Hereditary Spastic ParaplegiaFRAMENCT06742697
Flexibility, Resistance, Aerobic, Movement Execution Training in Adults With Hereditary Spastic Paraplegia
A study testing Flexibility, Resistance, Aerobic, Movement Execution training in people with Hereditary Spastic Paraplegia, run by IRCCS Eugenio Medea at 2 sites in Italy.
Trial summary
Hereditary Spastic Paraplegia (HSP) is a group of inherited neurological disorders that cause progressive weakness and stiffness (spasticity) in the legs, reducing balance and walking ability. At present, there are no structured rehabilitation programs specifically designed to improve walking in people with HSP. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hereditary Spastic Paraplegia
- What is being tested?
- Flexibility, Resistance, Aerobic, Movement Execution training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 2 sitesItaly
- Study dates
- 23 Dec 2024to 30 Apr 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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
Who may be able to join
- Adults diagnosed with Hereditary Spastic Paraplegia.
- Presence of any functional deficit in the lower limbs that affects walking, such as muscle weakness, hypertonia, or balance issues.
- Ability to walk without the need for physical contact with another person, as defined by a Functional Ambulation Category score of 3 or higher.
- Ability to understand simple instructions, comprehend the purpose of the study, willingness to participate and undergo at least 10 treatment sessions, eligible and willing to sign the informed consent.
Who cannot join
- Botulinum toxin or surgery to treat lower limb hypertonia in the six months prior to enrollment in the study.
- Contraindications for moderate physical activity, such as stretching exercises, muscle strength training, and aerobic capacity training.
Trial locations and contacts
2 sites in 1 country.
Italy2 sites
Scientific Institute, IRCCS E. Medea, Department of Bosisio Parini, Lecco, Italy.
Bosisio Parini, Lombardy, 23842
Scientific Institute, IRCCS E. Medea, Department of Pieve di Soligo, Treviso, Italy
Pieve di Soligo, Veneto, 31053
About this study
Official title: Flexibility, Resistance, Aerobic, Movement Execution (FRAME) Training Program to Improve Gait Capacity in Adults With Hereditary Spastic Paraplegia: Protocol for a Single-cohort Feasibility Trial
Hereditary Spastic Paraplegia (HSP) is a group of inherited neurological disorders that cause progressive weakness and stiffness (spasticity) in the legs, reducing balance and walking ability. At present, there are no structured rehabilitation programs specifically designed to improve walking in people with HSP.
This study aims to find out whether a structured, therapist-guided exercise program called FRAME training can be delivered successfully to people with HSP, and whether it may help improve their walking. The program combines flexibility, muscle strengthening, motor control, balance and aerobic exercises. At the end of the program, participants receive a written manual and video tutorials to help them keep exercising at home.
Read the detailed description
Hereditary Spastic Paraplegia (HSP) is a heterogeneous group of inherited neurological disorders. It is characterized by progressive lower-limb weakness and spasticity that significantly impair walking endurance and speed. Several interventions have been studied for specific impairments, but there are still no comprehensive, structured neurorehabilitation programs designed to improve walking function in this population. This study explores a composite training approach (FRAME) that addresses the main factors limiting gait in HSP: reduced flexibility, muscle weakness, impaired motor control and balance, and low aerobic capacity.
Participants attend 10 to 16 therapist-guided sessions of 60 to 120 minutes, once or twice a week according to individual preferences and capabilities. Each session may include four components:
- Flexibility: stretching of the muscles typically affected by spasticity (triceps surae, adductors, rectus femoris, hamstrings), combined with biphasic high-frequency sensory electrical stimulation (100 Hz, 200 µs, intensity just below motor threshold, 30 minutes) to reduce muscle tone and enhance mobility.
- Resistance training and balance: strengthening of the muscles typically weakened in HSP, especially the proximal hip and trunk muscles. Core stability and resistance exercises are performed in sitting or standing under mild instability to promote muscle activation, balance and coordination.
- Movement execution and balance: gait training based on motor learning principles (repetitive task-oriented practice, variable practice, graded practice), with standing balance challenges and varied walking tasks (fast, slow, sideways and backward walking, stair climbing).
- Aerobic training: high-intensity interval training (HIIT), which has been shown to produce greater cardiovascular benefits than moderate-intensity exercise at a lower perceived effort. HIIT includes a 5-minute warm-up, two sets of 10 intervals (30 seconds high intensity / 30 seconds passive rest) with 5 minutes of rest between sets, and a 5-minute cool-down. The exercise mode (walking, running, cycling or squatting) is chosen to suit each participant.
At the end of the program, participants receive a transfer package (written manual and video tutorials) to support long-term home exercise.
This study is expected to give clinicians insight into whether a comprehensive, clinically oriented program can be delivered to adults with HSP and how much it may help them walk better. It will also inform future translational research in this field.
- Conditions
- Hereditary Spastic Paraplegia
- Being tested
- Flexibility, Resistance, Aerobic, Movement Execution training
- Keywords
- feasibility, gait, endurance, speed, balance, neurorehabilitation, hereditary spastic paraplegia, motor learning, aerobic exercise, high intensity interval training, resistance training, flexibility training, gait training
- Medical subject headings
- Spastic Paraplegia, Hereditary
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Flexibility, Resistance, Aerobic, Movement Execution trainingBehavioural
Flexibility: static and dynamic stretching combined with sensory, high-frequency electrical stimulation to reduce spasticity and improve mobility.
Resistance training: core stability and lower limb strength training in conditions of instability, to improve strength, coordination, and balance.
Movement execution training: gait training according to motor learning principles.
Aerobic exercise: in the form of high-intensity interval training at the end of each session, to improve cardiovascular status and foster motor learning consolidation (probably due to the release of brain derived neurotrophic factors).
| Study group | Role | What they receive |
|---|---|---|
| HSP Cohort | Experimental | The whole cohort of HSP patients will receive the same comprehensive neurorehabilitation program aiming at improving gait capabilities (speed and endurance). The content and the dose of the treatment will be personalized according to patient's specific needs and preferences. Receives: Behavioral: Flexibility, Resistance, Aerobic, Movement Execution training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feasibility (recruitment rate).
Study feasibility in terms of achieving sufficient recruitment rate, defined as the enrollment of 20 patients within 24 months from the start of the study.
Measured: From study start up to 24 months.
Feasibility (adherence rate).
Study feasibility in terms of achieving adequate adherence to the treatment plan, defined as completing at least 75% of the scheduled treatment sessions, and in any case a minimum of 10 treatment sessions.
Measured: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Feasibility (retention rate).
Study feasibility in terms of achieving sufficient patient retention, defined as at least 75% of the enrolled patients completing the study with adequate adherence to the treatment.
Measured: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Feasibility (safety).
Study feasibility in terms of absence of any serious adverse event related to patient participation in the study.
Measured: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Secondary outcomes (2)
Six Minute Walking Test (6MWT).
The 6MWT is a clinical assessment of gait endurance, by measuring the distance covered (metres) while walking on a straight even path (30 meters) for six minutes. According to original instructions, the patient is asked to walk along the path as fast as possible, taking turns at the edges of the path. Patients are allowed to walk autonomously or with assistive devices and to rest by standing.
Measured: Enrolment (T0), end of treatment five to ten weeks after T0 (T1), follow-up 12 weeks after T1 (T2).
Ten Metre Walk Test (10MWT).
The 10MWT is used to assess walking speed in meters/second (m/s) over a short distance. The total time taken to walk six meters (the central portion of a 10-meter walkway) is recorded to the nearest hundredth of a second. 6 meters is then divided by the total time taken to ambulate and recorded in m/s.
Two trials at comfortable pace are performed, followed by two trials at fast pace. Averages (one for comfortable pace, one for fast pace) are recorded.
Measured: Enrolment (T0), end of treatment five to ten weeks after T0 (T1), follow-up 12 weeks after T1 (T2).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Dec 2024
- Study start23 Dec 2024
- Primary completionJan 2027 (estimated)
- Study completion30 Apr 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Hereditary Spastic ParaplegiaStudies of the same condition, open and under way.
- More trials run by IRCCS Eugenio MedeaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Model description
- Single-cohort feasibility trial.
- Masking
- None (open label)
- Enrolment
- 20 participants (actual)
Sponsor and investigators
- Lead sponsor
- IRCCS Eugenio Medea
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Leonardo Boccuni, PhD, Principal investigator, Scientific Institute, IRCCS E. Medea, Department of Conegliano, Treviso, Italy.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06742697
- Sponsor's protocol ID
- 1130
- Acronym
- FRAME
- Status last verified
- Nov 2026
- First submitted
- 12 Dec 2024
- Last updated
- 5 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymized individual participant data will be shared with other researchers upon reasonable request.
Publications
Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev Neurother. 2007 Oct;7(10):1417-36. doi: 10.1586/14737175.7.10.1417.
PubMed 17939776Crozier J, Roig M, Eng JJ, MacKay-Lyons M, Fung J, Ploughman M, Bailey DM, Sweet SN, Giacomantonio N, Thiel A, Trivino M, Tang A. High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity. Neurorehabil Neural Repair. 2018 Jun;32(6-7):543-556. doi: 10.1177/1545968318766663. Epub 2018 Apr 20.
PubMed 29676956Thijs L, Voets E, Denissen S, Mehrholz J, Elsner B, Lemmens R, Verheyden GS. Trunk training following stroke. Cochrane Database Syst Rev. 2023 Mar 2;3(3):CD013712. doi: 10.1002/14651858.CD013712.pub2.
PubMed 36864008Maccora S, Torrente A, Di Stefano V, Lupica A, Iacono S, Pilati L, Pignolo A, Brighina F. Non-pharmacological treatment of hereditary spastic paraplegia: a systematic review. Neurol Sci. 2024 Mar;45(3):963-976. doi: 10.1007/s10072-023-07200-1. Epub 2023 Nov 16. No abstract available.
PubMed 37968432Bellofatto M, De Michele G, Iovino A, Filla A, Santorelli FM. Management of Hereditary Spastic Paraplegia: A Systematic Review of the Literature. Front Neurol. 2019 Jan 22;10:3. doi: 10.3389/fneur.2019.00003. eCollection 2019.
PubMed 30723448Ruano L, Melo C, Silva MC, Coutinho P. The global epidemiology of hereditary ataxia and spastic paraplegia: a systematic review of prevalence studies. Neuroepidemiology. 2014;42(3):174-83. doi: 10.1159/000358801. Epub 2014 Mar 5.
PubMed 24603320Boccuni L, Bortolini M, Stefan C, Dal Molin V, Dalla Valle G, Martinuzzi A. Flexibility, Resistance, Aerobic, Movement Execution (FRAME) training program to improve gait capacity in adults with Hereditary Spastic Paraplegia: protocol for a single-cohort feasibility trial. Front Neurol. 2025 Feb 18;16:1441512. doi: 10.3389/fneur.2025.1441512. eCollection 2025.
PubMed 40040914
Study at a glance
From the registry record, last updated by the sponsor on 5 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Flexibility, Resistance, Aerobic, Movement Execution (FRAME) Training Program to Improve Gait Capacity in Adults With Hereditary Spastic Paraplegia: Protocol for a Single-cohort Feasibility Trial
- ClinicalTrials.gov ID
- NCT06742697
- Acronym / sponsor ID
- FRAME / 1130
- Conditions
- Hereditary Spastic Paraplegia
- Keywords
- feasibility, gait, endurance, speed, balance, neurorehabilitation, hereditary spastic paraplegia, motor learning
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 20 participants (actual)
- Lead sponsor
- IRCCS Eugenio MedeaUniversity, hospital or other
- Study start
- 23 Dec 2024 (actual)
- Primary completion
- Jan 2027 (estimated)
- Study completion
- 30 Apr 2027 (estimated)
- First posted
- 19 Dec 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hereditary Spastic Paraplegia (HSP) is a group of inherited neurological disorders that cause progressive weakness and stiffness (spasticity) in the legs, reducing balance and walking ability. At present, there are no structured rehabilitation programs specifically designed to improve walking in people with HSP.
This study aims to find out whether a structured, therapist-guided exercise program called FRAME training can be delivered successfully to people with HSP, and whether it may help improve their walking. The program combines flexibility, muscle strengthening, motor control, balance and aerobic exercises. At the end of the program, participants receive a written manual and video tutorials to help them keep exercising at home.
Detailed description
Hereditary Spastic Paraplegia (HSP) is a heterogeneous group of inherited neurological disorders. It is characterized by progressive lower-limb weakness and spasticity that significantly impair walking endurance and speed. Several interventions have been studied for specific impairments, but there are still no comprehensive, structured neurorehabilitation programs designed to improve walking function in this population. This study explores a composite training approach (FRAME) that addresses the main factors limiting gait in HSP: reduced flexibility, muscle weakness, impaired motor control and balance, and low aerobic capacity.
Participants attend 10 to 16 therapist-guided sessions of 60 to 120 minutes, once or twice a week according to individual preferences and capabilities. Each session may include four components:
- Flexibility: stretching of the muscles typically affected by spasticity (triceps surae, adductors, rectus femoris, hamstrings), combined with biphasic high-frequency sensory electrical stimulation (100 Hz, 200 µs, intensity just below motor threshold, 30 minutes) to reduce muscle tone and enhance mobility.
- Resistance training and balance: strengthening of the muscles typically weakened in HSP, especially the proximal hip and trunk muscles. Core stability and resistance exercises are performed in sitting or standing under mild instability to promote muscle activation, balance and coordination.
- Movement execution and balance: gait training based on motor learning principles (repetitive task-oriented practice, variable practice, graded practice), with standing balance challenges and varied walking tasks (fast, slow, sideways and backward walking, stair climbing).
- Aerobic training: high-intensity interval training (HIIT), which has been shown to produce greater cardiovascular benefits than moderate-intensity exercise at a lower perceived effort. HIIT includes a 5-minute warm-up, two sets of 10 intervals (30 seconds high intensity / 30 seconds passive rest) with 5 minutes of rest between sets, and a 5-minute cool-down. The exercise mode (walking, running, cycling or squatting) is chosen to suit each participant.
At the end of the program, participants receive a transfer package (written manual and video tutorials) to support long-term home exercise.
This study is expected to give clinicians insight into whether a comprehensive, clinically oriented program can be delivered to adults with HSP and how much it may help them walk better. It will also inform future translational research in this field.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Single-cohort feasibility trial.
| Arm | Type | Receives |
|---|---|---|
| HSP Cohort | Experimental | Behavioral: Flexibility, Resistance, Aerobic, Movement Execution trainingThe whole cohort of HSP patients will receive the same comprehensive neurorehabilitation program aiming at improving gait capabilities (speed and endurance). The content and the dose of the treatment will be personalized according to patient's specific needs and preferences. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Adults diagnosed with Hereditary Spastic Paraplegia.
- Presence of any functional deficit in the lower limbs that affects walking, such as muscle weakness, hypertonia, or balance issues.
- Ability to walk without the need for physical contact with another person, as defined by a Functional Ambulation Category score of 3 or higher.
- Ability to understand simple instructions, comprehend the purpose of the study, willingness to participate and undergo at least 10 treatment sessions, eligible and willing to sign the informed consent.
Key exclusion criteria (2 listed)
- Botulinum toxin or surgery to treat lower limb hypertonia in the six months prior to enrollment in the study.
- Contraindications for moderate physical activity, such as stretching exercises, muscle strength training, and aerobic capacity training.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Flexibility, Resistance, Aerobic, Movement Execution trainingFlexibility: static and dynamic stretching combined with sensory, high-frequency electrical stimulation to reduce spasticity and improve mobility. Resistance training: core stability and lower limb strength training in conditions of instability, to improve strength, coordination, and balance. Movement execution training: gait training according to motor learning principles. Aerobic exercise: in the form of high-intensity interval training at the end of each session, to improve cardiovascular status and foster motor learning consolidation (probably due to the release of brain derived neurotrophic factors). | Behavioural | HSP Cohort |
Primary outcome
Feasibility (recruitment rate).
Time frame: From study start up to 24 months.
Study feasibility in terms of achieving sufficient recruitment rate, defined as the enrollment of 20 patients within 24 months from the start of the study.
Feasibility (adherence rate).
Time frame: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Study feasibility in terms of achieving adequate adherence to the treatment plan, defined as completing at least 75% of the scheduled treatment sessions, and in any case a minimum of 10 treatment sessions.
Feasibility (retention rate).
Time frame: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Study feasibility in terms of achieving sufficient patient retention, defined as at least 75% of the enrolled patients completing the study with adequate adherence to the treatment.
Feasibility (safety).
Time frame: Enrolment (T0), end of treatment five to ten weeks after T0 (T1).
Study feasibility in terms of absence of any serious adverse event related to patient participation in the study.
2 secondary outcomes
Six Minute Walking Test (6MWT).
Time frame: Enrolment (T0), end of treatment five to ten weeks after T0 (T1), follow-up 12 weeks after T1 (T2).
Ten Metre Walk Test (10MWT).
Time frame: Enrolment (T0), end of treatment five to ten weeks after T0 (T1), follow-up 12 weeks after T1 (T2).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Nov 2026.
- Background: PubMed 17939776Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev Neurother. 2007 Oct;7(10):1417-36. doi: 10.1586/14737175.7.10.1417.
- Background: PubMed 29676956Crozier J, Roig M, Eng JJ, MacKay-Lyons M, Fung J, Ploughman M, Bailey DM, Sweet SN, Giacomantonio N, Thiel A, Trivino M, Tang A. High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity. Neurorehabil Neural Repair. 2018 Jun;32(6-7):543-556. doi: 10.1177/1545968318766663. Epub 2018 Apr 20.
- Background: PubMed 36864008Thijs L, Voets E, Denissen S, Mehrholz J, Elsner B, Lemmens R, Verheyden GS. Trunk training following stroke. Cochrane Database Syst Rev. 2023 Mar 2;3(3):CD013712. doi: 10.1002/14651858.CD013712.pub2.
- Background: PubMed 37968432Maccora S, Torrente A, Di Stefano V, Lupica A, Iacono S, Pilati L, Pignolo A, Brighina F. Non-pharmacological treatment of hereditary spastic paraplegia: a systematic review. Neurol Sci. 2024 Mar;45(3):963-976. doi: 10.1007/s10072-023-07200-1. Epub 2023 Nov 16. No abstract available.
- Background: PubMed 30723448Bellofatto M, De Michele G, Iovino A, Filla A, Santorelli FM. Management of Hereditary Spastic Paraplegia: A Systematic Review of the Literature. Front Neurol. 2019 Jan 22;10:3. doi: 10.3389/fneur.2019.00003. eCollection 2019.
- Background: PubMed 24603320Ruano L, Melo C, Silva MC, Coutinho P. The global epidemiology of hereditary ataxia and spastic paraplegia: a systematic review of prevalence studies. Neuroepidemiology. 2014;42(3):174-83. doi: 10.1159/000358801. Epub 2014 Mar 5.
- Derived from this study: PubMed 40040914Boccuni L, Bortolini M, Stefan C, Dal Molin V, Dalla Valle G, Martinuzzi A. Flexibility, Resistance, Aerobic, Movement Execution (FRAME) training program to improve gait capacity in adults with Hereditary Spastic Paraplegia: protocol for a single-cohort feasibility trial. Front Neurol. 2025 Feb 18;16:1441512. doi: 10.3389/fneur.2025.1441512. eCollection 2025.
- Individual participant dataSharing planned: Yes. Anonymized individual participant data will be shared with other researchers upon reasonable request.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Leonardo Boccuni, PhD principal investigator
Scientific Institute, IRCCS E. Medea, Department of Conegliano, Treviso, Italy.
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Flexibility, Resistance, Aerobic, Movement Execution training in people with Hereditary Spastic Paraplegia, run by IRCCS Eugenio Medea at 2 sites in Italy.
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 4 inclusion and 2 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: under way, not looking for participants, as of the sponsor's last update on 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Italy. 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?
This study is still under way. Results are not available in the source record yet.
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?
Feasibility (recruitment rate). (time frame: From study start up to 24 months.). 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?
On the ClinicalTrials.gov record for NCT06742697, which also lists 7 linked publications.
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 5 Nov 2026.