- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07537530
Gait Rehabilitation in Stroke Patients Using Functional Electrical Stimulation and Visual Feedback (BrainSTEP)
A Randomized Controlled Pilot Study of Gait Rehabilitation in Stroke Patients Using Functional Electrical Stimulation and Visual Feedback
recoveriX PRO system is a Brain-Computer Interface (BCI) device that combines Motor Imagination (MI), with Functional Electrical Stimulation (FES) and Virtual Reality (VR) as feedback devices. The user wears an electroencephalography (EEG) cap that registers the neural activity during the mental practice. This system allows the user to control the feedback devices (FES +VR) with the MI.
The goal of this clinical trial is to know the safety and clinical effectiveness of recoveriX-based treatment for improving gait functions in stroke patients. Researchers will compare the functional results obtained by recoveriX system, to the standard treatment based in FES + VR + MI without monitoring the EEG activity.
The questions to answer are:
- Will stroke patients who undergo recoveriX therapy significantly improve their gait ability?
- Is the functional improvement (gait speed) achieved with the BCI treatment superior to the standard MI+FES+VR treatment?
- Is the recoveriX-based therapy as safe as the standard treatment?
Participants will have to perform a complete assessment to evaluate their functionality before and after the intervention (motor skills, walking ability, impact of the disease in daily living activities).
Patients in the BCI group will receive 25 sessions (3 sessions per week) of BCI training with FES and VR feedback (24 sessions in total).
Patients in the control group will receive 25 sessions (3 sessions per week) of FES + VR therapy. Patients in the control group will receive the same instructions as the experimental but will not wear the EEG cap.
Study Overview
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Upper Austria
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Schiedlberg, Upper Austria, Austria, 4521
- g.tec medical engineering GmbH
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 6-months or more post stroke
- With a restriction of the lower extremities preventing the persons from activities of daily life
- Participants must be German speaking.
- Demonstrate intact cognition to provide informed consent and follow instructions.
- Be able to perform TUG and 10MWT (3 times).
Exclusion Criteria:
- Debilitating conditions or vision impairment that would impede full participation in the study.
- Other neurological conditions affecting the motor system or the compliance to the therapy (for example Polyneuropathy or Musculoskeletal Diseases).
- Uncontrolled epilepsy or seizures
- Significant circulatory disturbances of the stimulated extremities
- Inability to independently maintain the seated position (without assistance) for about 60 minutes.
- Pregnant
- Active or passive implanted medical devices such as pacemakers which do not allow the use of FES.
- Implanted metallic fragments in the upper and lower extremities which can limit the use of FES.
- Under the influence of anesthesia or similar medication.
- With fractures or lesions in the extremity to be stimulated.
- Inadequate control of a BCI system.
- Sensory disorders which can significantly affect the patient's ability to feel pain and to react to unsuitable proprioceptive stimuli.
- Botulinum toxin treatment of his/her paretic lower limb during this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: BCI
Patients in the BCI group will receive 25 sessions (3 times per week) of BCI training with FES and VR feedback.
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The intervention utilizes the recoveriX PRO system.
This is a neurofeedback therapy device that combines Brain-Computer Interface based motor imagery, functional electrical stimulation (FES), and virtual reality (VR).
This approach enables participants to engage in motor imagery exercises while receiving real-time feedback based on neural signals.
Participants will complete a total of 25 recoveriX sessions, scheduled at 3 sessions per week, with each session lasting 1 hour.
Other Names:
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Sham Comparator: Control
Patients in the control group receive 25 sessions (3 times per week) of FES and VR therapy.
Patients in the control group will receive the same instructions as the experimental but will not wear the EEG cap.
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The participants will train the Motor Imagination (MI) combined with Functional Electrical Stimulation (FES) and Virtual Reality (VR) feedback.
Feedback provided to the patients will not be linked to the neural signals.
The amount of stimulation delivered by the feedback devices (FES and VR) will be similar to the experimental group.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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10 Meter Walk Test
Time Frame: From enrollment to the end of treatment at 8 weeks
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The 10MWT assesses walking speed in meters per second over a short distance and is one of the most used to evaluate functional mobility, gait, and balance for lower limb therapy. This is a metric and continuous variable. The 10MWT is used for clinical purposes and in research. It supports the assessment of the degree of damage and describes the recovery of lower extremity after a stroke. Individuals walk 10 meters without assistance and the time is measured for the intermediate 6 meters to allow for acceleration and deceleration. Assistive devices can be used but should be kept consistent and documented from test to test. If physical assistance is required to walk, the 10MWT should not be performed. Patients will receive the following instructions: "Walk as fast as you can safely walk and stop when you reach the far mark." |
From enrollment to the end of treatment at 8 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Timed Up and Go test
Time Frame: From enrollment to the end of treatment at 8 weeks
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This test assesses the time that patient needs to get out of chair, walk 3 meters, turn around, walk back 3 meters, and sit down again.
The increase in TUG score is consistent with the symptomatology of stroke manifested as muscle weakness and spasticity.
Muscle weakness and spasticity are characterized by difficulty in generating appropriately timed and sufficient muscle force to accomplish a given functional task, which could explain the lengthened time score of TUG in subjects with stroke.
This is a metric and continuous variable.
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From enrollment to the end of treatment at 8 weeks
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Modified Ashworth Scale
Time Frame: From enrollment to the end of treatment at 8 weeks
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The MAS assesses the spasticity in patients after the CNS damages. This is an ordinal scale with 6 levels. Score criteria:
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From enrollment to the end of treatment at 8 weeks
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Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- de Castro-Cros M, Sebastian-Romagosa M, Rodriguez-Serrano J, Opisso E, Ochoa M, Ortner R, Guger C, Tost D. Effects of Gamification in BCI Functional Rehabilitation. Front Neurosci. 2020 Aug 21;14:882. doi: 10.3389/fnins.2020.00882. eCollection 2020.
- Sieghartsleitner S, Sebastian-Romagosa M, Cho W, Grunwald J, Ortner R, Scharinger J, Kamada K, Guger C. Upper extremity training followed by lower extremity training with a brain-computer interface rehabilitation system. Front Neurosci. 2024 Mar 4;18:1346607. doi: 10.3389/fnins.2024.1346607. eCollection 2024.
- Sebastian-Romagosa M, Udina E, Ortner R, Dinares-Ferran J, Cho W, Murovec N, Matencio-Peralba C, Sieghartsleitner S, Allison BZ, Guger C. EEG Biomarkers Related With the Functional State of Stroke Patients. Front Neurosci. 2020 Jul 7;14:582. doi: 10.3389/fnins.2020.00582. eCollection 2020. Erratum In: Front Neurosci. 2022 Sep 23;16:1032959. doi: 10.3389/fnins.2022.1032959.
- Sebastian-Romagosa M, Cho W, Ortner R, Murovec N, Von Oertzen T, Kamada K, Allison BZ, Guger C. Brain Computer Interface Treatment for Motor Rehabilitation of Upper Extremity of Stroke Patients-A Feasibility Study. Front Neurosci. 2020 Oct 21;14:591435. doi: 10.3389/fnins.2020.591435. eCollection 2020.
- Sebastian-Romagosa M, Cho W, Ortner R, Sieghartsleitner S, Von Oertzen TJ, Kamada K, Laureys S, Allison BZ, Guger C. Brain-computer interface treatment for gait rehabilitation in stroke patients. Front Neurosci. 2023 Oct 18;17:1256077. doi: 10.3389/fnins.2023.1256077. eCollection 2023.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1300/2024
- 104215020 (Other Identifier: Austrian Federal Office for Safety in Health Care)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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