Study of a Pediatric Robotic Exoskeleton P.REXAgilik to Improve Walking in Children Ages 3 to 17 with Movement Disorders Affecting the Knee
Led by National Institutes of Health Clinical Center (CC) · Updated on 2025-10-27
44
Participants Needed
1
Research Sites
N/A
Total Duration
AI-Summary
What this Trial Is About
Researchers are investigating whether a robotic device worn on the legs can improve walking ability in children aged 3 to 17 years who have gait disorders involving the knee joint due to cerebral palsy, spina bifida, muscular dystrophy, or incomplete spinal cord injury. The study aims to assess the effectiveness of this wearable robot in improving knee extension and overall gait function compared to standard therapy. This trial is a randomized crossover design conducted by the National Institutes of Health Clinical Center.
Participants will undergo three 12-week phases. One phase involves continuing their usual therapy, another phase includes using a customized robotic exoskeleton in a lab setting with different modes to assist or challenge walking, and the third phase allows participants to take the exoskeleton home for daily use walking at least one hour per day, five days per week. The exoskeleton is tailored to each child through leg scanning, and its use will be monitored for safety and compliance.
Throughout the study, participants will have their walking ability assessed using physical exams, movement recordings with body markers, and tests of muscle strength and motor function before and after each phase. Researchers will measure knee joint angle during walking as the primary outcome, along with changes in muscle activity, gait speed, and gross motor function. Follow-up assessments will continue six weeks post-intervention to observe lasting effects. The total study participation spans 36 weeks.
CONDITIONS
Brief Title
Evaluating Long-term Use of a Pediatric Robotic Exoskeleton (P.REX/Agilik) to Improve Gait in Children With Movement Disorders
Research Team
T
Thomas C Bulea, Ph.D.
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National Institutes of Health Clinical Center (CC)
Lead Sponsor
How This Trial Compares With Other Options
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
Exoskeleton with motor‑assist
Exoskeleton baseline (no assist)
What it is
A motor‑assist configuration of the EA‑KAFO exoskeleton provides powered knee extension support during gait to assist walking.
The baseline configuration of the same EA‑KAFO exoskeleton does not provide powered assistance and serves as the comparator condition.
Role in trial
Investigational condition evaluated in children to assess feasibility of motor‑assisted gait.
Comparator condition within the same device representing walking without powered assistance.
Primary use
Test long‑term use of powered exoskeleton to improve gait in children with movement disorders.
Baseline walking condition without assistance to compare with powered aid.
How it is given or performed
Participants wear the EA‑KAFO exoskeleton configured with motor‑assist at the knee during walking.
Participants wear the EA‑KAFO exoskeleton in baseline configuration without motor assistance during walking.
Evidence status
Effectiveness for improving knee extension or gait is being evaluated; evidence not yet available.
Used as control condition; no evidence of benefit since it lacks motor assist.
Important risks
Risks not described; safety data pending trial results.
Risks not described; baseline configuration safety data pending trial results.
Important limitations
Only short‑term crossover comparison; generalizability to long‑term community use pending.
Baseline configuration may not reflect real‑world walking without device so comparison may have limited external relevance.
Patient impact
No direct patient‑relevant outcome evidence established yet.
Has no anticipated benefit; serves as control.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 3Years - 17Years
All Genders
Eligibility Criteria
You may qualify if you...
Signed informed consent and assent forms for screening and study participation
Willingness and ability to comply with all study procedures and availability for the study duration
Age between 3 and 17 years old
Gait pathology involving the knee joint from cerebral palsy, muscular dystrophy, spina bifida, or incomplete spinal cord injury
Knee joint range of motion of at least 25 degrees in the sagittal plane with hip extended
Ankle joint range of motion of at least 15 degrees in the sagittal plane with foot in neutral alignment
Foot-thigh angle between -15 to 30 degrees in prone position
Able to walk at least 10 feet without stopping with or without a walking aid
You will not qualify if you...
Any neurological, musculoskeletal, or cardiorespiratory condition other than the listed diagnoses that affects walking ability with the exoskeleton
History of uncontrolled seizure in the past year
Pregnancy or positive pregnancy test at screening for those able to become pregnant
Any acute cardiopulmonary condition limiting exercise to less than 60 minutes per session or less than 5 days per week
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
screening and enrollment visit
Run-in Period
Duration - Not specified
Participants complete an in-lab training and accommodation period to get familiar with the robotic exoskeleton before using it outside the clinical setting.
1 to 2 visits
Treatment
Duration - 12 weeks
Participants receive 12 weeks of overground gait training with the robotic exoskeleton outside of the clinical setting or continue standard therapy according to their randomized group assignment.
Weekly visits for monitoring and assessments during the intervention period
Follow-up
Duration - 6 weeks
Participants complete assessments 6 weeks after the intervention to evaluate the persistence of treatment effects and safety.
1 follow-up visit
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
CROSSOVER
Primary Purpose
DEVICE_FEASIBILITY
Number of Arms
2
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Published Research Related To This Trial
A randomized cross-over study protocol to evaluate long-term gait training with a pediatric robotic exoskeleton outside the clinical setting in children with movement disorders.
Taylor M Devine, Katharine E Alter, Diane L Damiano...