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StrokeNCT06169657

Comparison of Gait Training Methods in Sub-acute Stroke and Spinal Cord Injury

An observational study of Stroke and Incomplete Spinal Cord Injury, run by Shirley Ryan AbilityLab at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of the project is to compare intensity (minutes in target heart rate zone) and steps per session across three gait training modalities, including body-weight supported treadmill training (BWSTT), overground gait training with body weight-support (BWS), and overground gait training utilizing a lower… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Stroke, Incomplete Spinal Cord Injury
What is being tested?
Body-weight-supported treadmill training (BWSTT), EksoNR exoskeleton gait training and Overground gait training
Type of treatment
Medical device
How many people
0 participants
Where
1 siteUnited States
Study dates
1 Sep 2024to 31 Dec 2025
Phase
Observational
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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Individuals poststroke or post-iSCI that are inpatients at Shirley Ryan AbilityLab

Who may be able to join

  • Age 18-75 years old, inclusive
  • Medical clearance from primary medical team (signed Medical Clearance form)
  • Adequate cognitive function as determined by the NIH scale: score ≤1 on question 1b and score =0 on question 1c
  • Gait speed between 0-0.79 m/s
  • Informed consent provided by participant or POA
  • English speaking
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  • Additional Inclusion Criteria for patients post-stroke:
  • First stroke, ischemic or hemorrhagic, within the past six months
  • Unilateral, supratentorial stroke
  • Additional Inclusion Criteria for patients iSCI:
  • ASIA C or D
  • Traumatic iSCI, within past six months

Who cannot join

  • Severe aphasia limiting ability to express needs or discomfort verbally or nonverbally
  • History of or concurrent neurologic condition (i.e., stroke, SCI, PD, TBI, MS, etc.)
  • History of peripheral nerve injury
  • Severe knee, hip, or ankle osteoarthritis
  • Severe osteoporosis as indicated by physician medical clearance
  • Open wounds on skin surfaces in contact with exoskeleton or harness
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  • Unstable spine or unhealed fractures
  • Weight bearing precautions
  • Unresolved deep vein thrombosis (DVT)
  • Pregnancy
  • Prisoners
  • Additional Exclusion criteria for EksoNR13:
  • Weight >220 lbs (100 kg)
  • Height below 60 inches or above 76 inches
  • Standing hip width of approximately 18 inches or more
  • Joint contractures or range of motion deficits that limit normal range of motion during ambulation:
  • Knee flexion contracture greater than 12°
  • Hip flexion contracture greater than 17°
  • Inability to achieve 0° neutral ankle dorsiflexion with knee flexion up to 12°
  • Bilateral hip flexion less than 110°
  • Significant spasticity in the lower limbs (Modified Ashworth Scale ≥3)
  • Leg length discrepancy:
  • Greater than 0.5 in. (1.27 cm) for upper legs
  • Greater than 0.75 in. (1.91 cm) for lower legs
  • Active heterotopic ossification
  • Significant spasticity in the lower limbs (Modified Ashworth Scale ≥3)
  • High anxiety or claustrophobia
  • Clostridium difficile or other gastrointestinal isolation precautions
  • Colostomy
  • Uncontrolled autonomic dysreflexia
  • Lower limb prosthesis

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Shirley Ryan AbilityLab

    Chicago, Illinois, 60611

Other trials in United States

About this study

Official title: Comparison of Intensity and Step Count of Gait Training Modalities in the Inpatient Rehabilitation Setting in Sub-acute Central Nervous System Injury

The purpose of the project is to compare intensity (minutes in target heart rate zone) and steps per session across three gait training modalities, including body-weight supported treadmill training (BWSTT), overground gait training with body weight-support (BWS), and overground gait training utilizing a lower extremity exoskeleton, between patients presenting with varying functional ambulation capacities in the inpatient setting. Additionally, the researchers will compare physical therapist (PT) burden across these modalities and patient functional presentation levels.

Read the detailed description

Aim 1 of this study is to measure stepping repetition and intensity via heart rate of three gait-training modalities utilized with patients in the subacute phase of stroke and iSCI during inpatient rehabilitation in order to guide therapists through clinical decision-making of selecting the optimal intervention for patients based on functional presentation. Aim 2 of this study is to measure therapist burden across each gait training modalities, as this is an additional factor that contributes to the number of steps taken and intensity experienced by the patient.

The gait training modalities assessed will include BWSTT, overground gait training with a lower extremity exoskeleton, and overground gait training with BWS. The participants' functional level will be classified by gait speed obtained via the 10 meter walk test (10MWT), a standardized assessment commonly used in rehabilitation. These functional classification categories include household ambulator (low level) and limited community ambulator (high level), determined by Fritz et al. 2009.

The researchers hypothesize that low functioning/household ambulators will achieve more minutes in high-intensity training zones utilizing the exoskeleton due to the enhanced participation and increased weight-bearing the device supports compared to the other modalities. In addition, a greater number steps will be achieved in this mode due to the exoskeleton's ability to decrease overall therapist burden compared to BWSTT and overground with BWS. In contrast, the researchers anticipate that steps per session and overall intensity will be decreased in high functioning/limited community ambulators due the unnecessary support the exoskeleton provides at this functional level. The researchers believe that high functioning/ limited community ambulators will achieve the highest number of steps and intensity during BWSTT due to the ability to increase challenges via treadmill parameters such as speed and incline while utilizing a harness for safety and bodyweight support only as necessary. In contrast, the researchers believe the amount of BWS and assistance a PT must provide relative to the patient's contribution to practice successful stepping during BWSTT will result in a lower intensity and number of steps achieved in low functioning/household ambulators.

Being tested
Body-weight-supported treadmill training (BWSTT), EksoNR exoskeleton gait training, Overground gait training
Keywords
Stroke, Incomplete Spinal Cord Injury, Gait Rehabilitation, Exoskeleton, Balance
Medical subject headings
Stroke

What participants receive

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

  • Body-weight-supported treadmill training (BWSTT)Device

    Walking on a treadmill in a harness with body weight support as needed

  • EksoNR exoskeleton gait trainingDevice

    Walking in the EksoNR exoskeleton

  • Overground gait trainingDevice

    Walking overground in a harness with body weight support as needed

Study groups in NCT06169657
Study groupRoleWhat they receive
Inpatients Post-stroke, low level ambulatorsIndividuals post acute or subacute stroke that that are inpatients at the Shirley Ryan AbilityLab ages 18-75 with initial gait speed 0.0-0.39 m/s
Receives: Device: Body-weight-supported treadmill training (BWSTT); Device: EksoNR exoskeleton gait training; Device: Overground gait training
Inpatients Post-stroke, high level ambulatorsIndividuals post acute or subacute stroke that that are inpatients at the Shirley Ryan AbilityLab ages 18-75 with initial gait speed 0.4-0.79 m/s
Receives: Device: Body-weight-supported treadmill training (BWSTT); Device: EksoNR exoskeleton gait training; Device: Overground gait training
Inpatients with iSCI, low level ambulatorsIndividuals post-SCI or subacute that that are inpatients at the Shirley Ryan AbilityLab ages 18-75 with initial gait speed 0.0-0.39 m/s
Receives: Device: Body-weight-supported treadmill training (BWSTT); Device: EksoNR exoskeleton gait training; Device: Overground gait training
Inpatients with iSCI, high level ambulatorsIndividuals post-SCI or subacute that that are inpatients at the Shirley Ryan AbilityLab ages 18-75 with initial gait speed 0.4-0.79 m/s
Receives: Device: Body-weight-supported treadmill training (BWSTT); Device: EksoNR exoskeleton gait training; Device: Overground gait training

What is being measured

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

  1. Observation of Step count

    The number of steps taken during each session will be measured using activity monitors/pedometers. These devices are small accelerometers that can be worn on a belt and/or on the ankle to record steps and Kcals during an activity. The therapist leading the intervention session will apply the ActiGraph at the beginning of each intervention session and remove it upon completion. A higher step count is a better outcome.

    Measured: Each session through completion of study, up to 10 days

  2. Observation of Time spent in age-predicted maximum high-intensity target heart rate zone

    The target range of 70-85% of age-predicted maximum heart rate will be calculated for each participant utilizing HR max = 208 - [0.7 × age] as developed by Tanka et al in 2001. The target range of 70-85% of age-predicted maximum heart rate will be calculated for each participant. The researchers will record the amount of time participants spend in their pre-calculated target zone during each gait training. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. More time spent in the maximum intensity zone target zone is a better outcome.

    Measured: Each session through completion of study, up to 10 days

  3. Observation of Time spent in age-predicted moderate-intensity target heart rate zone

    The target range of 50-70% of age-predicted maximum heart rate will be calculated for each participant utilizing HR max = 208 - [0.7 × age] as developed by Tanka et al in 2001. The target range of 50-70% of age-predicted maximum heart rate will be calculated for each participant. The researchers will record the amount of time participants spend in their pre-calculated target zone during each gait training. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. Less time spent in the moderate intensity pre-calculated target zone is a better outcome as the more minutes in the high intensity zone is the best outcome.

    Measured: Each session through completion of study, up to 10 days

  4. Observation of Time spent in age-predicted low-intensity target heart rate zone

    The target range of 50% of age-predicted maximum heart rate will be calculated for each participant utilizing HR max = 208 - [0.7 × age] as developed by Tanka et al in 2001. Low intensity equals 50% or less of age-predicted maximum heart rate and will be calculated for each participant. The researchers will record the amount of time participants spend in their pre-calculated target zone during each gait training. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. Less time spent in the low intensity zone is better as the goal is to achieve more minutes in high-intensity zone.

    Measured: Each session through completion of study, up to 10 days

Secondary outcomes (8)
  1. Observation of Minutes spent in equipment setup per session

    Total time in minutes spent applying and removing equipment. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. Less time would be considered better as that indicates more time spent walking.

    Measured: Each session through completion of study, up to 10 days

  2. Observation of Minutes spent in rest breaks per session

    Total time in minutes the participant spends resting (not walking or applying/ removing equipment) between walking bouts. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. Less time would be considered better as that indicates more time spent walking.

    Measured: Each session through completion of study, up to 10 days

  3. Observation of Minutes spent stepping

    Total time in minutes the participant spends walking (not including rest breaks or applying/ removing equipment) during a session. The minimum amount of time would be 0 minutes and the maximum amount of time would be 60 minutes as this would be the total time of the session. Less time would be considered better as that indicates more time spent walking.

    Measured: Each session through completion of study, up to 10 days

  4. Observation of Patient Borg Rating of perceived exertion (RPE)

    The Borg Rating of Perceived Exertion is a tool to measure the subjective report of effort, exertion, and fatigue during physical work. It consists of a 15-point scale from 6-20, in which 6=no exertion and 20=absolute maximum exertion. It is presented to the participant in written format with descriptors to standardize the report of perceived exertion across tasks. An optimal score is between 14-20 as this indicates higher perceived walking intensity for the participant.

    Measured: Each session through completion of study, up to 10 days

  5. Observation of Patient Intrinsic Motivation Inventory (IMI)

    The Intrinsic Motivation Inventory (IMI) is a multidimensional measurement that measures participants' subjective experience related to a target activity in laboratory experiments. The instrument consists of seven subscale scores related to interest/enjoyment, perceived competence, effort/importance, felt pressure/tension, perceived choice, value/usefulness and relatedness while performing a given activity. 29 items, adapted from the standardized instrument, are addressed on a 7 point scale, 1-7, in which one indicates not at all and seven indicates very true. A higher score is better.

    Measured: Each session through completion of study, up to 10 days

  6. Observation of therapist maximum heart rate

    Therapist heart rate will be measured throughout each session as an indicator of burden. There is no standard minimum or maximum value, however a higher heart rate indicates increased therapist burden.

    Measured: Each session through completion of study, up to 10 days

  7. Observation of therapist maximum Borg Rating of perceived exertion (RPE)

    The Borg Rating of Perceived Exertion is a tool to measure the subjective report of effort, exertion, and fatigue during physical work. It consists of a 15-point scale from 6-20, in which 6=no exertion and 20=absolute maximum exertion. It is presented to the participant in written format with descriptors to standardize the report of perceived exertion across tasks. A lower score is better, indicating less burden on the therapist.

    Measured: Each session through completion of study, up to 10 days

  8. Observation of therapist Numerical Pain Rating Scale (NPRS)

    The NPRS is used to measure the subjective report of pain intensity. It consists of an 11-point scale, 0-10, in which zero indicates no pain and ten indicates the most intense pain imaginable. A lower score is better, indicating less pain.

    Measured: Each session through completion of study, up to 10 days

Timeline

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

  1. First posted13 Dec 2023
  2. Study start1 Sep 2024 (estimated)
  3. Primary completion25 Nov 2024
  4. Study completion31 Dec 2025 (estimated)

Why it stopped: The study team had been practicing running the study interventions, but the core study team members left the organization before any subjects could be enrolled. There is now insufficient personnel time dedication to this study, so it is being closed.

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06169657
Sponsor's protocol ID
STU00219486
Status last verified
May 2025
First submitted
5 Dec 2023
Last updated
25 May 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Stroke and Incomplete Spinal Cord Injury, run by Shirley Ryan AbilityLab at 1 site in United States.

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 12 inclusion and 31 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 25 May 2025. 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 United States. 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 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?

Observation of Step count (time frame: Each session through completion of study, up to 10 days). The study lists 4 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 25 May 2025.

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