Stroke Clinical Trial
Official title:
Wearable Interactive Lower-limb Exoskeleton Robotic Device for Gait Training of Post-stroke Patients on Different Walking Conditions
A new lower-limb training system is introduced to enhance the clinical service for post-stroke lower limb rehabilitation and to assist the establishment of public clinical trial in different settings and share experiences on the robot-assisted functional training.
Status | Recruiting |
Enrollment | 64 |
Est. completion date | June 12, 2019 |
Est. primary completion date | June 12, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: 1. First episode of stroke, 2. Hemiparesis resulting from a unilateral ischemic or hemorrhagic stroke, 3. Functional Ambulation Category (FAC) > 2 out of 6, i.e. have ability to walk on the ground independently or under supervision, with or without assistive device, 4. Have sufficient cognition to follow instructions and to understand the content and purpose of the study. Exclusion Criteria: 1. Uncontrolled cardiovascular or respiratory disorders, 2. Moderate to serve contractures in the lower extremities, 3. Orthopedic problems or muscle diseases that impair mobility, 4. Difficulty to comply with the study protocol and the gait training schedule, i.e. at least 2 sessions per week. |
Country | Name | City | State |
---|---|---|---|
Hong Kong | Department of Biomedical Engineering, The Chinese University of Hong Kong | Hong Kong |
Lead Sponsor | Collaborator |
---|---|
Chinese University of Hong Kong |
Hong Kong,
Yeung LF, Ockenfeld C, Pang MK, Wai HW, Soo OY, Li SW, Tong KY. Design of an exoskeleton ankle robot for robot-assisted gait training of stroke patients. IEEE Int Conf Rehabil Robot. 2017 Jul;2017:211-215. doi: 10.1109/ICORR.2017.8009248. — View Citation
Yeung LF, Ockenfeld C, Pang MK, Wai HW, Soo OY, Li SW, Tong KY. Randomized controlled trial of robot-assisted gait training with dorsiflexion assistance on chronic stroke patients wearing ankle-foot-orthosis. J Neuroeng Rehabil. 2018 Jun 19;15(1):51. doi: — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Gait Analysis with EMG Collection | The spatial-temporal, kinetic, and kinematic gait parameters of the stroke patients were collected at the hip, knee, and ankle joints. In addition, the foot tilt angle was computed using the absolute angle between the affected foot and the ground, which is negative when the foot is pointing downwards. This angle measurement can help identifying abnormality in foot orientation during walking, such as foot slapping at initial contact or dropped foot pointing downwards after mid-swing (Zhang, Davies & Xie, 2013). Electromyography (EMG) of the lower limb muscles were also collected to investigate the muscle recruitment during walking with the robotic assistance. | Baseline, Post-Training | |
Other | Subjective Feedback from Participants | Subjective feedbacks were collected from participated stroke patients using questionnaire, with three 10-point Likert scale rating asking them about safety, effectiveness, and overall satisfaction of the gait training with the Exoskeleton Ankle Robot, with reference to the other conventional physiotherapy they had received before participating in this trial. Likert scale has been shown to measure satisfaction with good reliability (Wittink & Bayer, 1994). | Post-Training | |
Other | Mini-Mental State Examination (MMSE) | Mini-Mental State Examination (MMSE), assesses the cognitive capability of the subject to make sure they understand the purpose of participation in the clinical trial. | Baseline | |
Primary | Functional Ambulatory Category (FAC) | Functional Ambulatory Category (FAC) is a reliable measurement of independent walking ability on level-ground walking and stair ambulation, which is a good prediction of independent community walking post-stroke (Mehrholz, et al., 2007). FAC consists of 6-level scale: patients with FAC=4 requires supervision in level ground walking, FAC=5 requires supervision only when walking on non-level surface such as stairs. | Baseline, Post-Training, 3-month follow up | |
Secondary | Fugl-Meyer Assessment for Lower-Extremity (FMA-LE) | Fugl-Meyer Assessment for Lower-Extremity (FMA-LE), consists of 34-level cumulative scoring system to examine lower-limb functions of hemiplegic stroke patients quantitatively through a set of lower-limb movement tasks in reflex, flexor/extensor synergy, volitional movement, coordination and speed (Fugl-Meyer, et al., 1975). All assessment items are either scoring "full", "partial", or "none" functionality in the affected side, which minimizes ceiling and floor effects. FMA-LE demonstrated high internal consistency and a reliable assessment tool for a group of 140 hemiplegic community dwelling patients (Park & Choi, 2014). | Baseline, Post-Training, 3-month follow up | |
Secondary | Modified Ashworth Scale (MAS) | Modified Ashworth Scale (MAS), consists of 4-level scale to examine joint spasticity based on muscle tone and resistance detected during passive stretching with good inter-rater reliability (ICC =0.85) (Bohannon & Smith, 1987). | Baseline, Post-Training, 3-month follow up | |
Secondary | Berg Balance Scale (BBS) | Berg Balance Scale (BBS), consists of 56-level measures to examine balance ability and to predict falling risk with high reliability (ICC=0.98) (Steffen, Hacker & Mollinger, 2002). Stroke patients were assessed based on their performance on 14 simple mobility tasks, including transfer, standing, and reaching. | Baseline, Post-Training, 3-month follow up | |
Secondary | Timed 10-Meter Walk Test (10mWT) | Timed 10-Meter Walk Test (10mWT), measures comfortable and fast walking speeds in short distance. The ability to increase walking speed above a comfortable pace suggests the capability to adapt to varying environments, such as crossing street, with high reliability (ICC=0.90-0.96) (Flansbjer, et al., 2005). Average walking speed of healthy elderly subjects ranges in 0.6m/s-1.4m/s, and can increase to 21%-56% above the comfortable pace for faster walking speed. | Baseline, Post-Training, 3-month follow up | |
Secondary | 6-minute Walk Test (SMWT) | Six-Minute Walk Test (SMWT), measures the maximum walking distance covered in fixed duration as a sub-maximal test of endurance and aerobic capacity. The measurement of 6MWT is highly correlated to FAC (Mehrholz, et al., 2007) with good reliability (ICC=0.94-0.96) (Steffen, Hacker & Mollinger, 2002). | Baseline, Post-Training, 3-month follow up |
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