Investigating the Mechanisms of Welwalk Robot in Restoring Motor Function of the Lower Extremities in Stroke Patients

NCT ID: NCT07057700

Last Updated: 2025-07-10

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

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-01

Study Completion Date

2027-06-01

Brief Summary

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Current evidence and clinical applications of robotic gait training devices for motor function recovery post-stroke are increasingly available. Although existing research demonstrates that robotic gait training can improve patients' gait and balance, there remains a lack of in-depth investigation into its specific mechanisms of action concerning central nervous system (CNS) reorganization - notably, changes in activity within the motor cortex and associated neural networks. The intrinsic changes within the CNS have received insufficient attention, limiting a comprehensive and profound understanding of the rehabilitation outcomes. Therefore, this study aims to elucidate the potential mechanisms underlying robotic gait training-induced neuroplasticity by integrating functional near-infrared spectroscopy (fNIRS) technology with multi-dimensional lower limb motor function assessment tools (such as FAC, BBS, AMEDA, 10MWT, 6MWT, TUGT). It will systematically investigate the effects of robotic gait training on both the central nervous system and lower limb motor function in stroke patients. Furthermore, the study will compare the differences in functional recovery efficacy between robotic gait training and conventional rehabilitation therapies.

Detailed Description

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In this study, participants will be randomly allocated into two groups: the Welwalk training group and the conventional rehabilitation therapy group.

Welwalk Training Group: Each session will consist of 30 minutes of Welwalk robot-assisted training, followed by 15 minutes of gait training and 15 minutes of supplementary exercises.Control Group (Conventional Rehabilitation Therapy): Each session will consist of 45 minutes of gait training and 15 minutes of supplementary exercises.The intervention period will span 3 weeks, with sessions administered six times per week. Each session will last 1 hour.

Clinical assessments will be conducted by certified healthcare professionals at four time points: at baseline (prior to the commencement of formal training), and after the 1st week, 2nd week, and 3rd week of treatment.

Conditions

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Stroke Walking Impairment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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welwalk training

Daily physiotherapy training using the welwalk lower limb walking training robot

Group Type EXPERIMENTAL

welwalk training

Intervention Type DEVICE

welwalk training group 30 min of welwalk robot-assisted training + 15 min of walking training + 15 min of other training per session.The intervention lasted a total of 3 weeks, 6 sessions/week, 1 hour/session.

conventional physical therapy

Daily training using traditional physiotherapy such as core training, gait training, etc.

Group Type ACTIVE_COMPARATOR

physical therapy

Intervention Type OTHER

45 min of walking training + 15 min of other training per session. The intervention lasted a total of 3 weeks, 6 sessions/week, 1 hour/session.

Interventions

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welwalk training

welwalk training group 30 min of welwalk robot-assisted training + 15 min of walking training + 15 min of other training per session.The intervention lasted a total of 3 weeks, 6 sessions/week, 1 hour/session.

Intervention Type DEVICE

physical therapy

45 min of walking training + 15 min of other training per session. The intervention lasted a total of 3 weeks, 6 sessions/week, 1 hour/session.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients or family gave written informed consents to participate in this study.
* Patients with first hemiplegia caused by primary supratentorial intracerebral hemorrhage or cerebral infarction.
* Within 1 year of stroke onset
* Aged ≥ 20
* Body weight is between 40 and 80 kg
* No excessive spasticity in hip, knee, and ankle joints (Modified Ashworth Scale \<3)
* sufficient cognition to follow simple instructions and to understand the content and purpose of the study (Chinese version-MOCA ≥ 20 points)
* Patients who have risks of giving-way when they walk with Ankle-Foot orthosis (AFO)

Exclusion Criteria

* A history of myocardial infarction
* Muscular or neurological disorder including diabetic neuropathy
* Symptomatic angina or arrhythmia
* Symptomatic respiratory disorder
* Communicable infection
* Joint contracture or limb deformity that affects walking (Range of motion of hip extension \< 5 degree, knee extension \< -5 degree (can be flexible), ankle dorsiflexion with knee extension position \< 5 degree)
* Heterotropic ossification that restrict the range of motion of joints of lower extremities
* Being vulnerable to fracture like severe osteoporosis of spine or lower extremities
* Incontinence of urine or feces that may deface the robotic knee-ankle-foot device of Welwalk
* Inadequate control of hypertension (resting systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 120 mmHg)
* Inadequate control of tachycardia (heart rate at rest ≥ 120 bpm)
* Training restriction due to reduced cardiac function or respiratory dysfunction
* Visual or auditory impairment hindering training
* Pregnant patients
* Recent participation in other clinical trials
* Patient whom examination doctor judge improper as a trial subject
* Anyone not able to sustain the training protocol with Welwork or regular training
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ruijin Hospital

OTHER

Sponsor Role lead

Responsible Party

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Qing Xie, PhD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Shanghai Ruijin Hospital, affiliated to Shanghai Jiao Tong University, School of medicine,

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Central Contacts

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Ming Kang, master of science

Role: CONTACT

+8615830039916

Facility Contacts

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Jian Li

Role: primary

+86-137 0165 7578

References

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Zhang B, Li D, Liu Y, Wang J, Xiao Q. Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta-analysis. J Adv Nurs. 2021 Aug;77(8):3255-3273. doi: 10.1111/jan.14800. Epub 2021 Mar 6.

Reference Type BACKGROUND
PMID: 33675076 (View on PubMed)

Wang C, Zhang Q, Hou S, Guo D, Han X, Huo W, Zhang Y. Split-belt treadmill training improves gait symmetry and lower limb function in patients with stroke. Sci Rep. 2025 May 8;15(1):16123. doi: 10.1038/s41598-025-98322-3.

Reference Type BACKGROUND
PMID: 40341197 (View on PubMed)

Sheng Y, Han J. Biomechanical characteristics and neuromuscular action control mechanism of single-dual-task walking-conversion training in stroke patients. J Back Musculoskelet Rehabil. 2025 May;38(3):576-592. doi: 10.1177/10538127241308215. Epub 2025 Feb 12.

Reference Type BACKGROUND
PMID: 39973293 (View on PubMed)

Caliandro P, Molteni F, Simbolotti C, Guanziroli E, Iacovelli C, Reale G, Giovannini S, Padua L. Exoskeleton-assisted gait in chronic stroke: An EMG and functional near-infrared spectroscopy study of muscle activation patterns and prefrontal cortex activity. Clin Neurophysiol. 2020 Aug;131(8):1775-1781. doi: 10.1016/j.clinph.2020.04.158. Epub 2020 May 18.

Reference Type BACKGROUND
PMID: 32506008 (View on PubMed)

Li X, Zhang H, Zhang W, Wu J, Dai L, Long N, Jin T, Gu L, Chen J. Neural mechanisms underlying the improvement of gait disturbances in stroke patients through robot-assisted gait training based on QEEG and fNIRS: a randomized controlled study. J Neuroeng Rehabil. 2025 Jun 18;22(1):136. doi: 10.1186/s12984-025-01656-2.

Reference Type BACKGROUND
PMID: 40533805 (View on PubMed)

Belda-Lois JM, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D, Iosa M, Molinari M, Tamburella F, Ramos A, Caria A, Solis-Escalante T, Brunner C, Rea M. Rehabilitation of gait after stroke: a review towards a top-down approach. J Neuroeng Rehabil. 2011 Dec 13;8:66. doi: 10.1186/1743-0003-8-66.

Reference Type BACKGROUND
PMID: 22165907 (View on PubMed)

Fan T, Zheng P, Zhang X, Gong Z, Shi Y, Wei M, Zhou J, He L, Li S, Zeng Q, Lu P, Zhao Y, Zou J, Chen R, Peng Z, Xu C, Cao P, Huang G. Effects of exoskeleton rehabilitation robot training on neuroplasticity and lower limb motor function in patients with stroke. BMC Neurol. 2025 May 3;25(1):193. doi: 10.1186/s12883-025-04203-7.

Reference Type BACKGROUND
PMID: 40319228 (View on PubMed)

Chen S, Zhang W, Wang D, Chen Z. How robot-assisted gait training affects gait ability, balance and kinematic parameters after stroke: a systematic review and meta-analysis. Eur J Phys Rehabil Med. 2024 Jun;60(3):400-411. doi: 10.23736/S1973-9087.24.08354-0. Epub 2024 Apr 22.

Reference Type BACKGROUND
PMID: 38647534 (View on PubMed)

Hao QH, Qiu MM, Wang J, Tu Y, Lv ZH, Zhu TM. The effect of lower limb rehabilitation robot on lower limb -motor function in stroke patients: a systematic review and meta-analysis. Syst Rev. 2025 Mar 26;14(1):70. doi: 10.1186/s13643-025-02759-6.

Reference Type BACKGROUND
PMID: 40140968 (View on PubMed)

Zhang S, Fan L, Ye J, Chen G, Fu C, Leng Y. An Intelligent Rehabilitation Assessment Method for Stroke Patients Based on Lower Limb Exoskeleton Robot. IEEE Trans Neural Syst Rehabil Eng. 2023;31:3106-3117. doi: 10.1109/TNSRE.2023.3298670. Epub 2023 Aug 2.

Reference Type BACKGROUND
PMID: 37490379 (View on PubMed)

Hesse S, Mehrholz J, Werner C. Robot-assisted upper and lower limb rehabilitation after stroke: walking and arm/hand function. Dtsch Arztebl Int. 2008 May;105(18):330-6. doi: 10.3238/arztebl.2008.0330. Epub 2008 May 2.

Reference Type BACKGROUND
PMID: 19629252 (View on PubMed)

Xu S, Zhu S, Li M, Zhang T, Wang Q, Sui Y, Shen Y, Chaojie K, Zhuang R, Guo C, Wang T, Zhu L. Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study. Front Neurol. 2025 Jan 13;15:1449667. doi: 10.3389/fneur.2024.1449667. eCollection 2024.

Reference Type BACKGROUND
PMID: 39871991 (View on PubMed)

Rodriguez-Fernandez A, Lobo-Prat J, Font-Llagunes JM. Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments. J Neuroeng Rehabil. 2021 Feb 1;18(1):22. doi: 10.1186/s12984-021-00815-5.

Reference Type BACKGROUND
PMID: 33526065 (View on PubMed)

Scrivener K, Dorsch S, McCluskey A, Schurr K, Graham PL, Cao Z, Shepherd R, Tyson S. Bobath therapy is inferior to task-specific training and not superior to other interventions in improving lower limb activities after stroke: a systematic review. J Physiother. 2020 Oct;66(4):225-235. doi: 10.1016/j.jphys.2020.09.008. Epub 2020 Oct 14.

Reference Type BACKGROUND
PMID: 33069609 (View on PubMed)

Other Identifiers

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2025230

Identifier Type: -

Identifier Source: org_study_id

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