The ReWalk Exoskeletal Walking System for Persons With Paraplegia (VA_ReWalk)

This study is currently recruiting participants. (see Contacts and Locations)
Verified March 2014 by James J. Peters Veterans Affairs Medical Center
Sponsor:
Information provided by (Responsible Party):
Ann M. Spungen, EdD, James J. Peters Veterans Affairs Medical Center
ClinicalTrials.gov Identifier:
NCT01454570
First received: September 14, 2011
Last updated: March 27, 2014
Last verified: March 2014
  Purpose

It is well appreciated that an extreme sedentary lifestyle from paralysis, contributes to many secondary medical problems such as diabetes and insulin resistance, obesity, constipation, poor blood pressure regulation, cardiovascular disease, reduced quality of life, and more. The ReWalk-I exoskeleton walking device permits investigation of the potential benefits of frequent upright posture and walking on many of the secondary consequences of spinal cord injury. The researchers are investigating the ability of persons with paraplegia to learn to stand and walk with the ReWalk-I and the effects of being upright and walking on several of these secondary medical consequences of spinal cord injury.


Condition Phase
Paraplegia
Phase 1

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: The ReWalk Exoskeletal Walking System for Persons With Paraplegia

Resource links provided by NLM:


Further study details as provided by James J. Peters Veterans Affairs Medical Center:

Primary Outcome Measures:
  • Percent change from baseline [ Time Frame: ReWalk training at 4 and 12 weeks, and 1-month follow-up ] [ Designated as safety issue: No ]

    1. To determine efficacy for mobility defined as the ability to perform the following with the ReWalk-I exoskeletal system, without staff assistance:

    1. Sit-to-stand,
    2. Stand-to-sit,
    3. Standing balance for 1 minutes with both crutches,
    4. Standing balance for 30 seconds with one crutch,
    5. Ten meter walk in ≤2 minutes,
    6. Walk ≥30 meters in 6-minutes, and
    7. Ascend, turn around and descend 4 stairs in 5 minutes.


Secondary Outcome Measures:
  • Percent change from baseline [ Time Frame: ReWalk training at 4 and 16 weeks, and 1-month follow-up ] [ Designated as safety issue: No ]
    Sitting and standing balance skills, bowel function, bladder function by survey, muscle spasms by survey, quality of life by survey, resting and exercise energy expenditure, body composition, and neurological tests. Additional mobility training will be observed for a timed-up-and-go (TUG) and a mild obstacle course (incline, decline, carpeting, step, simulated curb, walking in a figure 8)


Estimated Enrollment: 40
Study Start Date: February 2011
Estimated Study Completion Date: November 2015
Estimated Primary Completion Date: April 2015 (Final data collection date for primary outcome measure)
Detailed Description:

Potential participants will be pre-screened with the inclusion criteria for eligibility. The informed consent process will begin for those participants who have been determined to meet the inclusion criteria. After the potential participant's signed consent has been provided, further evaluations for eligibility will be performed (e.g., there are several medical and physical exclusion criteria). Those potential participants who meet both the inclusion and exclusion criteria will be eligible to enroll into the ReWalk-I study. Baseline evaluations and personalized measurements for fitting to the ReWalk-I will be performed over one week, before the training sessions begin. The ReWalk sessions will consist of a Learning Phase (12 sessions in 4 weeks) and a Training Phase (18 sessions in 6 weeks). These times may vary by each participant's ReWalk learning curve. Training will begin with sit-to-stand, stand-to-sit, and standing balance activities. Progression to walking will occur as skills advance. Each session will be an average 50 minutes, with 3 sessions per week. The skills to be learned include 1) sit-to-stand, 2) stand-to-sit, 3) 2-arm standing balance, 4) 1-arm standing balance, 5) walking, and 6) stair climbing. The study evaluations will be repeated after the Learning Phase, after the Training Phase and 1-month post training follow-up.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
  1. Do you have paraplegia?
  2. Is your SCI greater than 6 months?
  3. Are you between the ages of 18 to 65y?
  4. Is your height between 63 and 75 inches?
  5. Do you weigh less than 220 pounds?
  6. Are you legally able to sign for your own consent?

Persons who answer "no" to any of the above questions will not be eligible for the study

Criteria

Inclusion Criteria:

  1. Males or females with paraplegia
  2. Duration of SCI >6 months
  3. Ages 18 to 65 y
  4. Height 160 to 190cm (63-75in or 5'3" to 6'3")
  5. Weight <100kg (<220 lb)
  6. Ability to give informed consent

Exclusion Criteria:

  1. Diagnosis of neurological injury other than SCI including:

    • Multiple sclerosis (MS)
    • Stroke
    • Cerebral Palsy (CP)
    • Amyotrophic lateral sclerosis (ALS)
    • Traumatic Brain injury (TBI)
    • Spina bifida
    • Parkinson's disease (PD)
    • Other neurological condition that the study physician considers in his/her clinical judgment to be exclusionary
  2. Severe concurrent medical disease, illness or condition
  3. Recent lower extremity fracture within the past 2 years;
  4. DXA results indicating a t-score below -3.0 and knee BMD <0.70 gm/cm2
  5. Systemic or peripheral infection
  6. Atherosclerosis, congestive heart failure, or history of myocardial infarction
  7. Trunk and/or lower extremity pressure ulcers;
  8. Other illness, that the study physician considers in his/her clinical judgment to be exclusionary
  9. Severe spasticity (defined by an Ashworth score of >4.0 or clinical impression of the study physician or physical therapist)
  10. Significant contractures defined as flexion contracture limited to 35º at the hip and 20º at the knee;
  11. Diagnosis of heterotrophic ossification of the lower extremities;
  12. Femoral neck or the total proximal femur bone mineral density T-scores < -3.0
  13. Psychopathology documentation in the medical record or history of that may conflict with study objectives
  14. Hypertension (SBP>140, DBP>90)
  15. Pregnancy and/or lactating females
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01454570

Locations
United States, New York
James J. Peters Veterans Affairs Medical Center; Center of Excellence for the Major Consequences of SCI. Recruiting
Bronx, New York, United States, 10468
Contact: Pierre K Asselin, MSBioMedEng    718-584-9000 ext 3124    pierre.asselin@va.gov   
Contact: Steven Knezevic, MSExerPhys    718-584-9000 ext 3130    steven.knezevic@va.gov   
Principal Investigator: Ann M Spungen, EdD         
Sponsors and Collaborators
James J. Peters Veterans Affairs Medical Center
Investigators
Principal Investigator: Ann M Spungen, EdD Bronx JJPVAMC CoE 7A-13
  More Information

Additional Information:
No publications provided

Responsible Party: Ann M. Spungen, EdD, Associate Director of CoE / Health Science Specialist, James J. Peters Veterans Affairs Medical Center
ClinicalTrials.gov Identifier: NCT01454570     History of Changes
Other Study ID Numbers: JJPVAMC: SPU-09-11, Protocol#: SPU-09-11
Study First Received: September 14, 2011
Last Updated: March 27, 2014
Health Authority: United States: Institutional Review Board
United States: Federal Government

Keywords provided by James J. Peters Veterans Affairs Medical Center:
exoskeleton walking system
paraplegia
paralysis

Additional relevant MeSH terms:
Paraplegia
Paralysis
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms

ClinicalTrials.gov processed this record on October 19, 2014