Dosing overground robotic gait training after spinal cord injury: a randomized clinical trial protocol.

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2024-10-18 DOI:10.1186/s13063-024-08503-0
Alexandria Suhalka, Fernando Zanela da Silva Areas, Faith Meza, Christa Ochoa, Simon Driver, Seema Sikka, Rita Hamilton, Hui-Ting Goh, Librada Callender, Monica Bennett, Hui-Ting Shih, Chad Swank
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引用次数: 0

Abstract

Background: Robotic exoskeletons have changed rehabilitation care available to people after spinal cord injury (SCI). Yet, the current evidence base is insufficient to identify the optimal dose and neurophysiological mechanism of robotic exoskeleton gait training (RGT) as an effective rehabilitation approach. This study will (1) examine whether the frequency of RGT after motor incomplete SCI impacts function and health outcomes, (2) analyze the neuroplastic effects of RGT dose, and (3) evaluate the safety, tolerability, and feasibility of delivering RGT.

Methods: We will enroll 144 participants with motor incomplete SCI admitted to inpatient rehabilitation within 6 months of SCI. Participants will be randomized based on injury severity and level into one of 3 RGT frequency groups (high, moderate, low) or none/usual care only. Participants will complete 24 RGT sessions and be assessed at admission and discharge to inpatient rehabilitation, post-RGT intervention, 1-month post-RGT, and 9-month post-SCI. Outcomes include Walking Index for Spinal Cord Injury-II, health outcomes (gait speed, Spinal Cord Independence Measure, pain, fatigue, spasticity, general health, quality of life, physical activity), and motor evoked potential amplitudes obtained using transcranial magnetic stimulation.

Discussion: Successful completion of this study will provide an evidence-based intervention, specifically tailored to meet the unique needs of people with SCI, which supports walking recovery; maximizing health, function, and ultimately participation. The intervention will further support widespread clinical implementation of exoskeleton use during acute rehabilitation.

Trial registration: ClinicalTrials.gov NCT05218447. Registered on June 23, 2022.

脊髓损伤后的地面机器人步态训练剂量:随机临床试验方案。
背景:机器人外骨骼改变了脊髓损伤(SCI)患者的康复治疗。然而,目前的证据基础不足以确定机器人外骨骼步态训练(RGT)作为一种有效康复方法的最佳剂量和神经生理学机制。本研究将:(1)研究运动性不完全 SCI 后进行 RGT 的频率是否会影响功能和健康结果;(2)分析 RGT 剂量的神经可塑性效应;(3)评估提供 RGT 的安全性、耐受性和可行性:我们将招募 144 名患有运动性不完全 SCI 并在 SCI 后 6 个月内接受住院康复治疗的患者。参与者将根据损伤严重程度和水平随机分为 3 个 RGT 频率组(高、中、低)或无/仅常规护理组。参与者将完成 24 次 RGT 训练,并在入院和出院时接受住院康复评估、RGT 干预后评估、RGT 后 1 个月评估以及 SCI 后 9 个月评估。评估结果包括脊髓损伤步行指数-II、健康状况(步速、脊髓独立性测量、疼痛、疲劳、痉挛、一般健康状况、生活质量、体力活动)以及通过经颅磁刺激获得的运动诱发电位振幅:本研究的成功完成将提供一种循证干预措施,专门针对 SCI 患者的独特需求量身定制,支持步行康复;最大限度地提高健康、功能和最终的参与度。该干预措施将进一步支持在急性康复期间临床上广泛使用外骨骼:试验注册:ClinicalTrials.gov NCT05218447。注册日期:2022 年 6 月 23 日。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
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