The ReWalk Exoskeletal Walking System for Persons With Paraplegia (VA_ReWalk)
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ClinicalTrials.gov Identifier: NCT01454570
Recruitment Status : Unknown
Verified April 2015 by Ann M. Spungen, EdD, James J. Peters Veterans Affairs Medical Center. Recruitment status was: Recruiting
First Posted : October 19, 2011
Last Update Posted : April 10, 2015
James J. Peters Veterans Affairs Medical Center
Information provided by (Responsible Party):
Ann M. Spungen, EdD, James J. Peters Veterans Affairs Medical Center
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 or disease
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.
Percent change from baseline [ Time Frame: ReWalk training at 4 and 12 weeks, and 1-month follow-up ]
1. To determine efficacy for mobility defined as the ability to perform the following with the ReWalk-I exoskeletal system, without staff assistance:
Standing balance for 1 minutes with both crutches,
Standing balance for 30 seconds with one crutch,
Ten meter walk in ≤2 minutes,
Walk ≥30 meters in 6-minutes, and
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 ]
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)
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Layout table for eligibility information
Ages Eligible for Study:
18 Years to 65 Years (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Do you have paraplegia?
Is your SCI greater than 6 months?
Are you between the ages of 18 to 65y?
Is your height between 63 and 75 inches?
Do you weigh less than 220 pounds?
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
Males or females with paraplegia
Duration of SCI >6 months
Ages 18 to 65 y
Height 160 to 190cm (63-75in or 5'3" to 6'3")
Weight <100kg (<220 lb)
Ability to give informed consent
Diagnosis of neurological injury other than SCI including:
Multiple sclerosis (MS)
Cerebral Palsy (CP)
Amyotrophic lateral sclerosis (ALS)
Traumatic Brain injury (TBI)
Parkinson's disease (PD)
Other neurological condition that the study physician considers in his/her clinical judgment to be exclusionary
Severe concurrent medical disease, illness or condition
Recent lower extremity fracture within the past 2 years;
DXA results indicating a t-score below -3.0 and knee BMD <0.70 gm/cm2
Systemic or peripheral infection
Atherosclerosis, congestive heart failure, or history of myocardial infarction
Trunk and/or lower extremity pressure ulcers;
Other illness, that the study physician considers in his/her clinical judgment to be exclusionary
Severe spasticity (defined by an Ashworth score of >4.0 or clinical impression of the study physician or physical therapist)
Significant contractures defined as flexion contracture limited to 35º at the hip and 20º at the knee;
Diagnosis of heterotrophic ossification of the lower extremities;
Femoral neck or the total proximal femur bone mineral density T-scores < -3.0
Psychopathology documentation in the medical record or history of that may conflict with study objectives