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Safety and Usability of a Robotic Gait Device for Children and Adolescents With Neurological or Neuromuscular Disease in Their Natural Environment

Not Applicable
Recruiting
Conditions
Cerebral Palsy
Acquired Brain Injury
Spinal Muscular Atrophy
Interventions
Device: EXPLORER
Registration Number
NCT06167954
Lead Sponsor
MarsiBionics
Brief Summary

The goal of this clinical trial is to analyze the usability and safety of the robotic gait device EXPLORER in children with cerebral palsy, acquired brain injury and spinal muscular atrophy.

Participants will use the exoskeletons in their home and the community and variables regarding safety and usability will be measured and recorded.

Detailed Description

Neurological and neuromuscular diseases are the main cause of motor disability in children, leading to the inability to stand and walk in many cases. Robotic devices are a useful tool in the rehabilitation of these children, but most of them are designed to be used in the clinical setting. EXPLORER is a robotic device designed to assist gait in children with motor disability in their homes and the community. The aim of this study is to analyze the safety and usability of the EXPLORER in children with cerebral palsy, acquired brain injury and spinal muscular atrophy.

A test phase will be conducted in order to make some final modifications and improve the device. Some participants of the sample will use the device in 1-3 occasions in a controlled environment.

After these modifications, participants will use the final version of the device in 8 different occasions in their homes and the community in order to prove its safety and usability.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Diagnosis of cerebral palsy, acquired brain injury or spinal muscular atrophy
  • Medical authorization for standing, gait training and weight bearing.
  • Informed consent signed by legal guardians.
  • Maximum user weight of 60 kg.
  • Hip width (between greater trochanters) ≤40 cm.
  • Length of the thigh (distance from the greater trochanter to the lateral condyle of the tibia) from 21cm to 36cm.
  • Tibia leg length (distance from the lateral condyle of the tibia to the lateral malleolus) from 20cm to 35cm.
  • Shoe size ≤40 (EU)
Exclusion Criteria
  • Medical contraindications for standing or walking.
  • Non-reducible contractures or heterotropic ossifications above the degrees allowed by the device or out of the trajectory imposed by the device
  • Spasticity equal to 4 on the Modified Ashworth Scale at the time of use of the device.
  • More than 20º of hip and/or knee non-reducible contractures at the time of using the exoskeleton.
  • Necessity to walk with more than 5º of hip abduction.
  • Impossibility to reach 5º of ankle dorsiflexion with ir without orthoses.
  • Lower length dysmetria that cannot be mitigated with a wedge under the foot.
  • Skin lesion on parts of the lower extremities that are in contact with the device.
  • History of fracture without trauma.
  • Presence of other conditions causing exercise intolerance (such as uncontrolled hypertension, coronary artery disease, arrhythmia, congestive heart failure, severe pulmonary disease).
  • Conductual disorders that may interfere with the use of the device or their participation in the study, like impulsiveness.
  • Allergy to any of the EXPLORER materials: cotton, nylon, polyester, PPS, PEEK or ABS.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
EXPLOREREXPLORER8 sessions with the robotics gait device in their homes and natural environment for all participants
Primary Outcome Measures
NameTimeMethod
Serious Adverse Eventsthrough study completion, along 8 weeks

occurrence of any serious adverse event to the participant or the caregiver

Falls prevalencethrough study completion, along 8 weeks

Number of falling events occurred from the participant or caregiver

Oxygen saturationthrough study completion, along 8 weeks

measurement of Oxygen saturation when medical prescription

Skin integritythrough study completion, along 8 weeks

Occurrence of any injury of the skin in the areas of contact and produced by the use of the device

Pain (Visual Analogic Scale)through study completion, along 8 weeks

pain measured by the Visual Analogic Scale (VAS) by the participant and the caregiver, scored from 0 to 10, being 0 "no pain" and 10 "unbearable pain"

Heart ratethrough study completion, along 8 weeks

measurement of heart rate

Spasticitythrough study completion, along 8 weeks

spasticity measured by the Modified Ashworth Scale (MAS), scored from 0 (no spasticity) to 4 (affected part in rigid flexion or extension)

Donning and doffing timethrough study completion, along 8 weeks

Time to don and doff the device to each participant

Walking timethrough study completion, along 8 weeks

Walking time provided by the device

Blood pressurethrough study completion, along 8 weeks

measurement of blood pressure

Number of stepsthrough study completion, along 8 weeks

Number of steps taken provided by the device

Interventions of the investigatorsthrough study completion, along 8 weeks

The number of times that the investigators have to intervene in the session in order to avoid damage when the device is being used by the caregiver

Participant satisfactionat the end of the intervention, 8th week

Satisfaction of the participant (caregiver) with the device measured by the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0. (QUEST 2.0), scored with a Likert type scale from 0 to 5, being 0 the lowest satisfaction and 5 the highest possible satisfaction with the device

Secondary Outcome Measures
NameTimeMethod
Acceptabilityat the end of the intervention, 8th week

Analysis of the drop-out rate during the study period

Accessibility of the exterior spacesthrough study completion, along 8 weeks

Rate of the exterior spaces that are suitable to use the device

Accessibility of the housethrough study completion, along 8 weeks

Rate of the houses suitable to use the device

Accessibility of the participantthrough study completion, along 8 weeks

Rate of the participants suitable to use the device

Trial Locations

Locations (5)

Hospital Universitario Niño Jesús-Servicio de Neuro Ortopedia

🇪🇸

Madrid, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Universitario Gregorio Marañón

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Infantil Universitario Niño Jesús-Servicio de Rehabilitación

🇪🇸

Madrid, Spain

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