- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05503316
The Roll of Balance Confidence in Gait Rehabilitation in Persons With a Lesion of the Central Nervous System
Persons with an injury of the central nervous system clearly experience motor impairments. Among the most commonly described consequences are gait abnormalities and impaired balance. Although these are undeniably linked, they are also influenced by other factors. A recent systematic review (Xie, 2022) reports impaired balance, the presence of depression or anxiety, and decreased function of the lower limbs as important risk factors for fear of falling in persons after a stroke. Also for people with a spinal cord injury, the fear of falling has a major impact on their level of participation and quality of life (Sing, 2021). Preventing falls and reducing fear of falling is an important part of neurological rehabilitation programs as it is known that fear of falling has a negative impact on the patient's activity level. This in turn will lead to an increased risk of falling and a negative effect on neurological recovery due to insufficiently practicing their balance while walking.
Since 2019 the rehabilitation center of UZ gent offers GRAIL training. This device aims to train walking balance and gait adaptability in a virtual environment. Patients who are admitted and/or undergoing ambulatory rehabilitation at UZ Gent are given the opportunity to complete a 5-week training schedule on the GRAIL. Before and after this training intervention period, the investigators evaluate the gait pattern of these patients. After the training period, the patients also complete a questionnaire about their experience while training on the GRAIL and often also indicate that they become more confident in their own balance when walking. That is why the researchers now also want to measure this.
Research questions:
- Do people with high confidence in their balance when walking differ from those with low confidence in their balance when walking?
- Does GRAIL training have a different effect on confidence in balance than traditional rehabilitation? To answer the 2nd research question, patients who follow the traditional rehabilitation (control group) also receive the same tests as the people who follow GRAIL training.
Randomization (prepared in advance via a computer program) determines who will follow the GRAIL training and who will follow the traditional rehabilitation.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Anke Van Bladel, Phd
- Phone Number: 09 332 12 43
- Email: anke.vanbladel@ugent.be
Study Locations
-
-
-
Ghent, Belgium, 9000
- Recruiting
- Ghent University Hospital
-
Contact:
- Anke Van Bladel, PhD
- Phone Number: 093321243
- Email: Anke.VanBladel@UGent.be
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Persons who are admitted to the rehabilitation center of the Ghent University Hospital (in and outpatient) and suffered a stroke, spinal cord injury of traumatic brain injury
- Persons have to be able to walk for at least 6 minutes without the need of a person to help and with minimal help of a walking device. (level FAC 2 or higher)
- Participants who understand orders during the assessment and intervention.
Exclusion Criteria:
- Other neurological conditions (MS, Parkinson, ...)
- Orthopedic trauma or recent acute trauma that influence walking ability.
- Body weight exceeds 120 kg.
- Severe dizziness that makes it impossible to practice in standing position.
- Cardiac or pulmonary problems that require monitoring during exercising.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: GRAIL group
Participants will receive 5 weeks of training on the GRAIL device, which is focused on training balance during walking. Therapy frequency: 2*30 minutes per week. |
Participants will receive dynamic balance training while walking on the GRAIL device.
|
Active Comparator: Traditional gait rehabilitation
Participant will receiver traditional gait rehabilitation which also includes training balance during walking. Therapy frequency in both groups is equal. |
Participants will receive traditional gait rehabilitation that also includes balance training while walking but not on the GRAIL device.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gait speed (m/s)
Time Frame: Before the intervention
|
Difference in gait speed between persons with high balance confidence and low balance confidence measured during walking on the treadmill.
|
Before the intervention
|
Step length (m)
Time Frame: Before intervention
|
Step length (m)
|
Before intervention
|
Step width (m)
Time Frame: Before intervention
|
Step width (m)
|
Before intervention
|
Cadence (steps per minute)
Time Frame: Before intervention
|
Cadence (steps per minute)
|
Before intervention
|
Cadence (steps per minute)
Time Frame: Within one week after the intervention
|
Cadence (steps per minute)
|
Within one week after the intervention
|
Time in swing and stance phase (s)
Time Frame: Before intervention
|
Time in swing and stance phase (s)
|
Before intervention
|
Time in swing and stance phase (s)
Time Frame: Within one week after the intervention
|
Time in swing and stance phase (s)
|
Within one week after the intervention
|
Step width (m)
Time Frame: Within one week after the intervention
|
step width (m)
|
Within one week after the intervention
|
Step length (m)
Time Frame: Within one week after the intervention
|
Step length (m)
|
Within one week after the intervention
|
10 meter walk test
Time Frame: Before intervention
|
Difference in gait speed between persons with high balance confidence and low balance confidence measured during walking overground. Change in overground walking speed before and after intervention. |
Before intervention
|
10 meter walk test
Time Frame: Within one week after the intervention
|
Difference in gait speed between persons with high balance confidence and low balance confidence measured during walking overground. Change in overground walking speed before and after intervention. |
Within one week after the intervention
|
Margins of stability
Time Frame: Before intervention
|
Dynamic balance during walking measured during normal walking and during the balance task.
|
Before intervention
|
Margins of stability
Time Frame: Within one week after the intervention
|
Dynamic balance during walking measured during normal walking and during the balance task.
|
Within one week after the intervention
|
Activity-specific Balance Confidence (ABC) scale
Time Frame: Before intervention
|
Balance confidence scored by the participant (questionnaire) per item (16 items) geeft participant weer hoeveel vertrouwen hij heeft in dit item (0-100%) Hogere score is meer vertrouwen.
|
Before intervention
|
Activity-specific Balance Confidence (ABC) scale
Time Frame: Within one week after the intervention
|
Balance confidence scored by the participant (questionnaire) per item (16 items) geeft participant weer hoeveel vertrouwen hij heeft in dit item (0-100%) Hogere score is meer vertrouwen.
|
Within one week after the intervention
|
Visual analogue scale score to assess task specific confidence
Time Frame: Before intervention
|
Participants are asked to score the level of confidence that they have that they can complete the balance task (score 0-10). Higher score is more confidence. |
Before intervention
|
Visual analogue scale score to assess task specific restraints
Time Frame: Before intervention
|
Participants are asked to score the level of restraint that they have to complete the balance task due to fear of falling (score 0-10). Higher score is more restraint. |
Before intervention
|
Visual analogue scale score to assess task specific confidence
Time Frame: Within one week after the intervention
|
Participants are asked to score the level of confidence that they have that they can complete the balance task (score 0-10). Higher score is more confidence.Participants are asked to score the level of restraint that they have to complete the balance task due to fear of falling (score 0-10). |
Within one week after the intervention
|
Visual analogue scale score to assess task specific restraints
Time Frame: Within one week after the intervention
|
Participants are asked to score the level of restraint that they have to complete the balance task due to fear of falling (score 0-10). Higher score is more restraint. |
Within one week after the intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of life using the SF36_C questionnaire
Time Frame: Before intervention
|
Questionnaire to assess the quality of life (SF36_C)
|
Before intervention
|
Quality of life using the SF36_C questionnaire
Time Frame: Within one week after the intervention
|
Questionnaire to assess the quality of life (SF36_C)
|
Within one week after the intervention
|
Anxiety and depression
Time Frame: Before intervention
|
Hospital anxiety and depression scale (HADS)
|
Before intervention
|
Anxiety and depression
Time Frame: Within one week after the intervention
|
Hospital anxiety and depression scale (HADS)
|
Within one week after the intervention
|
Gait quality
Time Frame: Within one week after the intervention
|
Joint angles of lower limbs and trunk (degree) Do persons with high balance confidence walk different than persons with low balance confidence.
|
Within one week after the intervention
|
Scoring on a visual analogue scale to assess fear of falling
Time Frame: Before intervention
|
Visual analogue scale (0-10) to indicate fear of falling during walking overground in the rehabilitation center and during walking on the treadmill. Higher score is more fear to fall. |
Before intervention
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Anke Van Bladel, PhD, Ghent University Hopsital / Ghent University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ONZ-2022-0324
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Stroke
-
University Hospital, GhentRecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Stroke HemorrhagicBelgium
-
Moleac Pte Ltd.RecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, CryptogenicSingapore, Philippines
-
Moleac Pte Ltd.Not yet recruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke, Cardiovascular | Strokes Thrombotic | Stroke, Embolic | Stroke, Cryptogenic
-
IRCCS San Camillo, Venezia, ItalyRecruitingStroke | Stroke, Ischemic | Stroke Sequelae | Stroke HemorrhagicItaly
-
Vanderbilt University Medical CenterPatient-Centered Outcomes Research Institute; University of Alabama at BirminghamEnrolling by invitationStroke | Stroke, Ischemic | Stroke, Acute | Stroke Sequelae | Engagement, Patient | Stroke HemorrhagicUnited States
-
University of MinnesotaAmerican Occupational Therapy FoundationRecruitingStroke | Stroke Sequelae | Stroke Hemorrhagic | Stroke IschemicUnited States
-
University of British ColumbiaCanadian Institutes of Health Research (CIHR); Michael Smith Foundation for...RecruitingStroke | Stroke, Ischemic | Stroke Hemorrhagic | Chronic StrokeCanada
-
University of CincinnatiMedical University of South Carolina; University of California, Los Angeles; University...RecruitingStroke | Stroke, Ischemic | Stroke, Acute | Stroke HemorrhagicUnited States
-
University of LiegeCompletedStroke, Acute | Stroke Hemorrhagic | Stroke, ComplicationBelgium
-
Turkish Stroke Research and Clinical Trials NetworkElectroCore INC; Turkish Neurological SocietyCompletedStroke | Stroke, Ischemic | Stroke, Acute | Stroke, HemorrhagicTurkey
Clinical Trials on Dynamic balance training
-
Riphah International UniversityCompletedIntellectual ImpairmentPakistan
-
National Taiwan University HospitalTerminated
-
Marquette UniversityGreater Milwaukee FoundationCompletedMultiple Sclerosis
-
Gazi UniversityCompleted
-
Medipol UniversityRecruitingChronic Pain | Chronic Instability of Joint | Ankle Inversion Sprain | Athlete FootTurkey
-
Cairo UniversitySTDFRecruiting
-
Pôle Saint HélierHopital La MusseCompleted
-
Riphah International UniversityCompleted
-
Istanbul University - Cerrahpasa (IUC)UnknownParkinson Disease
-
East Carolina UniversityCompletedCerebral PalsyUnited States