathway for Gait Rehabilitation

NCT ID: NCT06859229

Last Updated: 2025-03-05

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-31

Study Completion Date

2027-02-28

Brief Summary

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\*\*Brief Summary\*\*

The study aims to explore how the integration of visual and motor systems can be trained and enhanced to improve gait rehabilitation in patients with various neurological and cardiovascular conditions. Scientific evidence highlights that physical activity requires coordination and precise processing of visual, auditory, and sensory information from the external environment, which is then integrated at the brain level. This process establishes synaptic connections that direct the movement of arms, hands, legs, and the trunk through bottom-up and top-down mechanisms. However, inaccurate or incomplete perceptual information can impair performance, even when accurate visual stimuli are provided, emphasizing the importance of assessing and enhancing visuo-motor integration.

The research investigates the central mechanisms controlling peripheral muscle activation patterns during gait. While over-ground walking in healthy individuals generally does not activate the prefrontal cortex except in dual-task scenarios, evidence suggests that post-stroke patients exhibit increased prefrontal cortex metabolism during walking. Recent studies have shown that gait training with exoskeletal systems improves walking patterns in post-stroke patients by altering muscle activation patterns and increasing fronto-parietal connectivity.

This study seeks to answer the following question: How do central and peripheral mechanisms interact to influence gait rehabilitation outcomes, and what role do visuo-motor integration and neuroplasticity play in this process? To address this, advanced neuroimaging technologies such as fMRI, dtMRI, and NIRS will be employed to investigate these mechanisms in vivo.

Detailed Description

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Conditions

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Neurological Diseases or Conditions Cardiovascular Diseases Neuromuscular Disease

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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Innovative gait rehabilitation pathway

The group will be treated with a dynamic pathway with advanced technology for gait rehabilitation.

Group Type EXPERIMENTAL

Innovative technology pathway for gait neurorehabilitation

Intervention Type DEVICE

Participants will be assigned to either an advanced or traditional training pathway based on the protocol. The innovative tehcnology pathway for gait rehabilitation will incorporate devices such as exoskeletons, virtual reality systems, and body-weight suspension (BWS) devices to enhance gait rehabilitation. At the end of the training period, participants will undergo follow-up evaluation tests to assess outcomes.

Conventional gait rehabilitation

The group will be treated with conventional gait rehabilitation strategies.

Group Type ACTIVE_COMPARATOR

Conventional gait rehabilitation strategy

Intervention Type OTHER

The control group will undergo a traditional rehabilitation program that follows standard clinical protocols for gait recovery. This program will include conventional therapeutic exercises aimed at improving strength, balance, coordination, and functional mobility

Interventions

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Innovative technology pathway for gait neurorehabilitation

Participants will be assigned to either an advanced or traditional training pathway based on the protocol. The innovative tehcnology pathway for gait rehabilitation will incorporate devices such as exoskeletons, virtual reality systems, and body-weight suspension (BWS) devices to enhance gait rehabilitation. At the end of the training period, participants will undergo follow-up evaluation tests to assess outcomes.

Intervention Type DEVICE

Conventional gait rehabilitation strategy

The control group will undergo a traditional rehabilitation program that follows standard clinical protocols for gait recovery. This program will include conventional therapeutic exercises aimed at improving strength, balance, coordination, and functional mobility

Intervention Type OTHER

Other Intervention Names

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Robotic rehabilitation virtual reality rehabilitation Gait rehabilitation conventional neurorehabilitation

Eligibility Criteria

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Inclusion Criteria

* Patients with a Montreal Cognitive Assessment (MoCA) score, corrected for age and education, equal to or greater than 20.
* Subjects capable of walking independently (Functional Ambulation Categories - FAC \> 2).

Exclusion Criteria

* Cognitive impairments that compromise the understanding and/or execution of the proposed exercises.
* Associated comorbidities that prevent maintaining an upright position or walking (e.g., hypotension).
* Refusal or inability to provide informed consent.
* Patients with contraindications to the use of the technological equipment required for the dynamic movement pathway.
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Centro Neurolesi Bonino Pulejo

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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IRCCS Centro Neurolesi Bonino-Pulejo

Messina, Maine, Italy

Site Status

Countries

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Italy

Central Contacts

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Rocco Salvatore CalabrĂ², MD, PhD

Role: CONTACT

+3909060128179

Mirjam Bonanno, PT, MSc

Role: CONTACT

+3909060128179

Facility Contacts

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Rocco Salvatore CalabrĂ², MD, PhD

Role: primary

+3909060128179

References

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Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, Hornby TG. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehabil Neural Repair. 2009 Jan;23(1):5-13. doi: 10.1177/1545968308326632.

Reference Type BACKGROUND
PMID: 19109447 (View on PubMed)

Hornby TG, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR. Enhanced gait-related improvements after therapist- versus robotic-assisted locomotor training in subjects with chronic stroke: a randomized controlled study. Stroke. 2008 Jun;39(6):1786-92. doi: 10.1161/STROKEAHA.107.504779. Epub 2008 May 8.

Reference Type BACKGROUND
PMID: 18467648 (View on PubMed)

Chang WH, Kim YH. Robot-assisted Therapy in Stroke Rehabilitation. J Stroke. 2013 Sep;15(3):174-81. doi: 10.5853/jos.2013.15.3.174. Epub 2013 Sep 27.

Reference Type BACKGROUND
PMID: 24396811 (View on PubMed)

Other Identifiers

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45/2020

Identifier Type: -

Identifier Source: org_study_id

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