Ignite Creation Date:
2024-05-06 @ 7:11 PM
Last Modification Date:
2024-10-26 @ 3:02 PM
Study NCT ID:
NCT05926596
Status:
NOT_YET_RECRUITING
Last Update Posted:
2023-07-03
First Post:
2023-06-22
Brief Title:
Leg Stretching Using an Exoskeleton on Demand for People With Spasticity
Sponsor:
VA Office of Research and Development
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Leg Stretching Using a Controllable Wearable Exoskeleton on Demand for People With Spasticity
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The purpose of this research study is to develop a protocol using a fully wearable portable lower-limb exoskeleton for improving leg and walking function in people with movement disorders The study investigates the effects of wearing the device during a set of experiments including leg stretching treadmill walking and overground walking in muscle activity joint motion and gait performance The goal is to develop an effective lower-limb strategy to restore lost leg function eg range of motion and gait ability and improve quality of life in people with movement deficits following a neurological disorder
Detailed Description:
People with neurological conditions including individuals with upper motor neuron injury experience motor and sensory deficits muscle weakness limited range of motion low weight-bearing capacity and impaired balance that limit ambulation and interfere with the ability to perform activities of daily living Lower-limb rehabilitation robots can assist with physical therapy and alleviate the burden of caregivers and nurses Thus the goal of this project is to develop wearable and portable technology to assist leg motion and stretching and correspondingly activate muscles in people with neurological conditions who experience spasticity
Spasticity results from increased muscle tone and interferes with the ability to functionally use voluntary muscle contraction for limb coordination and range of motion which limits body transfers ambulation and exercise Severe or intractable spasticity can lead to loss of body control and balance resulting in falls and injuries pressure injury of the skin contractures pain wheelchair seating difficulties in addition to other problems Existent treatments to manage spasticity and overcome functional deficits related to spasticity include medications neurosurgery whole body or limb vibration physical therapy passive cycling functional electrical stimulation FES along with other methods However medications may induce significant side effects including drowsiness malaise muscle weakness and pain eg at the injection site in addition their effectiveness is sensitive to dosing fluctuations Neurosurgery and direct spinal cord stimulation can treat intractable or focal spasticity but they carry surgical risks and their long-term benefits vary across individuals
Stretching can decrease the excitability of motor neurons maintain the viscoelastic properties of muscles and joints provide relief from muscles spasms and improve range of motion and gait function further stretching can be combined with oral medications to manage spasticity Stretching is performed routinely by therapists nurses and caregivers to provide muscle stretching or preserve range of motion in joints with relatively low adverse effects However providing on-demand reliable manual limb stretching throughout the day and night imposes a heavy burden on caregivers and nurses both at home and in medical facilities Hence a critical need exists to develop a wearable approach to applying on-demand safe and customized dynamic stretching to manage spasticity after SCI which can minimize the burden of caregivers and nurses
This project exploits the recent technological advances in wearable sensors and fully wearable exoskeletons with reduced form factor and weight which we have not exploited nor developed in our previous research protocols at Syracuse University These novel wearable exoskeletons are smart garments that conform to the human body and provide leg assistance in people with muscle weakness or hemiplegia Light-weight exoskeletons have the potential to expand the breadth of tasks and environments in which exoskeletons are used for Hence this project introduces a lightweight wearable exoskeleton to assist leg motion and stretching eg targeting people with spasticity under different postures eg while lying down on a mat or bed sitting on a chair or in a wheelchair
Aim 1 characterizes the performance of the wearable device and its closed-loop control algorithm to apply precise adjustments for safe automatic limb stretching and motion of single joints eg joints in isolation while sitting or lying on a mat The methods in this aim include the following 1 design a control algorithm to apply safe leg forces exploiting joint kinematics and inertial feedback data using wearable sensors and 2 examine the magnitude and timing of the applied forces to the hip knee and ankle joints and toes The research tasks in this aim will enable the customization of the applied forces across participants
Aim 2 expands the implementation of the closed-loop controller from Aim 1 to different body postures and activities that involve multi-joint control Participants wear the device to experience the applied forces by the wearable exoskeleton while lying down on a bedmat or sitting down Since the device is fully wearable it serves as a powerful tool to examine the motion and limb-stretching of individuals with neurological conditions and spasticity Thus the device is not limited to fixedstationary experimental conditions
The last aim collects qualitative data from participants caregivers nurses and clinicians if involved about the ease of use and satisfaction from using the wearable device Questionnaires and surveys are used to gather qualitative data Ease of use of the wearable device is assessed by examining if the protocol can be implemented within the expected duration including the time to don and doff the exoskeleton further it will be determined if the adherence to the protocol is achieved for all participants
Research Design- Methodology
A candidate for the study will be asked to complete a Screening Questionnaire by phone or in person to check for eligibility If the potential participant is eligible to enroll in the study the participant will receive more information regarding the enrollment process Participant will then complete a Demographics Questionnaire and answer questions about personal health and physical functioning
Each lab visit may take up to 2 hours including fitting the device warm-up testing procedures rest breaks unfitting the device and removing the electrodes and wearable sensors
Raw data will be collected from wearable sensors including the following joint angles 3D leg motion muscle electromyography EMG and motor currents from the wearable device Digital data recorded from experiments will be stored in mat files or csv password protected There are no biological specimens collected
Metadata will be applied to each component of the dataset following acquisition to ensure data is prepared for proper archiving Metadata will include type format date time storage location and context of data Data generated during this project use conventional digital formats including
MS Word Power Point Excel Portable Data Format PDF and LaTeX tex files
Graphics figures tables animations videos from tests jpeg png eps mp4 files
Code including MATLABSimulink files C code and ASCII text files
The paper participation records will be kept in locked file cabinets in the laboratory andor offices and the digital data will be stored on password-protected computersservers or encrypted electronic storage devices in the offices and laboratory of the PIs research team
Spasticity results from increased muscle tone and interferes with the ability to functionally use voluntary muscle contraction for limb coordination and range of motion which limits body transfers ambulation and exercise Severe or intractable spasticity can lead to loss of body control and balance resulting in falls and injuries pressure injury of the skin contractures pain wheelchair seating difficulties in addition to other problems Existent treatments to manage spasticity and overcome functional deficits related to spasticity include medications neurosurgery whole body or limb vibration physical therapy passive cycling functional electrical stimulation FES along with other methods However medications may induce significant side effects including drowsiness malaise muscle weakness and pain eg at the injection site in addition their effectiveness is sensitive to dosing fluctuations Neurosurgery and direct spinal cord stimulation can treat intractable or focal spasticity but they carry surgical risks and their long-term benefits vary across individuals
Stretching can decrease the excitability of motor neurons maintain the viscoelastic properties of muscles and joints provide relief from muscles spasms and improve range of motion and gait function further stretching can be combined with oral medications to manage spasticity Stretching is performed routinely by therapists nurses and caregivers to provide muscle stretching or preserve range of motion in joints with relatively low adverse effects However providing on-demand reliable manual limb stretching throughout the day and night imposes a heavy burden on caregivers and nurses both at home and in medical facilities Hence a critical need exists to develop a wearable approach to applying on-demand safe and customized dynamic stretching to manage spasticity after SCI which can minimize the burden of caregivers and nurses
This project exploits the recent technological advances in wearable sensors and fully wearable exoskeletons with reduced form factor and weight which we have not exploited nor developed in our previous research protocols at Syracuse University These novel wearable exoskeletons are smart garments that conform to the human body and provide leg assistance in people with muscle weakness or hemiplegia Light-weight exoskeletons have the potential to expand the breadth of tasks and environments in which exoskeletons are used for Hence this project introduces a lightweight wearable exoskeleton to assist leg motion and stretching eg targeting people with spasticity under different postures eg while lying down on a mat or bed sitting on a chair or in a wheelchair
Aim 1 characterizes the performance of the wearable device and its closed-loop control algorithm to apply precise adjustments for safe automatic limb stretching and motion of single joints eg joints in isolation while sitting or lying on a mat The methods in this aim include the following 1 design a control algorithm to apply safe leg forces exploiting joint kinematics and inertial feedback data using wearable sensors and 2 examine the magnitude and timing of the applied forces to the hip knee and ankle joints and toes The research tasks in this aim will enable the customization of the applied forces across participants
Aim 2 expands the implementation of the closed-loop controller from Aim 1 to different body postures and activities that involve multi-joint control Participants wear the device to experience the applied forces by the wearable exoskeleton while lying down on a bedmat or sitting down Since the device is fully wearable it serves as a powerful tool to examine the motion and limb-stretching of individuals with neurological conditions and spasticity Thus the device is not limited to fixedstationary experimental conditions
The last aim collects qualitative data from participants caregivers nurses and clinicians if involved about the ease of use and satisfaction from using the wearable device Questionnaires and surveys are used to gather qualitative data Ease of use of the wearable device is assessed by examining if the protocol can be implemented within the expected duration including the time to don and doff the exoskeleton further it will be determined if the adherence to the protocol is achieved for all participants
Research Design- Methodology
A candidate for the study will be asked to complete a Screening Questionnaire by phone or in person to check for eligibility If the potential participant is eligible to enroll in the study the participant will receive more information regarding the enrollment process Participant will then complete a Demographics Questionnaire and answer questions about personal health and physical functioning
Each lab visit may take up to 2 hours including fitting the device warm-up testing procedures rest breaks unfitting the device and removing the electrodes and wearable sensors
Raw data will be collected from wearable sensors including the following joint angles 3D leg motion muscle electromyography EMG and motor currents from the wearable device Digital data recorded from experiments will be stored in mat files or csv password protected There are no biological specimens collected
Metadata will be applied to each component of the dataset following acquisition to ensure data is prepared for proper archiving Metadata will include type format date time storage location and context of data Data generated during this project use conventional digital formats including
MS Word Power Point Excel Portable Data Format PDF and LaTeX tex files
Graphics figures tables animations videos from tests jpeg png eps mp4 files
Code including MATLABSimulink files C code and ASCII text files
The paper participation records will be kept in locked file cabinets in the laboratory andor offices and the digital data will be stored on password-protected computersservers or encrypted electronic storage devices in the offices and laboratory of the PIs research team
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 1I21RX004652-01A1 | NIH | None | httpsreporternihgovquickSearch1I21RX004652-01A1 |