AzTrials
AzTrials

Knee InstabilityBELK@CCPNCT04173975

Validation of the Efficacy and Usability of the BELK Orthosis Knee Module in a Neurological Setting (BELK@CCP)

A study testing With knee exoskeleton in people with Knee Instability and Neuromuscular Diseases, run by Casa di Cura Privata del Policlinico SpA.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
Search all trials

Trial summary

This present study will be devoted to the first clinical study on the efficacy of the BELK system in enhancing mobility and improve the knee rehabilitation process in people with NeuroMuscular Diseases (NMD) and Central Nervous System (CNS) disorders with knee instability that implies deficit in gait and in locomotion… Read more about this study

Who is it for?
Ages 30 to 85 years
What is being tested?
With knee exoskeleton
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
1 Jan 2021to 31 Aug 2021
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 30 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age: 30 - 85
  • Sex: males and females
  • Diagnosis of Neuromuscular diseases (NMD) or central nervous system (CNS) disorder with knee instability conditioning gait
  • Functional Ambulation Categories (FAC) > 3
  • Mini Mental State Examination (MMSE) > 24
  • Ability to walk at least 10 meters alone or with maximum 1 person assistance

Who cannot join

  • Bilateral impairment of the knees
  • Knee implant
  • Lower extremity amputation
  • Severe sensorial impairment of the lower limbs
  • Legal blindness or severe visual impairment
  • Pacemakers or metal implants
  • Refusal to give informed consent

About this study

Official title: Validation of the Efficacy and Usability of the BELK Orthosis Knee Module in a Neurological Setting

This present study will be devoted to the first clinical study on the efficacy of the BELK system in enhancing mobility and improve the knee rehabilitation process in people with NeuroMuscular Diseases (NMD) and Central Nervous System (CNS) disorders with knee instability that implies deficit in gait and in locomotion during ADL.

Participants will receive a 6-week training program (3 weeks with the BELK orthosis knee module) in a clinical setting in add-on to the standard neuro-rehabilitation treatment. Gait analysis and Instrumental Test will be performed every week till the end of the six-week training period while the Clinical Scales and Questionnaires will be performed after three weeks and at the end of the training period. Finally, additional outcome measures comprise the scores on the System Usability Scale (SUS) to evaluate the hardware and the Software Usability Measurement Inventory (SUMI) to evaluate the software of the BELK orthosis. These two measures will be administrated at the end of training with Belk orthosis, to rate patients' and operators' (e.g., physical therapist, medical doctors) satisfaction.

Read more

During 2018, the company GOGOA (www.gogoa.eu), specialized in design, manufacturing and commercialization of Robotic Assisted Rehabilitation (RAR) systems, has developed a first prototype of the BELK system, a powered wearable robotic device that can be used for knee rehabilitation, in the sub-acute phase of knee injuries. As BELK is a wearable device, it can be used both, by the physiotherapist in the rehabilitation centers, improving the knee rehabilitation process and increasing patients' comfort, and accelerating their rehabilitation process.

Casa di Cura del Policlinico (CCP https://www.ccppdezza.it/en/) is a fully integrated multi-specialty clinical center aiming at providing both inpatient and outpatient services mainly directed to neurological patients. The Center is constituted as a Department of Neuro-rehabilitation Sciences, accredited by the Italian National Health System, and economically supported by Regione Lombardia. CCP offers to chronic neurological patients the highest comprehensive standards of care in a comfortable environment, through a multidisciplinary patient management approach organized around a core rehabilitation program.

Read the detailed description

The study design comprises a clinical study aimed at assessing efficacy of the BELK orthosis knee module on management of instability of the knee in 15 adults who have NMD or a CNS disorder. Participants will receive a 6-week training program (3 weeks with the BELK orthosis knee module) in a clinical setting in add-on at the standard neurorehabilitation treatment.

The add-on rehabilitation training will be focused on lower limb with specific activities for knee instability, and will comprise 3 weeks using the BELK orthosis knee module and 3 weeks without any orthosis. The activities will concern both physical training (e.g., locomotion task, balance exercise, muscle reinforcement, proprioceptive task) and occupational treatment tasks (e.g., transferring/mobility, meal preparation, house-working).

This clinical study will be a Randomized Control Trial (RCT) crossover longitudinal.

The clinical trial will be split in the following phases :

  • Recruitment. Subjects admitted to CCP Neurorehabilitation unit will be recruited after considering inclusion and exclusion criteria through clinical history and medical visit.
  • Randomization. Enrolled participants will be randomly allocated (per 2 blocked randomization lists, generated electronically by www.random.org) into the BELK assisted group (Group A) or the control group (Group B).
  • Clinical, instrumental and questionnaires assessment at T0 (baseline)
  • Rehabilitation Treatment (first block) three weeks period, all the patients will perform rehabilitation training. The patients allocated in Group A will perform the training wearing the BELK device while patients allocated in Group B will perform the same exercise without any exoskeleton.
  • Clinical, instrumental and questionnaires assessment at T1 (crossover)
  • Rehabilitation Treatment (second block) three weeks period, all the patients will perform rehabilitation training. The patients allocated in Group B will perform the training wearing the BELK device while patients allocated in Group A will perform the same exercise without any exoskeleton.
  • Clinical, instrumental, questionnaires and usability assessment at T2 (final)
  • Additional Instrumental Test will be performed after the first and the second week of each rehabilitation treatment block (i.e., T01, T02, T11, T12).

Instrumental Test consist of:

  • Bio-mechanical performance (gait kinematics/kinetics analysis),
  • Surface electromyography for knee functional evaluation (EMG),
  • 6-minute walking test (6mWT),
  • Baseline assessments uptake (VO2),
  • Hearth rate (HR),
  • Breathing frequency (BF),
  • Timed Up and Go Test (TUG),
  • Stair Climb Test (SCT).

Clinical scales consist of:

  • Functional Independence Measure scale (FIM),
  • Functional Ambulation category scale (FAC),
  • lower-leg Ashworth scale (sum of score for hip, knee and ankle) (AS),
  • Mini Balance Evaluation Systems Test (Mini-Best),
  • Motricity Index (MI),
  • Self-reported perceived effort (CR-10 Borg).

Questionnaires consist of:

  • International Knee Documentation Committee subjective knee evaluation form (IKDC),
  • Knee Outcome Survey Activity of Daily Living (KOS ADL) and health-related quality of life (SF-36).
Being tested
With knee exoskeleton
Medical subject headings
Neuromuscular Diseases, Central Nervous System Diseases, Stroke

What participants receive

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

  • With knee exoskeletonDevice

    BELK is a wearable system that assists when and where the patient needs it intelligently through proper control of the system and optimized gait assistance techniques. Assisted-as-needed control allows to create a force field along a desired trajectory, proportionally applying torque only when patient deviates from the pre-programmed correct pattern. This force field control, by assisting only the segments that the patient need, produces a natural gait pattern, improving the rehabilitation process.

Study groups in NCT04173975
Study groupRoleWhat they receive
With knee exoskeletonExperimentalThe rehabilitation training will be focused on lower limb with specific activities for knee instability, and will concern both physical training (e.g., locomotion task, balance exercise, muscle reinforcement, proprioceptive task) and occupational treatment tasks (e.g., transferring/mobility, meal preparation, house-working). Each session will be 45 minutes long. Three time per week, for three weeks. The patients allocated in this arm will perform the training wearing the BELK device.
Receives: Device: With knee exoskeleton
Without exoskeletonNo interventionThe rehabilitation training will be focused on lower limb with specific activities for knee instability, and will concern both physical training (e.g., locomotion task, balance exercise, muscle reinforcement, proprioceptive task) and occupational treatment tasks (e.g., transferring/mobility, meal preparation, house-working). Each session will be 45 minutes long. Three time per week, for three weeks. The patients allocated in this arm will perform the training without any exoskeleton.

What is being measured

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

  1. Change in walking velocity

    Walking velocity [m/s] will be calculated during walk test (10MWT). Markers positioned on the body will be tracked through a motion capture software and analyzed.

    Measured: Before and Immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  2. Change in Gait Profile Score

    Gait Profile Score (GPS) is a useful index to analyze the gait performances. It is calculated starting from fifteen Gait Variable Score (GVS) which give a deeper view on the variables related to the locomotion trials.

    Measured: Before and Immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

Secondary outcomes (10)
  1. Change in 6-minute walking test (6MWT)

    The six-minute walk test (6MWT) measures the distance, in meters, that an individual is able to walk over a total of six minutes on a hard, flat surface.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  2. Change in joint force

    Joint forces will be calculated as the amount of pressure recorded in newtons on the force plates during walking tests.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  3. Change in Surface electromyography (sEMG)

    Surface electromyography (sEMG) is a non-invasive procedure involving the detection, recording and interpretation of the electric activity of groups of muscles at rest (i.e., static) and during activity (i.e., dynamic). The procedure is performed using a single or an array of electrodes placed on the skin surface over the muscles to be tested. Recording can also be made using a hand-held device, which is applied to the skin surface at different sites. Electrical activity is assessed by computer analysis of the frequency spectrum, amplitude, or root-mean-square of the electrical action potential.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  4. Change in energy cost of walking

    Energy cost of walking, expressed in ml O2/kg/m will be measured using indirect calorimetry device

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  5. Change in Stair Climb Test (SCT)

    The Stair Climb Test (SCT) measures, in seconds, the time taken by an individual to ascend and descend 10 steps (each step is 0.18 m in height).

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  6. Change in Timed Up and Go test (TUG)

    The Timed "Up and Go" Test measures, in seconds, the time taken by an individual to stand up from a standard arm chair (approximate seat height of 46 cm, arm height 65 cm), walk a distance of 3 meters (approximately 10 feet), turn, walk back to the chair, and sit down.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  7. Change in Short Form Survey Instrument (SF36)

    Confidence levels will be calculated using the Short Form Survey Instrument (SF36). Items are scored using Likert scale and yes/no options. Scales are standardized with a scoring algorithm to obtain a score ranging from 0-100. High scores indicate better health status.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  8. Change in International Knee Documentation Committee (IKDC) Questionnaire

    The IKDC Questionnaire is a subjective scale that provides patients with an overall function score. The questionnaire looks at 3 categories: symptoms, sports activity, and knee function. Symptoms sub scale helps to evaluate things such as pain, stiffness, swelling and giving-way of the knee. Meanwhile, the sports activity sub scale focuses on functions like going up and down the stairs, rising from a chair, squatting and jumping. The knee function sub scale asks patients one simple question: how is their knee at present versus how was their knee prior to injury?

    Scores are obtained by summing the individual items, then transforming the crude total to a scaled number that ranges from 0 to 100. This final number is interpreted as a measure of function with higher scores representing higher levels of function.

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  9. Change in Knee Outcome Survey (KOS)

    The Knee Outcome Survey (KOS) is a patient-completed questionnaire that provides a percentage of disability during every day activities (activities of daily living sub scale) or sports (sports activity sub scale). The lower the percentage, the higher the disability.

    This is a self-report measure that is broken down into two categories (ADLs and sport activities) that rates perceived disability with 5 being "no difficulty" and 0 being "unable to perform".[1]

    Measured: Before and immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)

  10. System Usability Scale (SUS)

    The scores on the System Usability Scale (SUS) was measured in order to assess the usability of BELK during rehabilitation training

    Measured: Immediately after the rehabilitation training of experimental arm.

Timeline

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

  1. First posted22 Nov 2019
  2. Study start1 Jan 2021 (estimated)
  3. Primary completion31 Mar 2021 (estimated)
  4. Study completion31 Aug 2021 (estimated)

Why it stopped: pandemic of coronavirus disease

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
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Participants will receive a 6-week training program in a clinical setting in add-on to the standard neuro-rehabilitation treatment. The add-on rehabilitation training will be focused on lower limb with specific activities for knee instability, and will comprise 3 weeks using the BELK orthosis knee module and 3 weeks without any orthosis.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04173975
Sponsor's protocol ID
BELK@CCP
Acronym
BELK@CCP
Status last verified
Feb 2022
First submitted
18 Nov 2019
Last updated
22 Feb 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing With knee exoskeleton in people with Knee Instability and Neuromuscular Diseases, run by Casa di Cura Privata del Policlinico SpA.

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

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. 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: withdrawn, as of the sponsor's last update on 22 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

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 withdrawn before enrolling participants, so there are no results.

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?

Change in walking velocity (time frame: Before and Immediately after the rehabilitation training of each arm (Initial, after 3 weeks and final)). The study lists 2 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 22 Feb 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in