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StrokeNCT03367091

Energy Consumption and Cardiorespiratory Load During Overground Gait Training With a Wearable Exoskeleton After Stroke

A study testing Ekso GT gait training with high swing assistance, Ekso GT gait training with neutral swing assistance and Ekso GT gait training with high swing resistance in people with Stroke, run by Vrije Universiteit Brussel at 1 site in Belgium.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

To investigate acute metabolic and cardiorespiratory responses during overground gait training with a wearable exoskeleton in persons after stroke Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Stroke
What is being tested?
Ekso GT gait training with high swing assistance, Ekso GT gait training with neutral swing assistance and Ekso GT gait training with high swing resistance
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1 participants
Where
1 siteBelgium
Study dates
9 Jul 2018to 31 Dec 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Included will be persons who

  • Had a stroke
  • Cannot walk independently or can walk independently on level ground, but still require help on stairs, slopes or uneven surfaces (FAC 0 - 4)

Excluded will be persons who

  • Can walk independently on level ground, stairs, slopes and uneven surfaces (FAC 5)
  • Have musculoskeletal problems (other than stroke) affecting the ability to walk
  • Have concurrent pulmonary diseases (e.g. asthma)
  • Have unstable cardiovascular conditions
  • Have concurrent neurological diseases (e.g. Parkinson's Disease)
  • Have communicative and/or cognitive problems affecting the ability to understand or follow instructions
  • Present contra-indications for using the Ekso GT (according to manufacturer's instructions)
  • Severe concurrent medical diseases (infections, circulatory, heart or lung, pressure sores)
  • Severe spasticity (Ashworth 4)
  • Range of motion restrictions that would prevent a patient from achieving normal, reciprocal gait pattern, or would restrict a patient from completing normal sit-to-stand or stand-to-sit transitions
  • Bilateral hip flexion < 110°
  • Knee flexion contracture > 12°
  • Inability to achieve 0° neutral angle dorsiflexion with knee flexion ≤ 12°
  • Weight ≥ 100 kg
  • Hip width < 35.8 cm or > 45.6 cm
  • Upper leg length < 51 cm or > 61.4 cm
  • Lower leg length < 48 cm or > 63.4 cm
  • Upper leg length discrepancy > 0.5 inch (1.3 cm)
  • Lower leg length discrepancy > 0.75 inch (1.9 cm)
  • Unstable spine, unhealed limbs or pelvic fractures
  • Unhealthy bone density
  • Heterotopic ossification
  • Significant contractures
  • Elbows and shoulders are unable to support crutches, walker or cane
  • Psychiatric or cognitive situations that may interfere with proper operation of the device

Trial locations and contacts

1 site in 1 country.

Belgium1 site
  • REVAlution center

    Herentals, Antwerp, 2200

Other trials in Belgium

About this study

Official title: Energy Consumption and Cardiorespiratory Load During Overground Gait Training With a Wearable Exoskeleton After Stroke: the Effect of the Level of Swing Assistance

To investigate acute metabolic and cardiorespiratory responses during overground gait training with a wearable exoskeleton in persons after stroke

Read the detailed description

RESEARCH AIMS:

  • To investigate the effect of the level of swing assistance on the acute metabolic and cardiorespiratory responses during overground gait training with a wearable exoskeleton in persons after stroke
  • To investigate if there is an interaction-effect between the level of swing assistance and the duration of walking
  • To compare the exercise intensity to aerobic training recommendations

STUDY DESIGN: An experimental, 1-group trial with randomized crossover design.

PATIENT RECRUITMENT: Participants will be recruited at the AZ Herentals (Herentals, Belgium).

LOCATION: The trial will be conducted at the REVAlution Center (Herentals, Belgium).

ELIGIBILITY CRITERIA: See section "Eligibility"

PROCEDURES: Before the start of the study, informed consent and baseline patient characteristics will be collected. Next, participants will be measured during three training sessions with the Ekso GT SmartAssist:

  • 20-minute training with high swing assistance
  • 20-minute training with neutral swing assistance
  • 20-minute training with high swing resistance

Trainings will be performed on a separate day in a randomized order (within one week and controlled for time of day).

Following settings will be used in all three conditions: sitting program ("Min lean"); standing program ("Auto lean"); step initiation program ("ProStep+"), training mode ("Off"), SmartAssist option ("2Free"); and stance support ("Low"). The level of stance support and swing assistance will be set symmetrically for the affected and non-affected side.

During training, participants will walk back and forth at a self-selected walking speed in a 30m hall way using a cane at the non-affected side.

Prior to the experimental conditions, participants will have had three training sessions in the Ekso GT.

RESTRICTIONS \& PROHIBITIONS: Participants will be instructed to not consume food, alcohol, caffeine or nicotine at least 3h prior to the intervention. Usual medication intake will be allowed with small amounts of water.

MATERIALS: The Ekso GT robotic exoskeleton with SmartAssist (Ekso Bionics Inc., USA) will be used during the overground training sessions.

A flexible facemask (adult facemask, small/medium, Cortex, Germany), lightweight chest carrying gas analysis system (Metamax 3B, Cortex, Germany) and Bluetooth heart rate belt (Polar H7, Polar Electro, Finland) will be used to measure metabolic and cardiorespiratory parameters. At the start of each measurement, gas (room air and reference gas (17.4% O2 and 5.1% CO2)) and volume (3L syringe) calibrations of the breath-by-breath gas analysis system will be performed in accordance with the manufacturer's instructions.

OUTCOMES: See section "Outcome Measures"

DATA-ANALYSES: Descriptive statistics will be calculated for baseline patient characteristics. To investigate the effect of level of swing assistance and duration, a repeated measures ANOVA (within factor duration and within factor assistance level) will be conducted (interaction-effect time x duration, main effect assistance level and main effect duration). In case of significant differences, posthoc analyses will be interpreted. The walking speed will be considered as a covariate in the ANOVA analysis (in case significant different between conditions). Significance level will be set at 5%.

Conditions
Stroke
Being tested
Ekso GT gait training with high swing assistance, Ekso GT gait training with neutral swing assistance, Ekso GT gait training with high swing resistance
Keywords
Wearable Exoskeleton, Stroke, Energy Consumption, Cardiorespiratory Load
Medical subject headings
Stroke

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ekso GT gait training with high swing assistanceOther

    Participant will walk for 20-minutes in the Ekso GT SmartAssist with the swing assistance set at "high assistance"

  • Ekso GT gait training with neutral swing assistanceOther

    Participant will walk for 20-minutes in the Ekso GT SmartAssist with the swing assistance set at "neutral"

  • Ekso GT gait training with high swing resistanceOther

    Participant will walk for 20-minutes in the Ekso GT SmartAssist with the swing assistance set at "high resistance"

Study groups in NCT03367091
Study groupRoleWhat they receive
Ekso GT gait trainingExperimentalParticipants will be measured during three Ekso GT gait trainings: * 20-minute Ekso GT gait training with high swing assistance * 20-minute Ekso GT gait training with neutral swing assistance * 20-minute Ekso GT gait training with high swing resistance. Each training will be performed on a separate day in a randomized order (within one week and controlled for time of day).
Receives: Other: Ekso GT gait training with high swing assistance; Other: Ekso GT gait training with neutral swing assistance; Other: Ekso GT gait training with high swing resistance

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Net oxygen cost (OC, ml/kg/m) at minute 5 of walking

    Net oxygen consumption (oxygen consumption (ml/kg/min) during walking minus during rest) divided by the walking speed (m/min)

    Measured: Minute 5 of 20-minute walking period

  2. Net oxygen cost (OC, ml/kg/m) at minute 10 of walking

    Net oxygen consumption (oxygen consumption (ml/kg/min) during walking minus during rest) divided by the walking speed (m/min)

    Measured: Minute 10 of 20-minute walking period

  3. Net oxygen cost (OC, ml/kg/m) at minute 15 of walking

    Net oxygen consumption (oxygen consumption (ml/kg/min) during walking minus during rest) divided by the walking speed (m/min)

    Measured: Minute 15 of 20-minute walking period

  4. Net oxygen cost (OC, ml/kg/m) at minute 20 of walking

    Net oxygen consumption (oxygen consumption (ml/kg/min) during walking minus during rest) divided by the walking speed (m/min)

    Measured: Minute 20 of 20-minute walking period

  5. Net heart rate (HR, beats/min) at minute 5 of walking

    Heart rate during walking (beats/min) minus resting heart rate

    Measured: Minute 5 of 20-minute walking period

  6. Net heart rate (HR, beats/min) at minute 10 of walking

    Heart rate during walking (beats/min) minus resting heart rate

    Measured: Minute 10 of 20-minute walking period

  7. Net heart rate (HR, beats/min) at minute 15 of walking

    Heart rate during walking (beats/min) minus resting heart rate

    Measured: Minute 15 of 20-minute walking period

  8. Net heart rate (HR, beats/min) at minute 20 of walking

    Heart rate during walking (beats/min) minus resting heart rate

    Measured: Minute 20 of 20-minute walking period

  9. Net minute ventilation (VE, L/min) at minute 5 of walking

    The amount of air in- or exhaled per minute (L/min) during walking minus during rest

    Measured: Minute 5 of 20-minute walking period

  10. Net minute ventilation (VE, L/min) at minute 10 of walking

    The amount of air in- or exhaled per minute (L/min) during walking minus during rest

    Measured: Minute 10 of 20-minute walking period

  11. Net minute ventilation (VE, L/min) at minute 15 of walking

    The amount of air in- or exhaled per minute (L/min) during walking minus during rest

    Measured: Minute 15 of 20-minute walking period

  12. Net minute ventilation (VE, L/min) at minute 20 of walking

    The amount of air in- or exhaled per minute (L/min) during walking minus during rest

    Measured: Minute 20 of 20-minute walking period

Secondary outcomes (16)
  1. Net Rating of Perceived Exertion (RPE, 6-20) at minute 5 of walking

    Rating of perceived effort, strain and/or fatigue during walking, pointed on a 15-point Borg scale (6-20) during walking minus during rest

    Measured: Minute 5 of 20-minute walking period

  2. Net Rating of Perceived Exertion (RPE, 6-20) at minute 10 of walking

    Rating of perceived effort, strain and/or fatigue during walking, pointed on a 15-point Borg scale (6-20) during walking minus during rest

    Measured: Minute 10 of 20-minute walking period

  3. Net Rating of Perceived Exertion (RPE, 6-20) at minute 15 of walking

    Rating of perceived effort, strain and/or fatigue during walking, pointed on a 15-point Borg scale (6-20) during walking minus during rest

    Measured: Minute 15 of 20-minute walking period

  4. Net Rating of Perceived Exertion (RPE, 6-20) at minute 20 of walking

    Rating of perceived effort, strain and/or fatigue during walking, pointed on a 15-point Borg scale (6-20) during walking minus during rest

    Measured: Minute 20 of 20-minute walking period

  5. Percentage maximal heart rate (%HRmax) at minute 5 of walking

    Heart rate divided by predicted maximum heart rate.

    Measured: Minute 5 of 20-minute walking period

  6. Percentage maximal heart rate (%HRmax) at minute 10 of walking

    Heart rate divided by predicted maximum heart rate.

    Measured: Minute 10 of 20-minute walking period

  7. Percentage maximal heart rate (%HRmax) at minute 15 of walking

    Heart rate divided by predicted maximum heart rate.

    Measured: Minute 15 of 20-minute walking period

  8. Percentage maximal heart rate (%HRmax) at minute 20 of walking

    Heart rate divided by predicted maximum heart rate.

    Measured: Minute 20 of 20-minute walking period

  9. Percentage heart rate reserve (%HRR) at minute 5 of walking

    Heart rate during walking minus during rest divided by predicted heart rate reserve (i.e. predicted maximum heart rate minus resting heart rate)

    Measured: Minute 5 of 20-minute walking period

  10. Percentage heart rate reserve (%HRR) at minute 10 of walking

    Heart rate during walking minus during rest divided by predicted heart rate reserve (i.e. predicted maximum heart rate minus resting heart rate)

    Measured: Minute 10 of 20-minute walking period

  11. Percentage heart rate reserve (%HRR) at minute 15 of walking

    Heart rate during walking minus during rest divided by predicted heart rate reserve (i.e. predicted maximum heart rate minus resting heart rate)

    Measured: Minute 15 of 20-minute walking period

  12. Percentage heart rate reserve (%HRR) at minute 20 of walking

    Heart rate during walking minus during rest divided by predicted heart rate reserve (i.e. predicted maximum heart rate minus resting heart rate)

    Measured: Minute 20 of 20-minute walking period

  13. Metabolic Equivalent of Task (MET) at minute 5 of walking

    Expression of the intensity of walking defined as the oxygen consumption (ml/kg/min) during walking divided by the oxygen consumption (ml/kg/min) in rest

    Measured: Minute 5 of 20-minute walking period

  14. Metabolic Equivalent of Task (MET) at minute 10 of walking

    Expression of the intensity of walking defined as the oxygen consumption (ml/kg/min) during walking divided by the oxygen consumption (ml/kg/min) in rest

    Measured: Minute 10 of 20-minute walking period

  15. Metabolic Equivalent of Task (MET) at minute 15 of walking

    Expression of the intensity of walking defined as the oxygen consumption (ml/kg/min) during walking divided by the oxygen consumption (ml/kg/min) in rest

    Measured: Minute 15 of 20-minute walking period

  16. Metabolic Equivalent of Task (MET) at minute 20 of walking

    Expression of the intensity of walking defined as the oxygen consumption (ml/kg/min) during walking divided by the oxygen consumption (ml/kg/min) in rest

    Measured: Minute 20 of 20-minute walking period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Dec 2017
  2. Study start9 Jul 2018
  3. Primary completion31 Dec 2018
  4. Study completion31 Dec 2018

Why it stopped: Organisational/Recruitment Issues

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
1 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03367091
Sponsor's protocol ID
EKSO STUDY I
Status last verified
Feb 2019
First submitted
30 Nov 2017
Last updated
7 Feb 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Ekso GT gait training with high swing assistance, Ekso GT gait training with neutral swing assistance and Ekso GT gait training with high swing resistance in people with Stroke, run by Vrije Universiteit Brussel at 1 site in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 7 Feb 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Organisational/Recruitment Issues). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Net oxygen cost (OC, ml/kg/m) at minute 5 of walking (time frame: Minute 5 of 20-minute walking period). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Feb 2019.

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