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This study aims to demonstrate the safety and effectiveness of the personal exoskeleton in individuals with spinal cord injury (SCI).
This personal exoskeleton, developed by Wandercraft as a new version of the Atalante X, offers a novel hands-free and self-balancing design, aiming at enhancing stability and mobility for users in daily activities. The study features an interventional, prospective, single-group, and open-label design, conducted over 2 months at one research facility. A minimum of 5 individuals with spinal cord injury (SCI) and their companions will be included, with the possibility of enrolling up to 10 SCI participants and their 10 respective companions. Over the course of nine to ten scheduled visits, participants undergo a sequence of procedures, beginning with screening and device fitting. This is followed by five training sessions which conclude with an evaluation to issue a competency certificate to confirm the ability to use the device across all its "basic skills". Additionally, two sessions are dedicated to evaluating the exoskeleton's effectiveness outcomes, complemented by an extra practice session. Each visit lasts an average of 1.5 hours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hands-free exoskeleton | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hands-free exoskeleton | Device | A "device trainer specialist" from the investigation site will deliver training sessions with the exoskeleton to pair of participants (a pair corresponds to an individual with SCI and his/her companion). The device trainer will follow the progression of the pair through the training program and ensure they learn all the device "basic skills". Each training session lasts an average of 1.5 hours, variations according to the user's learning pace and tolerance. During the sessions with the exoskeleton, the participants will engage in mobility activities on different surfaces and perform Activities of Daily Living in simulated environments such as kitchen, bathroom, elevators and outdoor spaces. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety of the device for its intended use and user population. | Collection and analysis of adverse events to evaluate the safety of the device for its intended use and user population, specifically for individuals with spinal cord injury (SCI) performing ambulatory activities hands-free, accompanied by a companion. | Throughout the study and up until the end of Visit 9, after an average of 9 hours of training and 3 hours of assessment. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects who complete the Timed Up and Go (TUG) in 3min or less. | The TUG evaluates the time from starting in a seated position to stand-up, walk 3 meters, turn around, walk back 3 meters and sit down on indoor surface. | After a mean of 7.5 hours of training and a mean of 9 hours of training. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of users who pass the device "basic skills" certification evaluation at the end of visit 6. | During the Certification Evaluation, the users' performance in executing all the device usability critical tasks will be observed and assessed by the trainer to ensure they are performed correctly (i.e., executed safely, regardless of the level of companion assistance, that is documented but isn't a criterion for success). The "basic skills" certification evaluation is passed if all the device basic skills have been learnt through the previous training sessions with the device (visits 2-5) and the critical tasks are re-executed correctly during the evaluation at visit 6. The device basic skills cover device theoretical knowledge, proper setup and installation in the device, walking and other ambulatory functions on different surfaces, Activities of Daily Living in indoor and outdoor environment techniques on various surfaces, and safety features such as emergency extraction. |
User inclusion criteria:
User exclusion criteria:
Companion inclusion criteria
Companion exclusion criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jeanne Vanmairis | Contact | +33 (0)1 79 35 31 09 | walkinparis@wandercraft.health |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wandercraft | Recruiting | Paris | 75004 | France |
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| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D010264 | Paraplegia |
| D011782 | Quadriplegia |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
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| Proportion of subjects who complete a distance of at least 40m on the Six-Minute Walk Test (6MWT). |
The 6MWT measures the distance in meters traversed over 6 min, on indoor surface. |
| After a mean of 7.5 hours of training and a mean of 9 hours of training. |
| Proportion of subjects who can complete at least 4 out of the 6 Activities of Daily Living (ADLs), in various simulated environments and with the exoskeleton. | The ADLs are done standing in front of the countertop in the kitchen, in a simulated living room, taking a 50m walk in the outdoor environment, taking the elevator, in the bathroom and walking in a hallway and through a door to get to the next room. | After a mean of 7.5 hours of training and a mean of 9 hours of training. |
| Proportion of subjects who complete the 10-Meter Walk Test (10MWT) on indoor surfaces in 1 minute or less. | The 10MWT measures the time in seconds taken to walk 10 meters. | After a mean of 7.5 hours of training and a mean of 9 hours of training. |
| Proportion of subjects who can don or doff the device within 10 minutes each, separately. | After a mean of 7.5 hours of training and a mean of 9 hours of training. |
| Throughout the study and up until an average of 7.5 hours of training. |
| Number of users who successfully master the different basic skills at a given visit. | For each basic skill, the visit number at which users are confirmed to have safely mastered the task is recorded on a "checklist", which lists all the device basic skills and is provided to the trainer. The goal is to track the users' learning progress and mastery of the device over time. | Throughout the study and up until an average of 7.5 hours of training. |
| Evaluation of the assistance level provided by companion. | Assistance provided by the companion when mastering each basic skill on the checklist at initial learning, at the certification evaluation, during the additional practice session and when performing each test. A 3-point scale based on the Functional Independence Measure (FIM) score, tailored to the device and its progression stage will be used: 1-Maximal assistance: The companion provides support with both hands touching the device and/or the user almost continuously. 2- Moderate assistance - The companion provides support with one or both hands touching the device and/or the user intermittently. 3- Close contact guard/no assistance - The companion does not touch the device and/or the user but is close enough to assist if needed. | Throughout the study and up until an average of 9 hours of training and 3 hours of assessment. |
| Overall Rating of Perceived Exertion (RPE) assessed with the Borg RPE scale by the users for the entire session. | The Borg scale rates the perceived exertion between 6 and 20 (very very light to very very hard exertion). The SCI users and their companions are asked to give their rating for the entire session, separately. | After an average of 7.5 hours of training, after an average of 7.5 hours of training and 1.5 hours of assessment and after an average of 9 hours of training and 3 hours of assessment. |
| Overall perceived safety with a 7-level Likert scale by the users on the entire session. | Each participant - SCI user and companion separately - will be asked to provide his/her level of agreement on the following statement: "I felt safe during the session." by using a 7-level agreement scale from 1: "Strongly disagree" to 7: "Totally agree". | After an average of 7.5 hours of training, after an average of 7.5 hours of training and 1.5 hours of assessment and after an average of 9 hours of training and 3 hours of assessment. |
| Up-right time in the device at each session. | This measure is taken by the device itself. | Throughout the study and up until an average of 9 hours of training and 3 hours of assessment. |
| Numbers of steps taken in the device at each session. | The measure is taken by the device itself. | Throughout the study and up until an average of 9 hours of training and 3 hours of assessment. |
| Distance walked in the device at each session. | The measure is taken by the device itself. | Throughout the study and up until an average of 9 hours of training and 3 hours of assessment. |
| Number of times the participants walk on each type of surface at each session. | This data is collected by the device trainers at each session. Users are considered to have walked on a surface during a session if they have covered a minimum distance of 10 meters on that surface. | Throughout the study and up until an average of 9 hours of training and 3 hours of assessment. |
| Perceived health benefits and overall satisfaction and motivation. | Perceived health benefits and overall satisfaction and motivation of the SCI users, assessed by a modified version of the Gagnon questionnaire. The statements under evaluation will be taken from the 41 statements originally found in the Gagnon questionnaire that encompass seven domains : - overall program satisfaction, - satisfaction with the robotic exoskeleton, - learnability of the robotic exoskeleton, - satisfaction with the program attributes, - perceived health benefits of walking with the robotic exoskeleton, - perceived risks and fears of walking with the robotic exoskeleton and - perceived motivation to engage in regular physical activity. | After an average of 9 hours of training and 3 hours of assessment. |
| Psychosocial Impact of Assistive Devices Scale (PIADS) Total Score | The Psychosocial Impact of Assistive Devices Scale (PIADS) is a 26-item questionnaire assessing the psychosocial impact of the exoskeleton on functional independence, well-being, and quality of life. It includes 3 subscales: competence (12 items), adaptability (6 items), and self-esteem (8 items). The questionnaire is completed after the final exoskeleton session at Visit 9. Higher scores indicate a more positive psychosocial impact of the device. | After an average of 9 hours of training and 3 hours of assessment. |
| Change in Function in Sitting Test (FIST) Total Score | The Function in Sitting Test (FIST) assesses sitting balance across sensory, motor, proactive, reactive, and steady-state components. It consists of 14 items scored from 0 to 4, with a total score range from 0 to 56. Higher scores indicate better sitting balance. Change is calculated from Visit 1 to Visit 9. | At baseline and after an average of 9 hours of training and 3 hours of assessment. |
| Change in Neurogenic Bowel Dysfunction (NBD) | The Neurogenic Bowel Dysfunction (NBD) Score evaluates bowel dysfunction in individuals with spinal cord injury. It consists of 10 weighted items, with a total score ranging from 0 to 47. Higher scores indicate more severe bowel dysfunction. Change is assessed from Visit 1 to Visit 9. | At baseline and after an average of 9 hours of training and 3 hours of assessment. |
| D014947 | Wounds and Injuries |
| D010243 | Paralysis |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |