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Trial registered on ANZCTR
Registration number
ACTRN12616000148471
Ethics application status
Approved
Date submitted
5/01/2016
Date registered
8/02/2016
Date last updated
22/06/2021
Date data sharing statement initially provided
22/06/2021
Date results provided
22/06/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
The evaluation of rehabilitation effects using exoskeleton EKSO GT in patients after stroke
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Scientific title
The evaluation of rehabilitation effects using exoskeleton EKSO GT in patients after stroke
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Secondary ID [1]
288229
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
hemiparesis
297148
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ambulation/gait limitations
297149
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mental health
297150
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quality of life
297151
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Stroke
297487
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Condition category
Condition code
Stroke
297374
297374
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0
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Ischaemic
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Neurological
297674
297674
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0
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Other neurological disorders
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Physical Medicine / Rehabilitation
297675
297675
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study will recruit individuals who have experienced a stroke. It will be focused on evaluation of the efficacy of new technology, a lower body exoskeleton EKSO GT with Variable Assist software extension (EKSO Bionics, Richmond, CA, USA), that allows ambulation of patients with various neurological disorders. All measurement procedures will be performed by members of the research team on subjects, that have been qualified to EKSO training basing on inclusion and exclusion criteria provided by both Ekso Bionics (in terms of safe use of the device) and the lead researcher (to maintain the coherence of the research group). The physical therapists conducting the training are certified EKSO Physical Therapist. Each training session will involve standing and walking in EKSO GT exosceleton. The intervention will be administrated on an individual one-on-one basis.
The duration of each training session will depend on the patient capabilities to walking, but will not exceed 60 min each. The training of each evaluated individual will be made over the course of 4 weeks, 3-4 times a week. The frequency of sessions will be determined each time at the discretion of the treating therapist. Each training session in Ekso GT will be stored in exosceleton software and noted in patients personal medical documentation. Evaluation of the patients state will be made at baseline and after 4 weeks of treatment.
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Intervention code [1]
293519
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Treatment: Devices
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Intervention code [2]
293520
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Rehabilitation
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Comparator / control treatment
The subjects in control group will recieve a standard rehabilitation typical for stroke survivors. It will include gait reeducation, neurorehabilitation with e.g PNF or Bobath methods. The rehabilitation will be administrated 3-4 times a week. Evaluation of the patients state will be made at baseline and after 4 weeks of treatment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Changes in quality of ambulation assessed by surface electromyography with foot-switch sensors,
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Assessment method [1]
296925
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Timepoint [1]
296925
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Baseline, after 4 weeks of treatment
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Primary outcome [2]
296926
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Changes in functional abilities assessed by balance analysis -evaluated by baropodometric platform
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Assessment method [2]
296926
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Timepoint [2]
296926
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Baseline and after 4 weeks of treatment
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Primary outcome [3]
297215
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Changes in functional abilities assessed by muscles strength analysis - evaluated by isokinetic dynamometer
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Assessment method [3]
297215
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Timepoint [3]
297215
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Baseline and after 4 weeks of treatment
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Secondary outcome [1]
319712
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Changes in gait progression assessed by walking time in EKSO, training mode type in EKSO, level of assists in EKSO, step count (composite secondary outcome)
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Assessment method [1]
319712
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Timepoint [1]
319712
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Baseline, during every second training session and after 4 weeks of treatment
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Secondary outcome [2]
319713
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Changes in gait quality assessed by surface electromyography with footswitch sensors. Analysis of muscle timing, recruitment over the gait phases, differences in activation between body sides and the changes over time
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Assessment method [2]
319713
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Timepoint [2]
319713
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Baseline and after 4 weeks of treatment
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Secondary outcome [3]
319714
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Changes in balance and load distribution assessed by baropodometric platform. Stabilometric evaluation of quiet standing (eyes open/eyes closed), weight bearing during quiet standing and stand up from chair/sit down on chair tasks.
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Assessment method [3]
319714
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Timepoint [3]
319714
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Baseline and after 4 weeks of treatment
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Secondary outcome [4]
319715
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Changes in muscular strength assessed by isokinetic dynamometer during knee flexion-extension
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Assessment method [4]
319715
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Timepoint [4]
319715
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Baseline and after 4 weeks of treatment
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Secondary outcome [5]
319716
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Cardiovascular effect of treatment assessed by heart rate and blood pressure measurements - evaluated by automatic sphygmomanometer
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Assessment method [5]
319716
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Timepoint [5]
319716
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Baseline, during every second training session and after 4 weeks of treatment
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Secondary outcome [6]
319717
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Impact of treatment on Spasticity assessed by Modified Ashworth Scale (MAS)
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Assessment method [6]
319717
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Timepoint [6]
319717
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Baseline, during every second training session and after 4 weeks of treatment
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Secondary outcome [7]
319718
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Change in bladder and bowel function assessed by medical staff evaluation- (composite secondary outcome)
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Assessment method [7]
319718
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Timepoint [7]
319718
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Baseline, during every second training session and after 4 weeks of treatment
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Secondary outcome [8]
319719
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Changes in functional abilities assessed by Riverbed Mobility Index, Barthel Index and neurological evaluation (exteroceptive sensation – sensation of touch, vibration, squeeze, proprioception, mirror test)
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Assessment method [8]
319719
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Timepoint [8]
319719
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Baseline and after 4 weeks of treatment
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Secondary outcome [9]
319720
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Quality of life assessed by questionnaire - Stroke Speci c Quality of Life Scale (SS-QOL) and SF-36
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Assessment method [9]
319720
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Timepoint [9]
319720
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Baseline and after 4 weeks of treatment
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Eligibility
Key inclusion criteria
Subjects must be post stroke – 1st ischaemic stroke incident
Subjects must be able to fit into device and have joint motion to allow ambulation in device
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Second or another stroke incident
Difference in lower limbs length bigger then 2 cm
Joint contractures of the hip, knee, or ankle that might limit normal ROM during ambulation
Medical issue that precludes full weight bearing and ambulation (e.g. orthopedic injuries, pain, severe osteoporosis, or severe spasticity)
History of significant problems with skin breakdown or current skin breakdown that would prevent subject from wearing the device
Cognitive and/or communicative disability (e.g. due to brain injury). Patients must be able to follow directions and demonstrate learning capability
Pregnancy
Untreated deep vein thrombosis (DVT)
Weight above 100 kg
Height lower then 150 cm or above 190 cm
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
11/05/2015
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Actual
11/05/2015
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Date of last participant enrolment
Anticipated
30/12/2016
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Actual
30/11/2017
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Date of last data collection
Anticipated
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Actual
31/12/2017
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
7490
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Poland
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State/province [1]
7490
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Funding & Sponsors
Funding source category [1]
292611
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University
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Name [1]
292611
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University of Physical Education in Krakow
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Address [1]
292611
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al. Jana Pawla II 78
31-571 Krakow
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Country [1]
292611
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Poland
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Primary sponsor type
Individual
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Name
prof. Anna Mika
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Address
University of Physical Education in Krakow
al. Jana Pawla II 78
31-571 Krakow
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Country
Poland
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Secondary sponsor category [1]
291332
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None
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Name [1]
291332
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None
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Address [1]
291332
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None
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Country [1]
291332
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Other collaborator category [1]
278751
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Other
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Name [1]
278751
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Institute of Physical Education, State Higher Vocational School in Nowy Sacz, Poland
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Address [1]
278751
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ul Kosciuszki 2
33-300 Nowy Sacz
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Country [1]
278751
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Poland
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294092
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The Ethical Committee of Regional Medical Chamber in Krakow
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Ethics committee address [1]
294092
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ul. Krupnicza 11a 31-123 Krakow
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Ethics committee country [1]
294092
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Poland
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Date submitted for ethics approval [1]
294092
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Approval date [1]
294092
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01/10/2014
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Ethics approval number [1]
294092
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77/KBL/OLI/2014
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Summary
Brief summary
Limitations of independent walking after stroke and of functional status are serious problem for a growing group of patients. Restoration of walking abilities by various mechanical devices and locomotor training have been previously reported. Therapy for neurological recovery of walking may include locomotor training with the use of body weight supported treadmill training by either, a robotic training system or manual placement of the feet during the treadmill walking. The most technologically advanced devices for mechanical support of the gait are exoskeletons. An exoskeleton is a wearbale robot which support or, in some cases substitute for the user’s own movements. The aim of this study is the evaluation of the quality of ambulation and functional status of stroke survivors while using the robotic exoscelaton. This study will recruit individuals who have experienced an ischemic stroke. It will be focused on evaluation of the efficacy of new technology, a lower body exoskeleton EKSO GT with Variable Assist software extension(EKSO Bionics, Richmond, CA, USA), that allows ambulation of patients with various neurological disorders. The Variable Assist software feature allows the patients with hemiparesis to be trained only on the affected side, whilst the non-affected side works as a non-motorized support frame only. The other feature is the ability of adaptation of the level of force support given to the lower limbs by EKSO drives independently to each limb. Those two features might significantly improve the therapy outcomes made with the use of the EKSO system. Members of the research team will perform all of the evaluation listed in methods section on subjects, that have been qualified to EKSO training basing on inclusion and exclusion criteria provided by both Ekso Bionics (in terms of safe use of the device) and the lead researcher (to maintain the coherence of the research group). The Physical therapists conducting the training are certified EKSO Physical Therapist. The training of each evaluated individual will be made over the course of 4 weeks, 3-4 times a week. The subjects in control group will recieve a standard rehabilitation typical for stroke survivors. It wil include gait reeducation, neurorehabilitation with e.g PNF or Bobath methods. The rehabilitation will be administrated 3-4 times a week. Evaluation of the patients state will be made before the first training session and after last one.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Anna Mika
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Address
60326
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University of Physical Education in Krakow
al. Jana Pawla II 78
31-571 Krakow
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Country
60326
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Poland
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Phone
60326
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+48 12 6831134
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Fax
60326
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Email
60326
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[email protected]
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Contact person for public queries
Name
60327
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Anna Mika
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Address
60327
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University of Physical Education in Krakow
al. Jana Pawla II 78
31-571 Krakow
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Country
60327
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Poland
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Phone
60327
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+48 12 6831134
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Fax
60327
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Email
60327
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[email protected]
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Contact person for scientific queries
Name
60328
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Anna Mika
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Address
60328
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University of Physical Education in Krakow
al. Jana Pawla II 78
31-571 Krakow
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Country
60328
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Poland
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Phone
60328
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+48 12 6831134
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Fax
60328
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Email
60328
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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