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Trial registered on ANZCTR
Registration number
ACTRN12612000636853
Ethics application status
Approved
Date submitted
1/06/2012
Date registered
14/06/2012
Date last updated
15/06/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Acute Neural and Biomechanical Effects of the Tibion Bionic Leg
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Scientific title
Acute Neural and Biomechanical Effects of the Tibion Bionic Leg in Persons Post-stroke
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Secondary ID [1]
280248
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Nil
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Universal Trial Number (UTN)
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Trial acronym
n/a
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
post-stroke hemiparesis
286202
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Condition category
Condition code
Neurological
286412
286412
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0
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Other neurological disorders
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Stroke
286876
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0
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Haemorrhagic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The goal of this study is to quantify the acute effects of the Tibion Bionic leg, a wearable exoskeleton robot that provides actuated limb assistance. We will study: a) neuromechanical parameters of walking and transfers and b) acute/immediate neural adaptations to during dynamic walking.
In Study1, participants will be observed walking and transferring (i.e., sit-to-stand) in their usual manner and walking and transferring while wearing the Tibion Bionic leg. Persons with hemiparesis post-stroke will wear the Bionic Leg on their more affected side. Healthy, age-matched control participants will wear the Bionic leg on a randomly chosen side. Three-dimensional motion analysis, including kinetics and EMG, will obtained to quantify the neuromechanical effects of actuated limb assistance. Activities in Study1 will involve approximately 8 hours of participation distributed over two sessions (days).
In Study2, both participants post-stroke and healthy controls will be studied during walking on an instrumented treadmill with and without the Tibion Bionic leg. Transcranial magnetic stimulation (TMS) will be delivered during walking to probe cortical excitability and modulation of intra-cortical inhibition during walking. TMS will be used as a probe (rather than an intervention) to assess adaptations in neuromotor control while walking with the Tibion Bionic Leg. Activities in Study2 will involve approximately 4hours of participation in one session.
Single-pulse TMS will be delivered to the motor cortex at sub-threshold intensity during walking. Stimulations will be delivered at a specific point in the gait cycle (i.e., initial contact) once per step for 30-50 steps. Paired-pulse TMS (sub-threshold stimulation followed by supra threshold stimulation at inter-stimulus intervals of 1-6ms) will be delivered to the same region of motor cortex during walking.
Participants in Study1 who meet inclusion criteria will be invited to participate in Study2. Enrollment in Study2 will be approximately 90days following Study1.
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Intervention code [1]
284592
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Treatment: Devices
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Intervention code [2]
284593
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Rehabilitation
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Comparator / control treatment
In Study1 neuromechanical function in persons post-stroke will be compared between performance with and without the Tibion Bionic Leg. Comparisons will also be made to age and gender matched control participants walking and performing sit-to-stand with and without the Tibion Bionic Leg.
In Study2, within subject comparisons will be made between with and without Tibion Bionic Leg conditions.
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Control group
Active
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Outcomes
Primary outcome [1]
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Study1a - knee joint power (kinetics) of side wearing the Tibion Bionic Leg - during walking
Kinetics are measuring using instrumented motion analysis including force plates.
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Assessment method [1]
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Timepoint [1]
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Study1a - Comparison between with and without Tibion Leg
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Primary outcome [2]
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Study1b - Proportion of total Vertical Ground Reaction Force (vGRF) contributed by paretic side during sit-to-stand
vGRF is measured using force plates in a motion analysis lab.
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Assessment method [2]
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Timepoint [2]
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Study1b - Comparison between with and without Tibion leg
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Primary outcome [3]
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Study2 - Intracortical inhibition (ICI) of the ipsilesional hemisphere
ICI is measured using transcranial magnetic stimulation (TMS).
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Assessment method [3]
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Timepoint [3]
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Study2 - Comparison during walking with and without Tibion leg
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Secondary outcome [1]
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Study1a - Paretic Limb Single-limb (PSLS) support time
PSLS is measured using motion analysis.
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Assessment method [1]
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Timepoint [1]
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Study1a - Comparison between with and without Tibion Leg
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Secondary outcome [2]
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Study1b - Knee joint power during sit-to-stand
Joint powers are measured using motion analysis including force plates.
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Assessment method [2]
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Timepoint [2]
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Study1b - Comparison between with and without Tibion leg
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Secondary outcome [3]
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Study2 - Paretic Limb Single-limb support time
PSLS is measured using motion analysis.
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Assessment method [3]
297735
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Timepoint [3]
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Study2 - Comparison during walking with and without Tibion leg
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Eligibility
Key inclusion criteria
stroke (either ischemic or hemorrhagic)-at least one, no more than three,
cortical or sub-cortical distribution,
minimum of 6months post-event,
ability to walk 25' on level using assistive devices and/or orthotics
ability to follow three-step commands
Health individuals, age and gender-matched to stroke participants.
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Minimum age
18
Years
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Maximum age
95
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
brainstem or cerebellar stroke
multiple strokes
BoTox injections within 90 days of enrollment
for Study2 - history of and/or risk of seizure, metal implants in head.
Healthy Controls both studies, any history of orthopaedic, neurologic or cardiovascular pathology.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/03/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
45
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4232
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United States of America
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State/province [1]
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FL
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Tibion Corporation
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Address [1]
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247 Santa Ana Court
Sunnyvale, CA 94085
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Country [1]
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United States of America
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Primary sponsor type
Commercial sector/Industry
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Name
Tibion Corporation
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Address
247 Santa Ana Court
Sunnyvale, CA 94085
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Country
United States of America
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Secondary sponsor category [1]
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University
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Name [1]
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University of Florida
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Address [1]
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College of Public Health & Health Professions
Department of Physical Therapy
Box 100154, UFHSC
Gainesville, FL 32610-0154
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Country [1]
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United States of America
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Secondary sponsor category [2]
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Government body
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Name [2]
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Department of Veterans Affairs
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Address [2]
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VA Brain Rehabilitation Research Center
Malcom Randall VAMC
1601 SW Archer Rd. (151A)
Gainesville, Florida 32608
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Country [2]
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United States of America
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Florida IRB-01
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Ethics committee address [1]
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IRB-01 Box 100173 Gainesville FL 32610-0173
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Ethics committee country [1]
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United States of America
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Date submitted for ethics approval [1]
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Approval date [1]
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24/08/2010
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Ethics approval number [1]
287369
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Summary
Brief summary
The goal of this project is to understand the immediate neural and mechanical effects of the Tibion PK-100 brace on walking function and sit-to-stand of persons post-stroke. Given our current working knowledge of the PK-100 Bionic Leg, we hypothesize that the actuation afforded by the PK-100 will enable improved biomechanical alignment and inter-segmental coordination to reveal: a) increased knee extension in stance phase and b) increased hip extension in mid-late stance that will be maintained into pre-swing. Together, these critical biomechanical components will enable c) unlocking of the knee at the stance-to-swing transition producing: i) increased knee flexion in pre-swing and early swing, ii) improved ankle plantar flexion at terminal stance and iii) improved limb momentum during the stance—to-swing transition. The enhanced stability and improved inter-segmental biomechanical alignment afforded by the PK-100 will facilitate enhanced neuromuscular activation of the paretic limb as evidenced by: a) increased magnitude of muscle activations, b) altered timing of muscle activation patterns towards normal and c) shift in joint powers towards normal. Study1 will address biomechanical parameters including motion patterns, kinetics and muscle activation patterns. Study2 will address parameters of neural control including: cortical excitability and intra-cortical inhibition of the ipsilesional hemisphere during walking with and without the Tibion Bionic Leg.
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Trial website
n/a
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Trial related presentations / publications
none to date
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Albina Guri
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Address
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Brain Rehabilitation Research Center
1601 SW Archer Rd (151A)
Gainesville, FL 32608
USA
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Country
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United States of America
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Phone
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+1 352 376 1611 x5441
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Fax
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+1 352 379 2332
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Email
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[email protected]
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Contact person for scientific queries
Name
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Carolynn Patten, Ph.D., PT
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Address
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Brain Rehabilitation Research Center
1601 SW Archer Rd (151A)
Gainesville, FL 32608
USA
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Country
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United States of America
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Phone
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+1 352 376 1611 x4160
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Fax
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+1 352 379 2332
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF