Spinal Cord InjuriesNCT03875066
Immediate Effects of Stepping Training Using External Feedback in Spinal Cord Injury Patients
A study testing Stepping training without feedback and Stepping training with feedback in people with Spinal Cord Injuries, run by Khon Kaen University at 1 site in Thailand.
Trial summary
Does stepping training with or without external feedback change functional ability of ambulatory patients with iSCI immediately after training? Are there significant differences between the immediate effects of stepping training with or without external feedback in ambulatory patients with iSCI? Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Spinal Cord Injuries
- What is being tested?
- Stepping training without feedback and Stepping training with feedback
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteThailand
- Study dates
- 19 Apr 2017to 31 Jul 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Independent ambulatory patients with iSCI at a chronic stage (Post-injury time > 12 months)
- Traumatic cause or non-progressive disease
- Independent walking with or without assistive devices at least 17 meters (Functional Independence Measure Locomotor (FIM-L) scores 5-7)
- Age at least 18 years
- Body mass index (BMI) between 18.5 - 29.9 kg/m2.
Who cannot join
- Any conditions or disorders that might affect ability to participate in the study and/or ambulatory ability of the subjects such as
- Brain function disorders
- Visual deficits that cannot be corrected using glasses or contact lens
- Musculoskeletal pain (with an intensity of pain more than 5 out of 10 on a numerical rating pain scale)
- Deformity of the musculoskeletal system
- Unable to follow a command of the tests
- Unstable medical conditions
- Color blindness
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Immediate Effects of Stepping Training With or Without External Feedback on Walking and Functional Ability in Ambulatory Patients With Spinal Cord Injury
- Does stepping training with or without external feedback change functional ability of ambulatory patients with iSCI immediately after training?
- Are there significant differences between the immediate effects of stepping training with or without external feedback in ambulatory patients with iSCI?
Read the detailed description
To compare immediate effects of stepping training with or without the utility of external feedback on functional ability relating to walking in ambulatory patients with iSCI (between-group comparison).
Secondary objective To compare immediate effects in a group of stepping training with or without the utility of external feedback on functional ability relating to walking in ambulatory patients with iSCI (within-group comparison).
- Conditions
- Spinal Cord Injuries
- Being tested
- Stepping training without feedback, Stepping training with feedback
- Keywords
- Rehabilitation, Neurological condition, Walking ability, Feedback, External information
- Medical subject headings
- Spinal Cord Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Stepping training without feedbackOther
Also called Control program
Subjects stand in a step standing position with placing one leg on the load cells of the device and the other leg at the posterolateral direction to the trained leg outside the load cells. Then subjects will be instructed to shift/take their body-weight onto the trained leg as most as they can. If the subjects can take a proper level of their body-weight onto the trained leg, the subjects can step the other leg forward to the marker. Then they have to do the same when steps the leg backward.
Stepping training with feedbackOther
Also called Experimental program
Subjects stand in a step standing position with placing one leg on the load cells of the device and the other leg at the posterolateral direction to the trained leg outside the load cells, look at the displayed section which will be positioned at their eye level. Then subjects will be instructed to shift/take their body-weight onto the trained leg until the green zone of the displayed section is lightened. When the subjects can take a proper level of their body-weight onto the trained leg, the beep sound will be alarmed to trigger the subjects and therapist that the subjects can step the other leg forward to the marker. Then they have to do the same when steps the leg backward.
| Study group | Role | What they receive |
|---|---|---|
| A to B | Other | Subjects were involved in an control training program (A). After 2 weeks washout period, Subjects were trained using the other program (B). Receives: Other: Stepping training without feedback; Other: Stepping training with feedback |
| B to A | Other | Subjects were involved in an control training program (B). After 2 weeks washout period, Subjects were trained using the other program (A). Receives: Other: Stepping training without feedback; Other: Stepping training with feedback |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change of walking balance using Timed up and go test [TUGT]
The test was designed to measure mobility and dynamic balance control related to walking. Subjects will be instructed to stand up from a standard chair, walk at a fastest and safe speed for 3 meters, turn around a traffic cone, walk back and sit down on the chair with or without a walking device. Then the average time required for the 3 trials will be recorded.
Measured: Baseline and immediately after complete one section training program
Secondary outcomes (3)
Change of walking speed using 10 meter walk test (10MWT)
The test assessed the time required over the 4 m in the middle of the 10-m walkway at a comfortable and fastest speed with or without an assistive device. The time was converted to a walking speed using the formula:
velocity (m/s) = distance (m)/ time (second).
Measured: Baseline and immediately after complete one section training program
Change of lower limb muscle strength using Five times sit-to-stand [FTSST]
The test has used to quantify lower extremity motor strength. The time taken to complete 5 chair-rise cycles at a fastest and safe speed will be recorded for each subject. Then the average time required for the 3 trials will be used for data analysis.
Measured: Baseline and immediately after complete one section training program
Change of lower limb support ability [LLSA] on more and less affected legs
The test was assessed to reflect a risk of musculoskeletal disorders. Participants stood upright with placing the tested leg on the digital load cell (Model L6E3-C, accuracy up to 0.1 kg, and uncertainty of the measurement ± 0.082 kg: patent application number 1701004050) and the other leg posterolaterally to the tested leg. Participants were instructed to shift their body-weight anterolaterally onto the tested leg as much as they could, and step the other leg forward, with or without using the arms according to their ability. Then the LLSA data was reported in term of percent of the participant's body-weight. These data were presented for the less and more affected limbs as identified using the sensorimotor scores. Each participant performed five trials per leg, the first two trials served as practice trials, and an other three trials were used for data analysis.
Measured: Baseline and immediately after complete one section training program
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Mar 2019
- Study start19 Apr 2017
- Primary completion31 Oct 2018
- Study completion31 Jul 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (23)Papers the sponsor has linked to this study.
- Other trials for Spinal Cord InjuriesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 30 participants (actual)
Sponsor and investigators
- Lead sponsor
- Khon Kaen University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Sugalya Amatachaya, Khon Kaen University
- Investigators
- Sugalya Amatachaya, Principal investigator, Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03875066
- Sponsor's protocol ID
- PHD57K0194
- Status last verified
- Mar 2019
- First submitted
- 10 Mar 2019
- Last updated
- 9 Dec 2019
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ada L, Dean CM, Lindley R, Lloyd G. Improving community ambulation after stroke: the AMBULATE Trial. BMC Neurol. 2009 Feb 11;9:8. doi: 10.1186/1471-2377-9-8.
PubMed 19208261Amatachaya S, Amatachaya P, Keawsutthi M, Siritaratiwat W. External cues benefit walking ability of ambulatory patients with spinal cord injury. J Spinal Cord Med. 2013 Nov;36(6):638-44. doi: 10.1179/2045772312Y.0000000086. Epub 2013 Apr 12.
PubMed 24090447Amatachaya S, Keawsutthi M, Amatachaya P, Manimmanakorn N. Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 2009 Sep;47(9):668-73. doi: 10.1038/sc.2008.168. Epub 2009 Jan 13.
PubMed 19139759Amatachaya S, Naewla S, Srisim K, Arrayawichanon P, Siritaratiwat W. Concurrent validity of the 10-meter walk test as compared with the 6-minute walk test in patients with spinal cord injury at various levels of ability. Spinal Cord. 2014 Apr;52(4):333-6. doi: 10.1038/sc.2013.171. Epub 2014 Jan 21.
PubMed 24445972Amatachaya S, Wannapakhe J, Arrayawichanon P, Siritarathiwat W, Wattanapun P. Functional abilities, incidences of complications and falls of patients with spinal cord injury 6 months after discharge. Spinal Cord. 2011 Apr;49(4):520-4. doi: 10.1038/sc.2010.163. Epub 2010 Dec 14.
PubMed 21151192Baer G, Smith M. The recovery of walking ability and subclassification of stroke. Physiother Res Int. 2001;6(3):135-44. doi: 10.1002/pri.222.
PubMed 11725595Balasubramanian CK, Bowden MG, Neptune RR, Kautz SA. Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis. Arch Phys Med Rehabil. 2007 Jan;88(1):43-9. doi: 10.1016/j.apmr.2006.10.004.
PubMed 17207674Behrman AL, Bowden MG, Nair PM. Neuroplasticity after spinal cord injury and training: an emerging paradigm shift in rehabilitation and walking recovery. Phys Ther. 2006 Oct;86(10):1406-25. doi: 10.2522/ptj.20050212.
PubMed 17012645Behrman AL, Harkema SJ. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000 Jul;80(7):688-700.
PubMed 10869131Bohannon RW. Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehabil. 2005 Sep;19(6):662-7. doi: 10.1191/0269215505cr873oa.
PubMed 16180603Bohannon RW, Smith J, Hull D, Palmeri D, Barnhard R. Deficits in lower extremity muscle and gait performance among renal transplant candidates. Arch Phys Med Rehabil. 1995 Jun;76(6):547-51. doi: 10.1016/s0003-9993(95)80509-5.
PubMed 7763154Brotherton SS, Krause JS, Nietert PJ. A pilot study of factors associated with falls in individuals with incomplete spinal cord injury. J Spinal Cord Med. 2007;30(3):243-50. doi: 10.1080/10790268.2007.11753932.
PubMed 17684890Brotherton SS, Krause JS, Nietert PJ. Falls in individuals with incomplete spinal cord injury. Spinal Cord. 2007 Jan;45(1):37-40. doi: 10.1038/sj.sc.3101909. Epub 2006 Feb 21.
PubMed 16491105Calancie B, Needham-Shropshire B, Jacobs P, Willer K, Zych G, Green BA. Involuntary stepping after chronic spinal cord injury. Evidence for a central rhythm generator for locomotion in man. Brain. 1994 Oct;117 ( Pt 5):1143-59. doi: 10.1093/brain/117.5.1143.
PubMed 7953595Capato TT, Tornai J, Avila P, Barbosa ER, Piemonte ME. Randomized controlled trial protocol: balance training with rhythmical cues to improve and maintain balance control in Parkinson's disease. BMC Neurol. 2015 Sep 7;15:162. doi: 10.1186/s12883-015-0418-x.
PubMed 26347052
Study at a glance
From the registry record, last updated by the sponsor on 9 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Immediate Effects of Stepping Training With or Without External Feedback on Walking and Functional Ability in Ambulatory Patients With Spinal Cord Injury
- ClinicalTrials.gov ID
- NCT03875066
- Acronym / sponsor ID
- PHD57K0194
- Conditions
- Spinal Cord Injuries
- Keywords
- Rehabilitation, Neurological condition, Walking ability, Feedback, External information
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Khon Kaen UniversityUniversity, hospital or other
- Study start
- 19 Apr 2017 (actual)
- Primary completion
- 31 Oct 2018 (actual)
- Study completion
- 31 Jul 2019 (actual)
- First posted
- 14 Mar 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
- Does stepping training with or without external feedback change functional ability of ambulatory patients with iSCI immediately after training?
- Are there significant differences between the immediate effects of stepping training with or without external feedback in ambulatory patients with iSCI?
Detailed description
To compare immediate effects of stepping training with or without the utility of external feedback on functional ability relating to walking in ambulatory patients with iSCI (between-group comparison).
Secondary objective To compare immediate effects in a group of stepping training with or without the utility of external feedback on functional ability relating to walking in ambulatory patients with iSCI (within-group comparison).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| A to B | Other | Other: Stepping training without feedback, Other: Stepping training with feedbackSubjects were involved in an control training program (A). After 2 weeks washout period, Subjects were trained using the other program (B). |
| B to A | Other | Other: Stepping training without feedback, Other: Stepping training with feedbackSubjects were involved in an control training program (B). After 2 weeks washout period, Subjects were trained using the other program (A). |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Independent ambulatory patients with iSCI at a chronic stage (Post-injury time > 12 months)
- Traumatic cause or non-progressive disease
- Independent walking with or without assistive devices at least 17 meters (Functional Independence Measure Locomotor (FIM-L) scores 5-7)
- Age at least 18 years
- Body mass index (BMI) between 18.5 - 29.9 kg/m2.
Key exclusion criteria (8 listed)
- Any conditions or disorders that might affect ability to participate in the study and/or ambulatory ability of the subjects such as
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Stepping training without feedbackAlso: Control programSubjects stand in a step standing position with placing one leg on the load cells of the device and the other leg at the posterolateral direction to the trained leg outside the load cells. Then subjects will be instructed to shift/take their body-weight onto the trained leg as most as they can. If the subjects can take a proper level of their body-weight onto the trained leg, the subjects can step the other leg forward to the marker. Then they have to do the same when steps the leg backward. | Other | A to B, B to A |
| Stepping training with feedbackAlso: Experimental programSubjects stand in a step standing position with placing one leg on the load cells of the device and the other leg at the posterolateral direction to the trained leg outside the load cells, look at the displayed section which will be positioned at their eye level. Then subjects will be instructed to shift/take their body-weight onto the trained leg until the green zone of the displayed section is lightened. When the subjects can take a proper level of their body-weight onto the trained leg, the beep sound will be alarmed to trigger the subjects and therapist that the subjects can step the other leg forward to the marker. Then they have to do the same when steps the leg backward. | Other | A to B, B to A |
Primary outcome
Change of walking balance using Timed up and go test [TUGT]
Time frame: Baseline and immediately after complete one section training program
The test was designed to measure mobility and dynamic balance control related to walking. Subjects will be instructed to stand up from a standard chair, walk at a fastest and safe speed for 3 meters, turn around a traffic cone, walk back and sit down on the chair with or without a walking device. Then the average time required for the 3 trials will be recorded.
3 secondary outcomes
Change of walking speed using 10 meter walk test (10MWT)
Time frame: Baseline and immediately after complete one section training program
Change of lower limb muscle strength using Five times sit-to-stand [FTSST]
Time frame: Baseline and immediately after complete one section training program
Change of lower limb support ability [LLSA] on more and less affected legs
Time frame: Baseline and immediately after complete one section training program
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Dec 2019.
- Background: PubMed 19208261Ada L, Dean CM, Lindley R, Lloyd G. Improving community ambulation after stroke: the AMBULATE Trial. BMC Neurol. 2009 Feb 11;9:8. doi: 10.1186/1471-2377-9-8.
- Background: PubMed 24090447Amatachaya S, Amatachaya P, Keawsutthi M, Siritaratiwat W. External cues benefit walking ability of ambulatory patients with spinal cord injury. J Spinal Cord Med. 2013 Nov;36(6):638-44. doi: 10.1179/2045772312Y.0000000086. Epub 2013 Apr 12.
- Background: PubMed 19139759Amatachaya S, Keawsutthi M, Amatachaya P, Manimmanakorn N. Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 2009 Sep;47(9):668-73. doi: 10.1038/sc.2008.168. Epub 2009 Jan 13.
- Background: PubMed 24445972Amatachaya S, Naewla S, Srisim K, Arrayawichanon P, Siritaratiwat W. Concurrent validity of the 10-meter walk test as compared with the 6-minute walk test in patients with spinal cord injury at various levels of ability. Spinal Cord. 2014 Apr;52(4):333-6. doi: 10.1038/sc.2013.171. Epub 2014 Jan 21.
- Background: PubMed 21151192Amatachaya S, Wannapakhe J, Arrayawichanon P, Siritarathiwat W, Wattanapun P. Functional abilities, incidences of complications and falls of patients with spinal cord injury 6 months after discharge. Spinal Cord. 2011 Apr;49(4):520-4. doi: 10.1038/sc.2010.163. Epub 2010 Dec 14.
- Background: PubMed 11725595Baer G, Smith M. The recovery of walking ability and subclassification of stroke. Physiother Res Int. 2001;6(3):135-44. doi: 10.1002/pri.222.
- Background: PubMed 17207674Balasubramanian CK, Bowden MG, Neptune RR, Kautz SA. Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis. Arch Phys Med Rehabil. 2007 Jan;88(1):43-9. doi: 10.1016/j.apmr.2006.10.004.
- Background: PubMed 17012645Behrman AL, Bowden MG, Nair PM. Neuroplasticity after spinal cord injury and training: an emerging paradigm shift in rehabilitation and walking recovery. Phys Ther. 2006 Oct;86(10):1406-25. doi: 10.2522/ptj.20050212.
- Background: PubMed 10869131Behrman AL, Harkema SJ. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000 Jul;80(7):688-700.
- Background: PubMed 16180603Bohannon RW. Manual muscle testing: does it meet the standards of an adequate screening test? Clin Rehabil. 2005 Sep;19(6):662-7. doi: 10.1191/0269215505cr873oa.
- Background: PubMed 7763154Bohannon RW, Smith J, Hull D, Palmeri D, Barnhard R. Deficits in lower extremity muscle and gait performance among renal transplant candidates. Arch Phys Med Rehabil. 1995 Jun;76(6):547-51. doi: 10.1016/s0003-9993(95)80509-5.
- Background: PubMed 17684890Brotherton SS, Krause JS, Nietert PJ. A pilot study of factors associated with falls in individuals with incomplete spinal cord injury. J Spinal Cord Med. 2007;30(3):243-50. doi: 10.1080/10790268.2007.11753932.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Sugalya Amatachaya principal investigator
Faculty of Associated Medical Sciences, Khon Kaen University, Thailand
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Stepping training without feedback and Stepping training with feedback in people with Spinal Cord Injuries, run by Khon Kaen University at 1 site in Thailand.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Thailand. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change of walking balance using Timed up and go test [TUGT] (time frame: Baseline and immediately after complete one section training program). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03875066, which also lists 23 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Dec 2019.