Research on Clinical Safety and Effectiveness of Wearable Assistive Devices With Flexible Structure for Daily Life Support of Stroke Patients

Gait independence is a critical goal for stroke patients and significantly impacts their return to society. Due to hemiplegia, stroke patients often face walking difficulties. Compensatory approaches using lower limb assistive devices have shown promise in improving independent walking. Wearable assistive devices, which minimize daily life restrictions, are gaining attention globally. Despite the availability of many imported rehabilitation assistive devices, their high cost and poor fit for East Asian patients highlight the need for domestic alternatives. In light of the global interest in robotics, there is a shortage of domestic research on advanced wearable robots. This study aims to clinically test and verify the effectiveness of a flexible, wearable robotic assistive device developed by Angel Robotics for stroke patients.

Study Overview

• Status: Completed
• Conditions: Stroke; Hemiplegia
• Intervention / Treatment: Device: Soft Wearable Robot

Detailed Description

The study will enroll 20 participants, providing knee and hip assistance during overground walking adaptation training. Participants will undergo an initial assessment followed by three 30-minute sessions of training with a powered hip assistive device over two weeks. Post-intervention Assessment 1 will follow this training. Then, participants will undergo three 30-minute sessions of training with a powered knee assistive device over the next two weeks, followed by Post-intervention Assessment 2. Each participant will have nine visits in total, including three functional assessments and six adaptation training sessions. The schedule for subsequent visits will be arranged during the first visit. The familiarization process will be conducted two to three times per week, adjusted for participants' convenience, with each set of three visits completed within three weeks. Trained therapists will handle the attachment and adjustment of the powered assistive devices.

Assessments will be conducted at three points: before the first training session, after the third session, and after the sixth session. Measurements will be taken under three conditions: without the assistive device, with the assistive device but without power assistance, and with the assistive device and power assistance, in random order.

This study will evaluate the following: Gait speed using the 10-meter walk test, Walking distance using the 6-minute walk test, 3D gait analysis (Human body model) assessing kinetics and kinematics, Energy consumption, including oxygen rate (VO2/ml/min per kg of body weight) and oxygen cost (oxygen rate per walking speed in m/min), Lower limb strength and motor function, assessed by the Functional Ambulatory Category (gait independence), Berg Balance Test (balance ability), and Rivermead Mobility Index (motor ability), These evaluations will help determine the effectiveness of the wearable robotic assistive device in aiding the gait of stroke patients.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of
    • Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 1. Adult patients aged 19 years and older 2. Diagnosed with stroke confirmed by neurologists or neurosurgeons through imaging techniques such as CT or MRI 3. Chronic hemiplegic stroke patients, 6 months or more post-stroke onset 4. Patients with a Functional Ambulatory Category (FAC) score of 3 or higher 5. Patients with a Mini-Mental State Examination (MMSE) score of 10 or higher, who can understand the study, have a voluntary willingness to participate, and have given consent to participate

Exclusion Criteria:

• 1. Acute/subacute stroke patients within 6 months of stroke onset 2. Quadriplegia 3. Ataxia 4. Severe lower limb joint contractures that make wearing the assistive device difficult 5. Patients with neurological, musculoskeletal, or cardiopulmonary diseases that affect walking 6. Any other conditions deemed inappropriate for participation in the study by the researcher

Study Plan

How is the study designed?

Design Details

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

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Experimental Group; This group is evaluated on three conditions.

Device: Soft Wearable Robot; This study aims to enroll 20 participants who will receive assistance in flexion and extension of the knee and hip during overground walking adaptation training. Following the initial assessment, participants will undergo three 30-minute sessions of overground walking adaptation training with a powered hip assistive device over two weeks. After completing these sessions, Post-intervention Assessment 1 will be conducted. Then, participants will undergo three 30-minute sessions of overground walking adaptation training with a powered knee assistive device over two weeks, followed by Post-intervention Assessment 2. Each participant will have a total of nine visits, including three functional assessments and six adaptation training sessions. The first visit will involve scheduling subsequent visits. The familiarization process will occur two to three times per week, adjustable for participants' convenience, with each set of three visits completed within three weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
10-meter walking test	The 10 Meter Walk Test (10MWT) is a simple and commonly used assessment to evaluate walking speed. During the test, participants are instructed to walk a distance of 10 meters. The time is measured for the middle 6 meters, allowing the first and last 2 meters for acceleration and deceleration. This approach ensures a more accurate assessment of the participant's steady-state walking speed.	Initial Assessment
10-meter walking test	The 10 Meter Walk Test (10MWT) is a simple and commonly used assessment to evaluate walking speed. During the test, participants are instructed to walk a distance of 10 meters. The time is measured for the middle 6 meters, allowing the first and last 2 meters for acceleration and deceleration. This approach ensures a more accurate assessment of the participant's steady-state walking speed.	After 2 weeks of hip assistive device adaptation training
10-meter walking test	The 10 Meter Walk Test (10MWT) is a simple and commonly used assessment to evaluate walking speed. During the test, participants are instructed to walk a distance of 10 meters. The time is measured for the middle 6 meters, allowing the first and last 2 meters for acceleration and deceleration. This approach ensures a more accurate assessment of the participant's steady-state walking speed.	After 2 weeks of knee assistive device adaptation training

Collaborators and Investigators

• Sponsor: Yonsei University

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2023
• Primary Completion (Actual): May 29, 2024
• Study Completion (Actual): May 29, 2024

Study Registration Dates

• First Submitted: August 7, 2024
• First Submitted That Met QC Criteria: August 7, 2024
• First Posted (Actual): August 12, 2024

Study Record Updates

• Last Update Posted (Actual): August 12, 2024
• Last Update Submitted That Met QC Criteria: August 7, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Paralysis; Stroke; Hemiplegia
• Other Study ID Numbers: 4-2023-0009

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: No