Exoskeleton and Spinal Cord Injury (EXTra-SCI)

February 1, 2022 updated by: Ashraf Gorgey, McGuire Research Institute

Exoskeleton Training After Spinal Cord Injury

The purpose of the current study is to investigate the effects of powered exoskeleton (EKSO) on cardiovascular performance as measured by resting blood pressure and heart rate, peak oxygen consumption during walking, energy expenditure, whole and regional body composition assessments. The effects of exoskeleton training on walking kinematics including stand-up time, walking time, distance covered and speed of walking will also be evaluated.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Powered exoskeletons using robotic suits have recently been introduced for the rehabilitation of persons with spinal cord injury (SCI). Exoskeletons offer a unique opportunity for persons with SCI to experience standing and walking at a low metabolic cost. Evidence suggested that exoskeleton assisted walking can decrease spasticity and improve bowel movement. Training may also improve the level of physical activity as well as psychological parameters that are likely to interfere with rehabilitation outcomes. Previous studies reported that a frequency of 2-3 times per week or more for 1-2 hours may be beneficial in the rehabilitation of persons with SCI. Using exoskeletal-assisted walking to improve the level of physical activity may be appealing to persons with SCI.

Exoskeleton training for 12 weeks may enhance energy expenditure, parameters of physical activity and result only on modest effects on both cardiovascular and body composition parameters. In other words, persons with tetraplegia may have greater cardiovascular and body composition adaptations compared to persons with paraplegia. Twenty subjects will participate in a powered exoskeleton (EKSO) for one or twice a week for 12 weeks. The program will involve walking with the robotic suits for 1 hour for persons with complete (n=10) and persons with incomplete (n=10) SCI.

Study Type

Interventional

Enrollment (Actual)

20

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Virginia
      • Richmond, Virginia, United States, 23249
        • Hunter Holmes McGuire VA Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. A written clearance by the medical doctor .
  2. Participants will have to be 1 year post-injury with any level of injury.
  3. All participants will be between 18-70 years old, men/women,

Exclusion Criteria:

  1. Participants with body weight greater than 220 lbs
  2. Whole body T-scores less than -2.5 standard deviation will result in elimination from the program.
  3. Hip width, upper leg length and lower leg length that do not fit in the robotic suit.
  4. Previous unhealed fracture in both lower or upper extremities
  5. Leg length discrepancy that is unlikely to be managed by having shoe inserts
  6. High resting blood pressure greater than 130/80 mmHg
  7. Sudden drop in blood pressure by 20 mmHg especially in persons with tetraplegia.
  8. Medical conditions prior enrollment similar to cardiovascular disease, uncontrolled type II diabetes mellitus, uncontrolled hypertension, and those on insulin, pressures sores stage 2 or greater, or urinary tract infection or symptoms.
  9. Pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Exoskeleton Training
Twenty men with complete and incomplete SCI will be enrolled in the trial.
Twenty subjects will participate in a powered exoskeleton (EKSO) for one or twice a week for 12 weeks. The program will involve walking with the robotic suits for 1 hour for persons with complete (n=10) and persons with incomplete (n=10).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood Pressure (mmHg)
Time Frame: 12 weeks
Resting blood pressure and post-exercise blood pressure will be measured every visit.
12 weeks
Walking time (minutes)
Time Frame: 12 weeks
The robotic unit will measure standing up time, walking time and walking distance for every visit.
12 weeks
Oxygen uptake (l/min)
Time Frame: 12 weeks
Oxygen uptake will be measured during sitting, standing and walking at the beginning and at the end of the training program.
12 weeks
Body Composition (kg)
Time Frame: 12 weeks
Body composition using dual energy x-ray absorptiometry anthropometrics' will be measured during sitting, standing and walking at the beginning and at the end of the training program.
12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Six minute-walk Test (meter)
Time Frame: 12 weeks
The test will competed at the beginning and at the end of study to measure distance.
12 weeks
Walking Index for Spinal Cord Injury II (WISCI II)
Time Frame: 12 weeks
The test will competed at the beginning and at the end of study
12 weeks
Electromyography (EMG) activity of 6 muscle groups (mV)
Time Frame: 12 weeks
The test will competed at the beginning and at the end of study
12 weeks
Mitochondrial health using near infra-red spectroscopy (seconds)
Time Frame: 12 weeks
The test will competed at the beginning and at the end of study
12 weeks
10 meter walk Test (m/sec)
Time Frame: 12 weeks
The test will competed at the beginning and at the end of study to measure speed.
12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2018

Primary Completion (Actual)

December 30, 2021

Study Completion (Actual)

December 30, 2021

Study Registration Dates

First Submitted

January 11, 2018

First Submitted That Met QC Criteria

January 18, 2018

First Posted (Actual)

January 25, 2018

Study Record Updates

Last Update Posted (Actual)

February 16, 2022

Last Update Submitted That Met QC Criteria

February 1, 2022

Last Verified

February 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • 02375

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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