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Evaluation of the Effectiveness and Safety of Keeogo™ Dermoskeleton in Subjects With Mobility Impairments Due to Stroke

Primary Purpose

Stroke, Ischemic, Stroke Hemorrhagic, Stroke

Status
Unknown status
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Keeogo™ Dermoskeleton
Sponsored by
B-Temia, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Stroke, Ischemic focused on measuring Keeogo™, Dermoskeleton, Powered dermoskeleton, Lower limb dermoskeleton, Assistive exoskeleton, Orthotic dermoskeleton

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

To be eligible to participate in this study, an individual must meet all of the following criteria:

  • Provide signed and dated informed consent form;
  • Willing to comply with all study procedures and be available for the duration of the study [2-3 days per week, 3-5 consecutive weeks];
  • Adults 18 years of age and older;
  • Confirmed Cerebrovascular Accident (CVA) with hemiparesis;
  • Stable stroke (≥ 6 months post-incident)
  • Sufficient cognition to follow simple instructions and understand the content and purpose of the study (MMSE > 20);
  • Capable of standing and walking independently for an extended period of time (MMT

    • 3 hip flexors and extensors, and ≥ 2 knee flexors and extensors with BBS ≥ 45);
  • Presence of any gait deficit, as defined by one or more of the following clinical observations:

    • Hip hike
    • Hip circumduction
    • Knee spasticity (MAS 2 to 3) as per Modified Ashworth Scale (MAS)
    • Mid-foot striking (aka 'flat foot landing')
    • Poor foot clearance (toe/foot drop or foot drag)
    • Narrow steps (< 1 shoe-width or < 8 cm)
  • Manual Muscle Test (MMT) of 4/5 for the unaffected upper extremity;
  • Able to sit on a bench for more than 5 minutes;
  • Is physically and mentally compatible with device to demonstrate ability to safely activate the Keeogo™ user interface;
  • Able to understand and follow instructions with assistance if needed.

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participation in this study:

  • Legally blind
  • Pregnant, lactating, or postpartum sacroiliac joint recovery is ongoing (recent childbirth, not yet cleared for vigorous exercise)
  • Skin condition that contraindicates use of orthotics or support braces
  • Recent (<6 mo) lower-body hospitalizations or active treatments due to a joint, muscle, bone, nerve or vascular injury or condition
  • Scheduled for major surgery within next 4 months
  • Lower-extremity amputation above or below the knee
  • Have uncontrolled hypertension
  • Recent (<1 year) heart attack
  • Have uncontrolled diabetes
  • Diagnosed with other health condition(s) that affect mobility and balance; chronic obstructive pulmonary disease; peripheral arterial disease; vestibular disorders; cerebellar disease; cerebral palsy; muscular dystrophy spinal cord injury; other brain injury aside from the reported CVA;

Sites / Locations

  • Shirley Ryan Ability Lab (SRA)
  • Human Performance and Engineering Research (HPER)
  • James J Peters VA Medical Center - Center for the Medical Consequences of Spinal Cord Injury
  • Assistive Technology Clinic (ATC)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Keeogo™ Dermoskeleton

Arm Description

Keeogo™ Dermoskeleton is a low-profile, assistive exoskeleton (or 'dermoskeleton') that orthotically fits to the lower limbs. Keeogo™ is worn on the user's lower body using a belt and contact areas attached around the thighs and calves.

Outcomes

Primary Outcome Measures

Incidence of device-related adverse events [Safety]
Safety will be evaluated on the basis of the number of device-related serious adverse events reported for subjects during their participation in the study.

Secondary Outcome Measures

Incidence of device malfunctions during study procedures [Device Reliability]
Device reliability will be evaluated on the basis of the number of device malfunctions reported by research study staff for the duration of study procedures at each study site.
Incidence of injury to Physical Therapist (PT) caused by device [PT safety]
PT safety will be evaluated on the basis of the number of serious device-related injuries reported by study physical therapists for the duration of study procedures at each study site.
Device, Effectiveness
Clinician and Patient Reported Outcomes (surveys) will be used to assess the effectiveness of the device in assisting gait. The surveys will rate subject performance in walking based on clinician observed deviations and subject perception of mobility limitation due to the stroke. Device effectiveness will be measured based on statistical analysis of the survey data between conditions (baseline compared to device-use) Ratings by the surveys will be validated using instrumented walkway and image data collected during walking.

Full Information

First Posted
June 6, 2019
Last Updated
October 25, 2019
Sponsor
B-Temia, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03986320
Brief Title
Evaluation of the Effectiveness and Safety of Keeogo™ Dermoskeleton in Subjects With Mobility Impairments Due to Stroke
Official Title
A Multi-site, Interventional, Comparative, Single-arm Trial to Evaluate the Safety and Effectiveness of Keeogo™ Dermoskeleton in Subjects With Hemiparesis Due to Ischemic or Hemorrhagic Stroke.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Unknown status
Study Start Date
July 22, 2019 (Actual)
Primary Completion Date
March 2020 (Anticipated)
Study Completion Date
September 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
B-Temia, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
A multi-site, interventional, non-comparative, single-arm trial to evaluate the safety of the Keeogo™ Dermoskeleton in subjects with hemiparesis due to ischemic or hemorrhagic stroke.
Detailed Description
Stroke affects thousands of individuals annually, leading to considerable physical impairment and functional disability. Gait is one of the most important activities of daily living affected in this patient population. Recent technological developments in passively powered dermoskeleton can create powerful adjunctive tools for rehabilitation and potentially accelerate functional recovery. Here, the investigators present the development and evaluation of a lower limb dermoskeleton, namely Keeogo™ (B-Temia), for use in rehabilitation institutions to assist individuals with hemiparesis due to stroke who are able to stand and initiate a step in performing ambulatory functions. Keeogo™ Dermoskeleton is a low-profile, assistive exoskeleton (or 'dermoskeleton') that orthotically fits to the lower limbs. Keeogo™ is worn on the user's lower body using a belt and contact areas attached around the thighs and calves.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, Ischemic, Stroke Hemorrhagic, Stroke, Hemiparesis, Cerebral Vascular Accident
Keywords
Keeogo™, Dermoskeleton, Powered dermoskeleton, Lower limb dermoskeleton, Assistive exoskeleton, Orthotic dermoskeleton

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Device: Keeogo™ Dermoskeleton This device is intended for use in rehabilitation institutions to assist individuals with hemiparesis due to stroke who are able to stand and initiate a step in performing ambulatory functions.
Masking
None (Open Label)
Masking Description
Sites will enroll participants in order of recruitment. No other randomization procedure will be applied.
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Keeogo™ Dermoskeleton
Arm Type
Experimental
Arm Description
Keeogo™ Dermoskeleton is a low-profile, assistive exoskeleton (or 'dermoskeleton') that orthotically fits to the lower limbs. Keeogo™ is worn on the user's lower body using a belt and contact areas attached around the thighs and calves.
Intervention Type
Device
Intervention Name(s)
Keeogo™ Dermoskeleton
Intervention Description
This device is intended for use in rehabilitation institutions to assist individuals with hemiparesis due to stroke who are able to stand and initiate a step in performing ambulatory functions.
Primary Outcome Measure Information:
Title
Incidence of device-related adverse events [Safety]
Description
Safety will be evaluated on the basis of the number of device-related serious adverse events reported for subjects during their participation in the study.
Time Frame
Duration of study participation for each subject, estimated 3-5 weeks
Secondary Outcome Measure Information:
Title
Incidence of device malfunctions during study procedures [Device Reliability]
Description
Device reliability will be evaluated on the basis of the number of device malfunctions reported by research study staff for the duration of study procedures at each study site.
Time Frame
Duration of study completion for each site, estimated 3-5 weeks
Title
Incidence of injury to Physical Therapist (PT) caused by device [PT safety]
Description
PT safety will be evaluated on the basis of the number of serious device-related injuries reported by study physical therapists for the duration of study procedures at each study site.
Time Frame
Duration of study completion for each site, estimated 3-5 weeks
Title
Device, Effectiveness
Description
Clinician and Patient Reported Outcomes (surveys) will be used to assess the effectiveness of the device in assisting gait. The surveys will rate subject performance in walking based on clinician observed deviations and subject perception of mobility limitation due to the stroke. Device effectiveness will be measured based on statistical analysis of the survey data between conditions (baseline compared to device-use) Ratings by the surveys will be validated using instrumented walkway and image data collected during walking.
Time Frame
Duration of study participation for each subject, estimated 3-5 weeks
Other Pre-specified Outcome Measures:
Title
30-Second Chair Stand Test
Description
Subjects sit in the middle of chair and place hands on opposite shoulder crossed at wrists. Keeping feet flat on floor, back straight, arms against chest, subjects rise to full standing position when told "go" followed by sit down, the start position. This movement is repeated for as many times as possible for 30 seconds. Additionally, the test is repeated for a total of 5 cycles with short rest (≤ 90 seconds) between sets. Patient and Clinician reported outcomes are assessed for this measure via a sit-to-stand-to-sit question on the survey given for the secondary effectiveness endpoint.
Time Frame
Duration of study completion for each site, estimated 3-5 weeks
Title
Timed Stair Test
Description
Subjects start with both feet on the bottom landing then ascend and descend a set number of stairs as quickly as possible in a safe manner using a rail only if needed. Time is recorded from ascent through descent. Patient and Clinician reported outcomes are assessed for this measure via a stair ascent/descent question on the survey given for the secondary effectiveness endpoint.
Time Frame
Duration of study completion for each site, estimated 3-5 weeks
Title
Patient and Clinician Reported Outcomes (surveys)
Description
Questionnaires provide patient and clinician-centric view of treatment of gait deficit.
Time Frame
Duration of study completion for each site, estimated 3-5 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible to participate in this study, an individual must meet all of the following criteria: Provide signed and dated informed consent form; Willing to comply with all study procedures and be available for the duration of the study [2-3 days per week, 3-5 consecutive weeks]; Adults 18 years of age and older; Confirmed Cerebrovascular Accident (CVA) with hemiparesis; Stable stroke (≥ 6 months post-incident) Sufficient cognition to follow simple instructions and understand the content and purpose of the study (MMSE > 20); Capable of standing and walking independently for an extended period of time (MMT 3 hip flexors and extensors, and ≥ 2 knee flexors and extensors with BBS ≥ 45); Presence of any gait deficit, as defined by one or more of the following clinical observations: Hip hike Hip circumduction Knee spasticity (MAS 2 to 3) as per Modified Ashworth Scale (MAS) Mid-foot striking (aka 'flat foot landing') Poor foot clearance (toe/foot drop or foot drag) Narrow steps (< 1 shoe-width or < 8 cm) Manual Muscle Test (MMT) of 4/5 for the unaffected upper extremity; Able to sit on a bench for more than 5 minutes; Is physically and mentally compatible with device to demonstrate ability to safely activate the Keeogo™ user interface; Able to understand and follow instructions with assistance if needed. Exclusion Criteria: An individual who meets any of the following criteria will be excluded from participation in this study: Legally blind Pregnant, lactating, or postpartum sacroiliac joint recovery is ongoing (recent childbirth, not yet cleared for vigorous exercise) Skin condition that contraindicates use of orthotics or support braces Recent (<6 mo) lower-body hospitalizations or active treatments due to a joint, muscle, bone, nerve or vascular injury or condition Scheduled for major surgery within next 4 months Lower-extremity amputation above or below the knee Have uncontrolled hypertension Recent (<1 year) heart attack Have uncontrolled diabetes Diagnosed with other health condition(s) that affect mobility and balance; chronic obstructive pulmonary disease; peripheral arterial disease; vestibular disorders; cerebellar disease; cerebral palsy; muscular dystrophy spinal cord injury; other brain injury aside from the reported CVA;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arun Jayaraman, PT, PhD.
Organizational Affiliation
Shirley Ryan Ability Lab (SRA)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shirley Ryan Ability Lab (SRA)
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Human Performance and Engineering Research (HPER)
City
West Orange
State/Province
New Jersey
ZIP/Postal Code
07052
Country
United States
Facility Name
James J Peters VA Medical Center - Center for the Medical Consequences of Spinal Cord Injury
City
Bronx
State/Province
New York
ZIP/Postal Code
10468
Country
United States
Facility Name
Assistive Technology Clinic (ATC)
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M6A 2E1
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
26289955
Citation
Buesing C, Fisch G, O'Donnell M, Shahidi I, Thomas L, Mummidisetty CK, Williams KJ, Takahashi H, Rymer WZ, Jayaraman A. Effects of a wearable exoskeleton stride management assist system (SMA(R)) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial. J Neuroeng Rehabil. 2015 Aug 20;12:69. doi: 10.1186/s12984-015-0062-0.
Results Reference
background
PubMed Identifier
30248015
Citation
Xu J, Murphy SL, Kochanek KD, Bastian B, Arias E. Deaths: Final Data for 2016. Natl Vital Stat Rep. 2018 Jul;67(5):1-76.
Results Reference
background
PubMed Identifier
28533700
Citation
He Y, Eguren D, Luu TP, Contreras-Vidal JL. Risk management and regulations for lower limb medical exoskeletons: a review. Med Devices (Auckl). 2017 May 9;10:89-107. doi: 10.2147/MDER.S107134. eCollection 2017.
Results Reference
background
PubMed Identifier
29183379
Citation
Lee SH, Lee HJ, Chang WH, Choi BO, Lee J, Kim J, Ryu GH, Kim YH. Gait performance and foot pressure distribution during wearable robot-assisted gait in elderly adults. J Neuroeng Rehabil. 2017 Nov 28;14(1):123. doi: 10.1186/s12984-017-0333-z.
Results Reference
background
PubMed Identifier
23850614
Citation
Morawietz C, Moffat F. Effects of locomotor training after incomplete spinal cord injury: a systematic review. Arch Phys Med Rehabil. 2013 Nov;94(11):2297-308. doi: 10.1016/j.apmr.2013.06.023. Epub 2013 Jul 9.
Results Reference
background
Links:
URL
https://www.cdc.gov/nchs/fastats/disability.htm
Description
Disability and Functioning (Noninstitutionalized Adults Aged 18 and Over)
URL
http://www.phac-aspc.gc.ca/publicat/cd-mc/mc-ec/assets/pdf/mc-ec-eng.pdf
Description
Mapping Connections. An Understanding of Neurological Conditions in Canada. The National Population Health Study of Neurological Conditions.: Neurological Health Charities Canada. Government of Canada. Canadian Institutes of Health Research.
URL
https://www150.statcan.gc.ca/n1/pub/12-581-x/2018000/pop-eng.htm
Description
Canada S. Canada at a Glance 2018. Population
URL
https://www.federalregister.gov/documents/2015/02/24/2015-03692/medical-devices-physical-medicine-devices-classification-of-the-powered-exoskeleton
Description
Medical Devices; Physical Medicine Devices; Classification of the Powered Exoskeleton A Rule by the Food and Drug Administration on 02/24/2015
URL
https://www.cdc.gov/nchs/fastats/stroke.htm
Description
(CDC) CfDCaP. National Center for Health Statistics - Cerebrovascular Disease or Stroke

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Evaluation of the Effectiveness and Safety of Keeogo™ Dermoskeleton in Subjects With Mobility Impairments Due to Stroke

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