NCT05249595

Brief Summary

Robotic therapies aim to improve limb function in individuals with neurological injury. Modulation of robotic assistance in many of these therapies is achieved by measuring the extant volitional strength of limb muscles. However, current sensing techniques, such as electromyography, are often unable to correctly measure the voluntary strength of a targeted muscle. The difficulty is due to their inability to remove ambiguity caused by interference from activities of neighboring muscles. These discrepancies in the measurement can cause the robot to provide inadequate assistance or over-assistance. Improper robotic assistance slows function recovery, and can potentially lead to falls during robot-assisted walking. An ultrasound imaging approach is an alternative voluntary strength detection methodology, which can allow direct visualization and measurement of muscle contraction activities. The aim is to formulate an electromyography-ultrasound imaging-based technique to sense residual voluntary strength in ankle muscles for individuals with neuromuscular disorders. The estimated voluntary strength will be involved in the advanced controller's design of robotic rehabilitative devices, including powered ankle exoskeleton and functional electrical stimulation system. It is hypothesized that the ankle joint voluntary strength will be estimated more accurately by using the proposed electromyography-ultrasound imaging-based technique. And this will help the robotic rehabilitative devices achieve a more adaptive and efficient assistance control, and maximize the ankle joint rehabilitation training benefits.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
25

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Feb 2020

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 10, 2020

Completed
1.7 years until next milestone

First Submitted

Initial submission to the registry

November 5, 2021

Completed
4 months until next milestone

First Posted

Study publicly available on registry

February 21, 2022

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2023

Completed
Last Updated

February 21, 2022

Status Verified

February 1, 2022

Enrollment Period

3.9 years

First QC Date

November 5, 2021

Last Update Submit

February 16, 2022

Conditions

Keywords

Voluntary strengthAnkle jointNeuromuscular modelAnkle exoskeletonFunctional electrical stimulationNonlinear controlSensor fusionTreadmill walkingWalking biomechanics

Outcome Measures

Primary Outcomes (2)

  • Human volitional effort

    The investigators calculate benchmark human volitional effort (torque \[N-m\]) using inverse dynamics. The investigators predict human volitional effort (torque \[N-m\]) using neuromuscular model and aforementioned outcome measures - sEMG, ultrasound imaging.

    Through study completion, an average of 40 months.

  • Evaluate the controller performance of human ankle joint

    The investigators measure the human ankle position \[rad\] and velocity \[rad/sec\] and the desired position \[rad\] and velocity \[rad/sec\] using a commercial sensor encoder when the controller is applied.

    Through study completion, an average of 40 months.

Secondary Outcomes (4)

  • Human body joint kinematics

    Through study completion, an average of 40 months.

  • Ground Reaction Forces

    Through study completion, an average of 40 months.

  • Muscle activation level

    Through study completion, an average of 40 months.

  • Muscle ultrasound image derived measures

    Through study completion, an average of 40 months.

Study Arms (2)

Group A - Particiapnts without neurological disorders

EXPERIMENTAL

Individuals without neurological disorders will be recruited (Group A).

Device: Surface electromypgraphy-based interface to predict human ankle joint motion intent and use in ankle assistive devicesDevice: Ultrasound imaging-based interface to predict human ankle joint motion intent and use in ankle assistive devicesDevice: Surface electromypgraphy and ultrasound imaging-based interface to predict human ankle joint motion intent and use in ankle assistive devices

Group S - Participants with iSCI or transverse myelitis

EXPERIMENTAL

Individuals with neurological disorders, like iSCI or transverse myelitis, will be recruited (Group S). These individuals usually have weakened ankle joint functionalities but can walk independently.

Device: Surface electromypgraphy-based interface to predict human ankle joint motion intent and use in ankle assistive devicesDevice: Ultrasound imaging-based interface to predict human ankle joint motion intent and use in ankle assistive devicesDevice: Surface electromypgraphy and ultrasound imaging-based interface to predict human ankle joint motion intent and use in ankle assistive devices

Interventions

The study involves the validation of computer algorithms to estimate human ankle joint motion intent and control of ankle joint assistance by using either a powered exoskeleton or an FES system. The ankle joint motions will include seated posture tasks and walking tasks. The instrumented treadmill and Vicon motion capture system will be used to facilitate the cyclic walking pattern and record the participant's kinematics. The human ankle joint volitional effort will be predicted by the sEMG signals from shank muscles. The powered exoskeleton or FES system will provide ankle joint assistance based on an assist-as-needed strategy.

Group A - Particiapnts without neurological disordersGroup S - Participants with iSCI or transverse myelitis

The study involves the validation of computer algorithms to estimate human ankle joint motion intent and control of ankle joint assistance by using either a powered exoskeleton or an FES system. The ankle joint motions will include seated posture tasks and walking tasks. The instrumented treadmill and Vicon motion capture system will be used to facilitate the cyclic walking pattern and record the participant's kinematics. The human ankle joint volitional effort will be predicted by the ultrasound imaging signals from shank muscles. The powered exoskeleton or FES system will provide ankle joint assistance based on an assist-as-needed strategy.

Group A - Particiapnts without neurological disordersGroup S - Participants with iSCI or transverse myelitis

The study involves the validation of computer algorithms to estimate human ankle joint motion intent and control of ankle joint assistance by using either a powered exoskeleton or an FES system. The ankle joint motions will include seated posture tasks and walking tasks. The instrumented treadmill and Vicon motion capture system will be used to facilitate the cyclic walking pattern and record the participant's kinematics. The human ankle joint volitional effort will be predicted by combining sEMG and ultrasound imaging signals from shank muscles. The powered exoskeleton or FES system will provide ankle joint assistance based on an assist-as-needed strategy.

Group A - Particiapnts without neurological disordersGroup S - Participants with iSCI or transverse myelitis

Eligibility Criteria

Age18 Years - 64 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Age between the ages of 18 and 64,
  • Weight less than 220 lb,
  • Able to perform ankle movements such as ankle up motion, ankle down motion, side motion towards inside, and side motion towards outside while seated, and
  • Able to walk normally at a preferred speed without any assistive device.

You may not qualify if:

  • Any difficulty or an orthopedic condition that would impede ankle movements such as ankle up motion, ankle down motion, side motion towards inside, and side motion towards outside,
  • Any difficulty walking normally or without assistance,
  • Absence of sensation in lower extremities,
  • An allergy to adhesive skin tapes and/or US gels,
  • Pregnant Females,
  • No ankle muscle response to FES.
  • years of age and have a primary diagnosis of traumatic/non-traumatic iSCI or demyelinating diseases like transverse myelitis,
  • Weight less than 220 lb,
  • Sub-acute or chronic phase (at least 3 months after injury) incomplete motor lesion (AIS C or D at enrollment) at cervical, thoracic or lumbar level,
  • Ability to ambulate over ground independent using either a cane or rolling walker, as well as those that do not require any assistive devices but do have some mobility difficulties,
  • Medically stable with medical clearance for participation, no evidence of cardiopulmonary or pulmonary disease, severe spasticity, and asymmetric hip positions,
  • Ability to respond to FES on dorsiflexors and plantarflexors, and
  • No use of any FES devices or already in use of a FES device for mobility support (like a Bioness device) but will not use the device during the study.
  • Subjects with other neuromuscular diseases such as polio, stroke, or multiple sclerosis,
  • Presence of transmissible diseases such as (but not limited to) hepatitis or immunodeficiency virus,
  • +11 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

1807 N. Fordham Blvd. UNC Center for Rehabilitation Care of Chapel Hill

Chapel Hill, North Carolina, 27514, United States

RECRUITING

4212C Engineering Building III 1840 Entrepreneur Dr.

Raleigh, North Carolina, 27695, United States

RECRUITING

Related Publications (4)

  • Zhang Q, Kim K, Sharma N. Prediction of Ankle Dorsiflexion Moment by Combined Ultrasound Sonography and Electromyography. IEEE Trans Neural Syst Rehabil Eng. 2020 Jan;28(1):318-327. doi: 10.1109/TNSRE.2019.2953588. Epub 2019 Nov 14.

    PMID: 31725385BACKGROUND
  • Zhang Q, Iyer A, Kim K, Sharma N. Evaluation of Non-Invasive Ankle Joint Effort Prediction Methods for Use in Neurorehabilitation Using Electromyography and Ultrasound Imaging. IEEE Trans Biomed Eng. 2021 Mar;68(3):1044-1055. doi: 10.1109/TBME.2020.3014861. Epub 2021 Feb 18.

    PMID: 32759078BACKGROUND
  • Zhang Q, Iyer A, Sun Z, Kim K, Sharma N. A Dual-Modal Approach Using Electromyography and Sonomyography Improves Prediction of Dynamic Ankle Movement: A Case Study. IEEE Trans Neural Syst Rehabil Eng. 2021;29:1944-1954. doi: 10.1109/TNSRE.2021.3106900. Epub 2021 Sep 27.

    PMID: 34428143BACKGROUND
  • Zhang Q, Sheng Z, Moore-Clingenpeel F, Kim K, Sharma N. Ankle Dorsiflexion Strength Monitoring by Combining Sonomyography and Electromyography. IEEE Int Conf Rehabil Robot. 2019 Jun;2019:240-245. doi: 10.1109/ICORR.2019.8779530.

    PMID: 31374636BACKGROUND

MeSH Terms

Conditions

Myelitis, Transverse

Condition Hierarchy (Ancestors)

MyelitisCentral Nervous System InfectionsInfectionsParaneoplastic Syndromes, Nervous SystemNervous System NeoplasmsNeoplasms by SiteNeoplasmsParaneoplastic SyndromesDemyelinating Autoimmune Diseases, CNSAutoimmune Diseases of the Nervous SystemNervous System DiseasesCentral Nervous System DiseasesSpinal Cord DiseasesDemyelinating DiseasesNeurodegenerative DiseasesNeuroinflammatory DiseasesAutoimmune DiseasesImmune System Diseases

Central Study Contacts

Nitin Sharma, Ph.D.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
OTHER
Intervention Model
PARALLEL
Model Details: The central objective of this study is to validate a new neuromuscular interface that combines surface electromyography and ultrasound imaging to predict human ankle joint voluntary strength or movement intent under isometric and dynamic conditions. The secondary objective is to design control algorithms for a powered ankle exoskeleton and functional electrical stimulation with the consideration of human voluntary strength or movement intent that is estimated from the surface electromyography and ultrasound imaging-based interface. This study is performed with two sets of subjects: people with neurological disorders and people without any neurological disorders. (why have parallel groups)
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

November 5, 2021

First Posted

February 21, 2022

Study Start

February 10, 2020

Primary Completion

December 31, 2023

Study Completion

December 31, 2023

Last Updated

February 21, 2022

Record last verified: 2022-02

Data Sharing

IPD Sharing
Will not share

IPD will not be shared outside of this research group. However, selected data may be published in academic journals, conference papers, or other publications. This data will be de-identified, and will not include the full set of data.

Locations