REWARD: REcovery of Walking Ability using a Robotic Device

ISRCTN ISRCTN67827069
DOI https://doi.org/10.1186/ISRCTN67827069
Secondary identifying numbers N/A
Submission date
07/01/2013
Registration date
05/02/2013
Last edited
13/01/2015
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Injury, Occupational Diseases, Poisoning
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Approximately half of the population of patients with lesions (damage) of the spinal cord have a motor or sensory incomplete lesion (iSCI), meaning that there is still some muscle function or sensory function present in regions below the lesion level. Although the majority of the iSCI population regains some form of ambulation (walking) after rehabilitation, loss of strength and coordination substantially limit the ability to walk. The improvement of walking ability is an important goal during rehabilitation after an iSCI because even small gains in ambulation can make a meaningful amelioration (improvement) of a patient’s daily life. In the last decade, to relieve therapists and improve duration of therapy, therapy has been automated using robotic devices such as the Lokomat, a commercially available device. The goal of this initial study is to investigate whether walking speed and other gait related outcome measures improves during an intervention in which the Lokomat device is used.

Who can participate?
Patients were recruited from both the inpatient and outpatient clinic of a rehabilitation center in Amsterdam (Reade Rehabilitation and Rheumatology, Amsterdam). Patients were asked to participate in the study if they were older than 17 years, have overall good health and have a motor or sensory incomplete lesion.

What does the study involve?
Patients were treated on the LokomatPro device (Hocoma, Switzerland) for a total of 24 sessions. Three settings were manipulated during this study: speed, amount of body weight support (BWS) and the amount of assistance of the robotic orthoses, Guidance Force (GF). These settings were used so that the patients were still able to walk for about 20-45 minutes without getting tired/exhausted. The ultimate goal was to be to walk at high but still comfortable speed, with as little body weight support and guidance force as possible for as many minutes possible within the therapy time. The duration of the training sessions was 60 minutes, including preparation time. Before and after the intervention patients had several tests to asses walking ability, strength, fitness and balance.

What are the possible benefits and risks of participating?
Patients received an extra 24 sessions therapy in the Lokomat. Possible beneficial effects are improved walking ability, improved strength, improved fitness and improved bowel function. Information from this study will help to guide clinical recommendations on optimal therapy after incomplete spinal cord injury.
By taking part in this study these patients may become fatigued (tired) by the training. Furthermore, there is a small risk on mild burns on the skin due to friction and possible discomfort from straps with which the body weight is supported during therapy.

Where is the study run from?
The study ran from Amsterdam Rehabilitation Research Centre

When is the study starting and how long is it expected to run for?
The study started in January 2009 and has ended in late 2012.

Who is funding the study?
Funding has been provided by Revalidatiefonds

Who is the main contact?
Prof. Dr. T.W.J. Janssen
T.W.J.Janssen@vu.nl

Contact information

Prof Thomas W.J. Janssen
Scientific

Van der Boechorststraat 9
Amsterdam
1081BT
Netherlands

Email T.W.J.Janssen@vu.nl

Study information

Study designPre-test post-test single group design
Primary study designInterventional
Secondary study designNon randomised controlled trial
Study setting(s)Hospital
Study typeQuality of life
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleREWARD: REcovery of Walking Ability using a Robotic Device: a pre-test, post-test single group study
Study acronymREWARD
Study objectivesWe hypothesized that patients would significantly improve their walking ability, strength and cardiorespiratory fitness during the intervention period.
Ethics approval(s)Centrale Commissie Mensgebonden Onderzoek (CCMO) VU University Medical Centre (NL22052.029.08)
Health condition(s) or problem(s) studiedIncomplete Spinal Cord Injury
InterventionPatients are treated on the Lokomat for a total of 24 sessions, with a frequency of twice a week (for 12 weeks).
Intervention typeDevice
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)
Primary outcome measureWalking speed at the timed 10m walk test at baseline and after the intervention of 24 sessions after twelve weeks
Secondary outcome measures1. Functional Ambulation Categories (FAC)
2. Berg Balance Scale (BBS)
3. Rivermead Mobility Index (RMI)
4. Hoffer classification (HOF)
5. Self-selected Walking Index for Spinal Cord Injury II (WISCI II)
6. Timed get-up and go test (TUG)
7. Cardiorespiratory outcome measures and isometric maximal knee extension and flexion strength

Measured at baseline and after the intervention of 24 sessions after twelve weeks
Overall study start date01/01/2009
Completion date01/09/2012

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants40
Key inclusion criteriaPatients, both male and female were asked to participate in the study if they were older than 17 years and had a motor or sensory incomplete lesion according to American Spinal Injury Association (ASIA) classification.
Key exclusion criteria1. Medical complications such as unstable hypertension, arrhythmias and unstable cardiovascular problems
2. Severe skeletal problems such as osteoarthritis or osteoporosis of the lower limbs
Date of first enrolment01/01/2009
Date of final enrolment01/09/2012

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Van der Boechorststraat 9
Amsterdam
1081BT
Netherlands

Sponsor information

Rehabilitation Fund (Revalidatiefonds) (Netherlands)
Government

J.F. Kennedylaan 99
Bunnik
3981 GB
Netherlands

Email secretariaat@fbw.vu.nl
Website http://www.revalidatiefonds.nl/
ROR logo "ROR" https://ror.org/02vmzh064

Funders

Funder type

Government

Rehabilitation Fund (Revalidatiefonds) (Netherlands)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/06/2013 Yes No