Stroke Clinical Trial
Official title:
Longitudinal Pilot Study on the Feasibility of Integrating Gait Training Through a New Over-ground Wearable Robotic System to Traditional Rehabilitation in People With Pyramidal Hemisyndromes.
Over-ground exoskeletons for gait rehabilitation are studied enough in people suffering
spinal cord injury, and its clinical use is escalating in the industrialized countries.
Nevertheless, studies on gait rehabilitation through exoskeletons in subjects with Pyramidal
Hemisyndrome (PH) are recognized by GRADE as Low Quality of evidence.
This interventional longitudinal pilot study is aimed to investigate the feasibility,
clinical effects, and compliance (from the experienced therapists (Indego Specialists)' point
of view) of using an over-ground wearable robotic system (Indego) for gait rehabilitation of
people with PH in the clinical practice.
Two substudies will be conducted with the following aims: to explore changes in the gait
pattern and muscle activity following Indego-assisted gait rehabilitation through the
kinematic gait analysis (in subjects able to walk) associated with surface electromyography
(sEMG) of 4 muscle groups of the lower limbs; to identify prognostic factors for walking
recovery, investigating also the effect of the treatment on functional connectivity through
the electroencephalographic (EEG) analysis.
In order to satisfy the study aims, 30 subjects with PH and walking impairment will be
recruited and assessed both clinically and instrumentally (in case of substudies) at the
beginning (T0) and the end (T1) of the treatment period.
The primary objective of this interventional longitudinal pilot study is to investigate the
feasibility of using an over-ground wearable robotic system (Indego) for gait rehabilitation
of people with PH associated with the traditional rehabilitation.
Secondary objectives of the study are:
- To explore the clinical effects of the treatment;
- To evaluate the feasibility of implementing this system in clinical practice from
experienced therapists (Indego Specialists)' point of view.
Two Sub-Studies (SS) will be conducted with the following aims:
1. Kinematic gait analysis (in subjects able to walk) associated with surface
electromyography (sEMG) of 4 muscle groups of the lower limbs in order to evaluate
changes in the gait pattern and muscle activity following gait rehabilitation through an
over-ground wearable exoskeleton system;
2. Electroencephalographic (EEG) analysis in order to: identify prognostic factors for
walking recovery; investigate the effect of the treatment on functional connectivity.
30 subjects with PH and walking impairment who meet the research project inclusion and
exclusion criteria will be recruited for this study. Patients will be evaluated at T0 and at
T1. Demographic (gender, date of birth, height, weight, education, dominant side, work
activity, presence of the social network, presence of architectural barriers at home) and
clinical data (comorbidity, drug therapy, blood pressure, the cardiac frequency at rest, date
of last acute event, number of previous neurological events, location of acute events) of all
participants will be recorded at T0. In the case of Sub-Studies, 10 patients (able to walk fo
4 meters without aids but with supervision) for SS1 and 5 patients for SS2 following the
first-ever monofocal cerebrovascular acute event will be recruited. These subjects will be
assessed both clinically and instrumentally (SS1: through the gait analysis and sEMG; SS2:
through the EEG) at T0 and T1.
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