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Spinal Cord InjuriesNCT04412447

Training for Persons With Complete SCI for FES Cycling: a Case Series

A study testing Functional Electrical Stimulation in people with Spinal Cord Injuries, run by Centre de Rééducation et Réadaptation Fonctionnelle La Châtaigneraie at 1 site in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The main objective of this study is to validate the effectivity of a simple home-based training for cycling with functional electrical stimulation (FES). The training is designed to progressively increase strength and endurance of the paralysed muscles of a person with complete spinal cord injury. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Spinal Cord Injuries
What is being tested?
Functional Electrical Stimulation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
1 siteFrance
Study dates
1 Oct 2019to Sep 2020
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 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • informed written consent
  • complete spinal cord injury AIS A or B
  • neurological level of lesion C6 - T12
  • post-lesion duration > 12 moths
  • paralysed muscles stimulable
  • joints of lower limb freely moveable
  • stable medical condition (absence of infectious respiratory or urinary event of cutaneous pathology confining the patient to bed and warranting treatment).

Who cannot join

  • Not affiliated to a social security scheme, beneficiary or not such a plan
  • Refusal to participate in the study (withdraw from study possible at any time)
  • Inability to give consent
  • body mass index higher or equal to 30
  • flaccid paralysis (denervation)
  • Inability to give consent
Show all 18Show fewer
  • neurogenic para-osteoarthropathy
  • active thrombophlebitis
  • muscular disease
  • cardiovascular disease including coronary antecedent
  • bone mineral density T-score below -2.5
  • treatment with a drug known to have an effect on bone (< 3 months)
  • Aids in the lower limbs
  • Epilepsy
  • Orthostatic hypotension
  • Fractures of the lower limbs older (< 12 months)
  • Pacemakers or other implants contraindicating the use of FES
  • Pregnancy (women)

Trial locations and contacts

1 site in 1 country.

France1 site
  • Centre de Rééducation et de Réadaptation Fonctionnelle La Châtaigneraie

    Menucourt, 95180

Other trials in France

About this study

Official title: Training of Persons With Complete Spinal Cord Injury for Pedaling on a Tricycle, Induced by Electrical Stimulation of the Paralysed Muscles: a Case Series

The main objective of this study is to validate the effectivity of a simple home-based training for cycling with functional electrical stimulation (FES). The training is designed to progressively increase strength and endurance of the paralysed muscles of a person with complete spinal cord injury. After a limited period of only several months, performance will be assessed during FES-assisted cycling on a recumbent tricycle over flat ground. The outcomes of this study should provide evidence for the effectivity of FES-cycling as potential rehabilitation method.

Read the detailed description

People with spinal cord injuries suffer from numerous comorbidities, linked in particular to immobility and sedentariness. Studies have shown the benefits of training and reconditioning to adapted effort in spinal cord injured people. Among other innovative techniques, functional electrical stimulation (FES) is aimed primarily at mobilizing as many muscles as possible. Concerning electro-stimulated pedaling on a tricycle, it would allow individuals with paraplegia or tetraplegia to practise physical activity in perspective of experiencing pleasure during training.

In 2016, our team carried out a pilot study aiming at using a recumbent tricylce powered by the lower limbs of a person with complete paraplegia under electrostimulation. The participant was trained for 12 months, whit the objective to participate at an international competition (Cybathlon 2016). This first study has opened up prospects and identified avenues for improvement.

The main objective of this study is to significantly improve, over a limited period of time, the pedalling performance on a tricycle by using electrical stimulation of the sub-lesional muscles of people with spinal cord injuries. Secondary focusses will be: physical and psychological tolerance to training; influence on pain, cardio-respiratory functions, body composition regarding muscle trophicity and bone metabolism; psycho-social impact; impact of modification of stimulation parameters (frequency, phase width, intensity, waveform, contact location) in performance optimization and delay of muscle fatigue; performance impact of mechanical modifications performed on the tricycle.

This is a prospective case study: patients suffering from a complete traumatic injury and followed at the Centre de Rééducation et de Réadaptation Fonctionnelle (CRRF) La Châtaigneraie (Menucourt) will be recruited by the investigating physician during a consultation for a period of approximately 6 months. The centre specialised in the management of acute and chronic neurological lesions. The eligibility criteria are predefined to ensure the participants safety. After verification of the criteria and before the start of the programme, an exercise test (monitoring of the evolution of VO2max) will be carried out in the Sports Medicine department of the CHI of Saint-Germain-en-Laye. The first phase (V1) consists of a one-month home-based isometric muscle training programme by electrostimulation followed by a two-month programme (phase V2) of home-based muscle training by electrostimulation on an ergocycle including one training per week at the CRRF. The home ergocycle electro-stimulation muscle training, will be continued once or twice a week and complemented in the third phase (V3) by training at the CRRF on a tricycle for one month. Only the patient selected to participate in the Cybathlon 2020 will continue with the final phase (V4), which includes, over a period of 2 to 4 months, muscle training by electrostimulation on an ergocycle at home, electrostimulation sessions on a tricycle up to 3 times a week at the CRRF. In this phase, the optimization of the stimulation and electrical patterns and the mechanics of the tricycle will take place in order to maximize the pilots overall performance. Finally, the pilot will take part in the tricycle FES-Cycling race at the Cybathlon 2020 in Zurich, i.e. an international competition and technological challenge, requiring to master 1200 metres in a maximum time of 8 minutes. The different training programs are based on sport-scientific principles and a physiotherapist will follow up on the home sessions. The collaborating teams (engineers and researchers from INRIA, the French National Institute for Research in Computer Science and Control) will measure performance in a bimonthly frequency.

This research should demonstrate that the safety, acceptability, satisfaction, self-esteem and quality of life induced by the practice of FES-assisted pedalling, opens a new way of training in rehabilitation centres and at home with the perspective of improving certain physiological functions in the long-term.

Being tested
Functional Electrical Stimulation
Medical subject headings
Spinal Cord Injuries

What participants receive

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

  • Functional Electrical StimulationDevice

    Electrical stimulation of motor-nerves innervating the musculature of the lower limb.

Study groups in NCT04412447
Study groupRoleWhat they receive
SubjectsExperimentalPhase V1: 1 month of home-based FES-training using isometric contractions of quadriceps and hamstring muscles (3 times a week). Phase V2: 2 months of home-based FES-training on an ergo-cycle with arm support (3 times a week) Phase V3: 1 month of home-based FES-training on an ergo-cycle with arm support (1-2 times a week) and FES-cycling training overground on a tricycle (1-2 times a week) in the clinical setting. Optional (only for selected pilot): Phase V4: 2-4 months of home-based FES-training on an ergo-cycle with arm support (1-2 times a week) and FES-cycling training overground on a tricycle (1-2 times a week) in the clinical setting. This phase is focussing on optimizing the performance of the pilot and improving the mechanical efficiency of the tricycle. Phase V5: Participation on Cybathlon 2020
Receives: Device: Functional Electrical Stimulation

What is being measured

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

  1. Change in Maximum Cycling-Distance in [m]

    Change in maximum distance cycled on flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  2. Change in Maximum Cycling-Speed in [km/h]

    Change in maximum speed during cycling over flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  3. Change in Average Cycling-Speed in [km/h]

    Change in average speed during cycling over flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  4. Change in Maximum Cycling-duration in [hh:mm:ss]

    Change in maximum duration during cycling over flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  5. Change in Maximum Pedaling-Cadence in [RPM]

    Change in maximum pedaling-cadence during cycling over flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  6. Change in Average Pedaling-Cadence in [RPM]

    Change in average pedaling-cadence during cycling over flat ground on a tricycle

    Measured: Change between 4 months of training (end of V3) and 6 months of training (end of V4)

  7. Ability to cycle 1200m in less than 8min

    Qualification criterion Cybathlon 2020. It will be assessed it the pilot is able to cycle 1200m in less than 8min over flat ground on a tricycle.

    Measured: After 6 months of training (end of V4)

Secondary outcomes (18)
  1. Change of blood pressure during training

    Blood pressure will be assessed before and after every training session. Mean change in blood pressure will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  2. Change of heart rate during training

    Heart rate will be assessed before and after every training session. Mean change in heart-rate will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  3. Maximum heart rate during training

    Maximum heart rate will be assessed during every training session. Mean and SD of the maximum heart-rate will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  4. Average heart rate during training

    Average heart rate will be assessed during every training session. Mean and SD of the average heart-rate will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  5. Cutaneous status

    Evaluation for absence of: skin lesions, pressure points, pressure ulcers, phlebitis, edema

    Measured: through study completion (up to one year)

  6. Musculo-skeletal pain or inflammation

    Evaluation for absence of: muscular pain, osteo-articular pain or inflammation

    Measured: through study completion (up to one year)

  7. Psychological: Satisfaction

    Evaluation of satisfaction [linear scale: 1 - 10; 1 = lowest satisfaction; 10 = highest satisfaction] will be assessed after every training session. Mean and SD of the satisfaction will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  8. Psychological: Acceptability

    Change in acceptability [questionnaire].

    Measured: through study completion (up to one year), every 30 days

  9. General Fatigue

    Assessment of change in general fatigue via [Borg scale; Range: 6-20; 6 = No exertion, sitting and resting; 20 = Maximal exertion] will be assessed before and after every training session. Mean and SD of the change in fatigue will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  10. Psycho-Social: Self-Esteem

    Change in self-esteem via [Rosenberg Scale; Range: 10 - 40; 10 = lowest Self-Esteem; 40= Highest Self-Esteem].

    Measured: through study completion (up to one year), every 15 days

  11. Psycho-Social: Quality of Life

    Change in quality-of-life via [questionnaire SF-36].

    Measured: through study completion (up to one year), every 30 days

  12. Cardio-Respiratory Fitness: Maximal Heartrate

    Change of maximal heartrate via electrocardiogram

    Measured: Change between timepoint before first training, after 4 months of training (end of V3) and after 6 months of training (end of V4)

  13. Cardio-Respiratory Fitness: VO2max

    Change of VO2max

    Measured: Change between timepoint before first training, after 4 months of training (end of V3) and after 6 months of training (end of V4)

  14. Musculo-skeletal changes: Thigh perimeter

    Assessment of thigh perimeter [cm]. Measurement is taken 10cm and 20cm proximal to the proximal edge of the patella.

    Measured: Change between timepoint before first training and after end of study (end of V5, ~ 7 months)

  15. Musculo-skeletal changes: Bone mineral density

    Bone mineral density via [DEXA]

    Measured: Change between timepoint before first training and after end of study (end of V5, ~ 7 months)

  16. Musculo-skeletal changes: Body composition

    Body composition via [DEXA].

    Measured: Change between timepoint before first training and after end of study (end of V5, ~ 7 months)

  17. Occurrence of spasms: before training

    Spasmic occurance will be assessed via [PENN Scale; Range: 0-4; 0 = No spasm; 4 = Spasms occuring more than 10 times per hour] before every training session. Mean and SD of the spasmic occurence will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

  18. Occurrence of spasms : after training

    Spasmic occurance will be assessed via [PENN Scale; Range: 0-4; 0 = No spasm; 4 = Spasms occuring more than 10 times per hour] after every training session. Mean and SD of the spasmic occurence will be calculated along all training-sessions.

    Measured: through study completion (up to one year), an average throughout the study-duration

Timeline

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

  1. First posted2 Jun 2020
  2. Study start1 Oct 2019
  3. Primary completionJun 2020 (estimated)
  4. Study completionSep 2020 (estimated)

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
Model description
Training of paralysed musculature of the lower limb by using electrical stimulation.
Masking
None (open label)
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04412447
Sponsor's protocol ID
2019-A00808-49
Status last verified
Jun 2020
First submitted
11 May 2020
Last updated
2 Jun 2020
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Fattal C, Schmoll M, Le Guillou R, Raoult B, Frey A, Carlier R, Azevedo-Coste C. Benefits of 1-Yr Home Training With Functional Electrical Stimulation Cycling in Paraplegia During COVID-19 Crisis. Am J Phys Med Rehabil. 2021 Dec 1;100(12):1148-1151. doi: 10.1097/PHM.0000000000001898.

    PubMed 34596097

Questions about this trial

What is this clinical trial studying?

A study testing Functional Electrical Stimulation in people with Spinal Cord Injuries, run by Centre de Rééducation et Réadaptation Fonctionnelle La Châtaigneraie at 1 site in France.

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 7 inclusion and 18 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: status not confirmed, as of the sponsor's last update on 2 Jun 2020. 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 France. 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?

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?

Change in Maximum Cycling-Distance in [m] (time frame: Change between 4 months of training (end of V3) and 6 months of training (end of V4)). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04412447, which also lists 1 linked publication.

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 2 Jun 2020.

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Clinical Trial NCT04412447 | AzTrials