VA Study on Powered Exoskeletons In Persons with SCI comes to an end

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      Bobby Marinov
      Keymaster

        Investigators:

        Ann M Spungen, EdD James J. Peters Veterans Affairs Medical Center

        Source: https://clinicaltrials.gov/ct2/show/NCT02658656

        Study Description

        Background Veterans with spinal cord injury (SCI) have many adverse secondary medical and quality of life (QOL) changes as a result of immobilization. Veterans with SCI who have completed rehabilitation after injury and are unable to ambulate receive a wheelchair as standard of care (SOC) for mobility. Powered exoskeletons are a technology that has recently become available as an alternate form of mobility by providing an external framework for support and computer controlled motorized hip and knee joints to assist with over ground ambulation.
        Condition or disease Intervention/treatment Phase
        Spinal Cord Injury Device: ReWalk 6.0 Not Applicable
        Study Type : Interventional  (Clinical Trial)
        Estimated Enrollment : 160 participants
        Allocation: Randomized
        Intervention Model: Parallel Assignment
        Masking: None (Open Label)
        Primary Purpose: Treatment
        Official Title: CSP #2003 – Exoskeleton Assisted-Walking in Persons With SCI: Impact on Quality of Life
        Actual Study Start Date : August 1, 2016
        Estimated Primary Completion Date : March 31, 2021
        Estimated Study Completion Date : September 30, 2021

         

        Resource links provided by the National Library of Medicine 

         

         

        Arm Intervention/treatment
        Active Comparator: Exoskeleton + SOC

        Patient will receive exoskeletal-assisted walking device for in home use for 4 months
        Device: ReWalk 6.0

        Exoskeletal Assisted Walking Device
        No Intervention: SOC

        Patient will receive standard of care (wheelchair use)
        Primary Outcome Measures :

        1. Mental Health Component Summary (MCS) of the Veterans Rand-36 (VR-36) [ Time Frame: Change from Baseline Assessment to 4 Months Post Intervention ]
          The Veterans RAND 36 Item Health Survey (VR-36) is a brief, generic, multi-use, self-administered health survey comprised of 36 items. The instrument is primarily used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific impact on general and selected populations. The items on the questionnaire correspond to eight principal health domains including general health perceptions, physical functioning, role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. The outcome in this study is the score from the Mental Health Component Summary (MCS) of the VR-36, which measures the vitality, social functioning, role-emotional, and mental health of the participant.
        2. The sum T-score for the SCI-QOL Physical Medical Health domain (three item banks of Bladder Management Difficulties, Bowel Management Difficulties, and Pain Interference) [ Time Frame: Change from Baseline Assessment to 4 Months Post Intervention ]
          The Spinal Cord Injury – Quality of Life (SCI-QOL) measurement tool was developed to assess patient reported outcome measures in persons with SCI. It is comprised of four broad domains of physical-medical health, emotional health, social participation, and physical functioning. Primary Outcome #2 will be a sum of the scores on the Bladder Management Difficulties, Bowel Management Difficulties, and Pain Interference item banks within the Physical-Medical Health domain.
        Information from the National Library of Medicine

         

        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, Learn About Clinical Studies.

        Ages Eligible for Study: 18 Years and older   (Adult, Older Adult)
        Sexes Eligible for Study: All
        Accepts Healthy Volunteers: No
        Criteria

        Inclusion Criteria:

        1. Veterans or active duty military personnel who are at least 18 years of age;
        2. Traumatic or non-traumatic SCI 6 months duration of SCI;
        3. Wheelchair-user for indoor and outdoor mobility;
        4. Anthropometric compatibility with the device:
          1. Weight <220 lb. (100 kg),
          2. Thigh length between 14 and 19 in (36 and 48 cm),
          3. Shank length between 17 and 22 in (43 and 55 cm);
        5. Able to hold the crutches in hands without modifications;
        6. Able to have a companion who can attend approximately one-third of the training sessions who will assist them at home and in the community; and
        7. Able to provide informed consent.

        Exclusion Criteria:

        1. Diagnosis of neurological injury other than SCI;
        2. Progressive condition that would be expected to result in changing neurological status;
        3. Severe concurrent medical disease, illness or condition judged to be contraindicated by the Site Physician;
        4. Unhealed or unstable traumatic or high impact lower extremity fracture (definition below) of any duration that is in the clinical judgement of the study physician to be exclusionary for standing and walking;
        5. Knee BMD < 0.60 gm/cm2;
        6. Total hip BMD T-scores < -3.5;
        7. Fragility, minimal trauma or low impact fracture of the lower extremity since spinal cord injury (definition below);
        8. Untreatable severe spasticity judged to be contraindicated by the Site Physician;
        9. Flexion contracture > 15� at the hip and/or > 10� at the knee;
        10. Limitations in ankle range of motion that cannot be adapted with an orthotic device (plantar flexion > 00);
        11. Untreated or uncontrolled hypertension (systolic blood pressure >140 mmHg; diastolic blood pressure >90 mmHg);
        12. Unresolved orthostatic hypotension (systolic blood pressure <90 mmHg; diastolic blood pressure <60 mmHg) as judged to be contraindicated by the Site Physician;
        13. Current pressure ulcer of the arms, trunk, pelvic area, or lower extremities;
        14. Psychopathology documentation in the medical record or history that may conflict with study objectives; and/or
        15. Pregnancy or women who plan to become pregnant during the study period.

        Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02658656

        Locations
        United States, California
        VA Long Beach Healthcare System, Long Beach, CA
        Long Beach, California, United States, 90822
        VA Palo Alto Health Care System, Palo Alto, CA
        Palo Alto, California, United States, 94304-1290
        United States, Florida
        James A. Haley Veterans’ Hospital, Tampa, FL
        Tampa, Florida, United States, 33612
        United States, Georgia
        Charlie Norwood VA Medical Center, Augusta, GA
        Augusta, Georgia, United States, 30904
        United States, Massachusetts
        VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
        Boston, Massachusetts, United States, 02130
        United States, Minnesota
        Minneapolis VA Health Care System, Minneapolis, MN
        Minneapolis, Minnesota, United States, 55417
        United States, Missouri
        St. Louis VA Medical Center John Cochran Division, St. Louis, MO
        Saint Louis, Missouri, United States, 63106
        United States, New Mexico
        New Mexico VA Health Care System, Albuquerque, NM
        Albuquerque, New Mexico, United States, 87108-5153
        United States, New York
        James J. Peters VA Medical Center, Bronx, NY
        Bronx, New York, United States, 10468
        United States, Ohio
        Louis Stokes VA Medical Center, Cleveland, OH
        Cleveland, Ohio, United States, 44106
        United States, Texas
        VA North Texas Health Care System Dallas VA Medical Center, Dallas, TX
        Dallas, Texas, United States, 75216
        Michael E. DeBakey VA Medical Center, Houston, TX
        Houston, Texas, United States, 77030
        South Texas Health Care System, San Antonio, TX
        San Antonio, Texas, United States, 78229
        United States, Virginia
        Hunter Holmes McGuire VA Medical Center, Richmond, VA
        Richmond, Virginia, United States, 23249
        United States, Wisconsin
        Clement J. Zablocki VA Medical Center, Milwaukee, WI
        Milwaukee, Wisconsin, United States, 53295-1000
        Sponsors and Collaborators
        VA Office of Research and Development
        Investigators
        Study Chair: Ann M Spungen, EdD James J. Peters Veterans Affairs Medical Center
        Responsible Party: VA Office of Research and Development
        ClinicalTrials.gov Identifier: NCT02658656     History of Changes
        Other Study ID Numbers: 2003
        First Posted: January 20, 2016    Key Record Dates
        Last Update Posted: October 12, 2020
        Last Verified: October 2020
        Individual Participant Data (IPD) Sharing Statement:
        Plan to Share IPD: No
        Plan Description: Individual Participant Data will not be shared.
        Studies a U.S. FDA-regulated Drug Product: No
        Studies a U.S. FDA-regulated Device Product: Yes
        Product Manufactured in and Exported from the U.S.: No
        Keywords provided by VA Office of Research and Development:
        Exoskeleton
        Additional relevant MeSH terms:
        Spinal Cord Injuries
        Spinal Cord Diseases
        Central Nervous System Diseases
        Nervous System Diseases
        Trauma, Nervous System
        Wounds and Injuries
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