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CompletedNCT03906656Updated Sep 19, 2024Results posted

Clinical Trial Comparing C-Brace to Knee Ankle Foot Orthosis (KAFO)/Stance Control Orthosis (SCO)

An interventional study of C-Brace and KAFO/SCO in Pareses, Lower Extremity, sponsored by Otto Bock Healthcare Products GmbH. Completed at 13 sites in 4 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by Otto Bock Healthcare Products GmbH · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
149
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Prospective, international, multi-center, open-labeled, randomized, controlled cross-over trial to evaluate effectiveness and benefits in patients with lower limb impairment in activities of daily living comparing the C-Brace microprocessor-controlled stance and swing orthosis to standard of care use of knee ankle foot orthosis/stance control orthoses

Read the detailed description

After obtaining informed consent, patients will be screened. For subjects fulfilling inclusion/exclusion criteria, a first baseline assessment will be conducted. Within one to two days, a second set of baseline data will be collected for performance measures. Subjects will then be randomly assigned to be fitted with C-Brace or to continue wearing the current KAFO/SCO. After fitting, an accommodation period follows that will last up to 14 days prior to the initial home use. The first follow-up data collection will occur after three months of the initial home use period. Afterwards, the patients will cross over to KAFO/SCO or C-Brace, respectively. The participants who were fitted with C-Brace will cross over to KAFO/SCO and vice versa. Another accommodation phase will be offered for both C-Brace and KAFO/SCO wearers to ensure that subjects can properly use both devices before the cross-over home use period. The second follow-up data collection will occur after 3-months of the cross-over home use period. At the end of the study, the patients can choose to keep the C-Brace for up to 24 months until reimbursement or to return to their original KAFO/SCO.

02

Conditions studied

  • Pareses, Lower Extremity

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03

In context

Paresis

468 studies on the registry are indexed under Paresis; 117 are open to participants now.

This study's enrollment of 149 is above the median of 37 across 420 interventional studies indexed under Paresis.

Browse Paresis studies →

Lead sponsor

Otto Bock Healthcare Products GmbH is the lead sponsor of 10 studies on the registry; 3 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patient has been tested with the Trial Tool (DTO) and demonstrated the potential to utilize the C-Brace successfully
  • Patient has a BBS score \< 45
  • Lower limb functional impairment according to CE label wording
  • Prior active and compliant use of unilateral or bilateral KAFO or SCO in the past 3 months prior to enrollment in the study
  • Patient meets minimum physical requirements to be fitted with a C-Brace, such as muscle status, joint mobility, leg axis and proper control of the orthosis must be guaranteed.
  • The User must fulfill the physical and mental requirements for perceiving optical/acoustic signals and/or mechanical vibrations
  • The existing muscle strength of the hip extensors and flexors must permit the controlled swing-through of the limb (compensation using the hip is possible).
  • Patient´s commitment to use C-Brace 2 at least 1-2 hours per day 5 days per week-
  • Patient is ≥ 18 years old
  • Patient is willing and able to independently provide .
  • Person is willing to comply with study procedures

Exclusion criteria

Exclusion Criteria:

  • Patient who is not able to follow the entire study visits or is unwilling/unable to follow the instructions
  • Patient was not able to use DTO
  • Patient who is not using an orthosis at least 1 to 2 hours/ day for 5 days per week
  • Patient with body weight > 125 kg (includes body weight and heaviest object (weight) carried)
  • Patient with Orthoprosthesis
  • Patient with flexion contracture in the knee and/or hip joint in excess of 10°
  • Patient with uncontrolled moderate to severe spasticity (relative moderate spasticity)
  • Leg length discrepancy in excess of 15 cm
  • Patient with unstable neurological or cardiovascular/pulmonary disease, cancer
  • Pregnancy
  • Patient using a C-Brace
  • Patient with known vertigo or with history of falls unrelated to orthosis use or unrelated to motor disability
  • Patient who has never been fitted an orthosis before
  • Patient is not able to answer the self-administered questionnaires independently; for patients with upper extremity impairment is it allowed to verbally answer the questions.
  • Patient participating already in a study during this study´s duration
  • Patient participated in earlier C-Brace studies
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
149 participants (actual)

Study arms

  • Active comparator
    KAFO/SCO

    Home use of 3 months with existing knee ankle foot orthosis (KAFO) or existing stance control orthosis (SCO)

    Device: KAFO/SCO

  • Experimental
    C-Brace

    Home use of 3 months with newly fitted C-Brace microprocessor-controlled stance and swing control orthosis.

    Device: C-Brace

Interventions

  • DeviceC-Brace

    The C-Brace consists of individually fabricated thigh, calf and foot components. An ankle joint, unilateral or bilateral fitting, or an individual spring element connects the foot and calf components. The sensor system continuously measures the flexion of the knee joint and its angular acceleration. This allows the C-Brace to detect the user's current walking phase, so it can regulate the hydraulic resistances as well as control the flexion and extension of the knee joint.

    Also known as: Microprocessor-controlled Stance and Swing Orthosis (MP-SSCO)

  • DeviceKAFO/SCO

    Current knee ankle foot orthosis that the subject was wearing at baseline

    Also known as: Locked KAFO, Posterior offset KAFO, Stance Control Orthosis

06

What researchers measure

Primary outcomes

  1. Primary Efficacy: Berg Balance Scale (BBS)

    The Berg Balance Scale is a 14-item scale designed to measure static and dynamic balance in adults in a clinical setting. The range in score for the BBS is 0 to 56, with higher scores indicating better balance. Points for each item are deducted if the time or distance requirements are not met, the patient's performance requires supervision, or the patient requires assistance from support or examiner.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

Secondary outcomes

  1. Activity-specific Balance Confidence (ABC) Scale

    Assessment of patient-perceived balance confidence for 16 activities of daily living. For each activity, subjects rate their level of confidence in doing the activity without losing their balance or becoming unsteady on a scale from 0% to 100%, with 100% being the highest level of confidence. The total score for the ABC scale is an average of all activity scores.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  2. Dynamic Gait Index (DGI)

    An 8-item test used to assess balance during walking tasks. It has a maximum score of 24 with each item being scored 0-3. A higher score indicates greater balance, and subjects lose a a point on all items for which an assistive device is needed.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  3. 6-minute Walk Test

    Distance walked in 6 minutes over 12-meter back-and-forth pathway as a measure of functional exercise capacity.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  4. Stair Assessment Index (SAI) - Down

    A 14-point ordinal scale (0 - 13) used to assess different gait patterns during descent of stairs. The range of total scores for the SAI is from 0 to 26, with a higher score indicating a more normative gait pattern and needing less assistance.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  5. Frequency of Falling

    Frequency of falling by using C-Brace compared to KAFO/SCO as measured by the number of falls in 3-month period by recollection at baseline and recorded in a Falls Diary during home-use periods

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  6. Fear of Falling

    Two questions on patients' fear of falling indoors and outdoors based on an 11-point scale (0 = no fear, 10 = max. fear). The total score will range from 0 to 20, with 20 being maximum fear of falling.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  7. Probability of Falling More Than Once When Using C-Brace Compared to KAFO/SCO

    Proportion of subjects having reported falling more than once will be compared between KAFO and C-Brace home-use periods

    Time frame: 3 months after initial home use period, and 3 months after cross-over home use period

  8. Reintegration to Normal Living (RNL) Index Questionnaire

    11 items measuring satisfaction regarding perceived physical functioning, and social and emotional life. Higher scores represent higher levels of participation. The range of the adjusted total score is 0 to 100.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  9. EQ-5D-5L

    Measure of health status composed of 5 dimensions: mobility, ability to self-care, ability to undertake usual activities, pain and discomfort, anxiety and depression. Each dimension is rated on a 5-point scale indicating the level of perceived problems for each dimension (level 1 indicating no problems and level 5 indicating extreme problems). The raw score is then aggregated and normalized based on region to a 0 to 1 scale (where 0 represents maximum issues and 1 represents no problems).

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  10. Work Limitations Questionnaires WLQ-25

    25-item questionnaire to evaluate at-work disability and productivity loss under four sub-scales: time demands, physical demands, mental/interpersonal demands, and output demands. Scale scores range from 0 (limited none of the time) to 100 (limited all of the time).

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  11. Orthotics & Prosthetics User Survey (OPUS)

    A self-report questionnaire designed to evaluate the outcome of orthotic and prosthetic services. Three of the five domains will be administered: lower extremity functional status (20 items, score ranges from 0 - 80, with high score being easier), health-related quality of life index (23 items, score ranges from 0 - 92, with higher score being better) and satisfaction with device (11 items, score ranges from 11 - 55, with higher score being more satisfaction) scales. The domains of upper limb functional measure and satisfaction with service are not applicable in this study.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  12. Medical Outcomes Study Short Form (SF-36)

    36-item scale constructed to survey health status and quality of life. It assesses eight health concept scales: physical functioning, role functioning/physical, role functioning/emotional, energy/fatigue, emotional well-being, social functioning, pain and general health. Each scale score ranges from 0 to 100 with 100 being the highest (better) score.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  13. Quebec User Evaluation on Satisfaction With Assistive Technology (QUEST)

    12-item instrument used to assess satisfaction with a specific assistive device. Each questions is rated on a 5-point scale, with 1=not satisfied at all and 5=very satisfied. The first 8 questions comprise the Device subscale and the last 4, the Services subscale. Each subscale and the total score are presented as averages ranging from 1 to 5, with higher scores representing greater satisfaction.

    Time frame: Baseline, 3 months after initial home use period, and 3 months after cross-over home use period

  14. Patient-Related Outcome Questions

    Two questions asking how the specific orthoses affected activities they enjoy and their quality of life. Each question is on a 5-point scale, with 1=much worse and 5=much better.

    Time frame: 3 months after cross-over home use period

07

Results

Posted Sep 19, 2024
Limitations and caveats
The study was affected by the COVID pandemic. Home-use periods interrupted by the pandemic were restarted, and the study was re-opened for enrollment of another 59 subjects. Neither the subjects nor investigators were blinded for interventions. Only subjects with impaired balance (BBS\<45) were included. It is unclear whether the amount of device training was sufficient.

Participant flow

Potential participants were pre-screened based on their medical and/or orthotic records. After signing a written informed consent, participants were screened for inclusion and exclusion criteria. The screening process comprised a thorough patient evaluation and a test with the functional C-Brace trial tool to check whether the potential study participant was able to initiate swing and utilize controlled knee flexion during weight bearing.

Fitting/Assessment Prior to Home Use 1
Participant flow — Fitting/Assessment Prior to Home Use 1
MilestoneKAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCO
Started5250
Completed5047
Not completed23
Withdrew: Withdrawal by subject10
Withdrew: Adverse event01
Withdrew: Lack of access to site during covid01
Withdrew: Lack of efficacy01
Withdrew: Lost to follow-up10
Home Use 1 (3 Months)
Participant flow — Home Use 1 (3 Months)
MilestoneKAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCO
Started5047
Completed4744
Not completed33
Withdrew: Adverse event12
Withdrew: Withdrawal by subject10
Withdrew: Lack of efficacy01
Withdrew: Protocol violation10
Fitting/Assessment Prior to Home Use 2
Participant flow — Fitting/Assessment Prior to Home Use 2
MilestoneKAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCO
Started4744
Completed4143
Not completed61
Withdrew: Adverse event20
Withdrew: Lack of access to site during covid10
Withdrew: Withdrawal by subject10
Withdrew: Lack of efficacy10
Withdrew: Personal problems01
Withdrew: Lost to follow-up10
Home Use 2 (3 Months)
Participant flow — Home Use 2 (3 Months)
MilestoneKAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCO
Started4143
Completed3541
Not completed62
Withdrew: Adverse event11
Withdrew: Lost to follow-up20
Withdrew: Death20
Withdrew: Lack of efficacy10
Withdrew: Could not cope with kafo after c-brace01

Outcome measures

PrimaryPrimary Efficacy: Berg Balance Scale (BBS)

The Berg Balance Scale is a 14-item scale designed to measure static and dynamic balance in adults in a clinical setting. The range in score for the BBS is 0 to 56, with higher scores indicating better balance. Points for each item are deducted if the time or distance requirements are not met, the patient's performance requires supervision, or the patient requires assistance from support or examiner.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Primary Efficacy: Berg Balance Scale (BBS)
score on a scaleBaselineKAFOC-Brace
Primary Efficacy: Berg Balance Scale (BBS)33.6 ± 11.037.3 ± 10.542.0 ± 9.1
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.0002 (Adjusted p-values based on Holm-Bonferroni method. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 3.5Mean difference is for paired data (n=73). This explains the discrepancy between the mean difference and the difference between the KAFO and C-Brace means (n=86 and n=77, respectively).
  • Baseline vs C-Brace · t-test, 2 sided · p = <0.00001 (Adjusted p-values based on Holm-Bonferroni method. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 6.8Mean difference is for paired data (n=77). This explains the discrepancy between the mean difference and the difference between the KAFO and C-Brace means (n=86 and n=77, respectively).
  • Baseline vs KAFO · t-test, 2 sided · p = <0.00001 · Mean difference (final values): 3.3Mean difference is for paired data (n=86). This explains the discrepancy between the mean difference and the difference between the Baseline and KAFO means (n=102 and n=86, respectively).
SecondaryActivity-specific Balance Confidence (ABC) Scale

Assessment of patient-perceived balance confidence for 16 activities of daily living. For each activity, subjects rate their level of confidence in doing the activity without losing their balance or becoming unsteady on a scale from 0% to 100%, with 100% being the highest level of confidence. The total score for the ABC scale is an average of all activity scores.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Activity-specific Balance Confidence (ABC) Scale
score on a scaleBaselineKAFOC-Brace
Activity-specific Balance Confidence (ABC) Scale53.1 ± 19.251.0 ± 18.362.3 ± 19.5
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.005 (P-value not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 7.0563.6 degrees of freedom.
SecondaryDynamic Gait Index (DGI)

An 8-item test used to assess balance during walking tasks. It has a maximum score of 24 with each item being scored 0-3. A higher score indicates greater balance, and subjects lose a a point on all items for which an assistive device is needed.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Dynamic Gait Index (DGI)
score on a scaleBaselineKAFOC-Brace
Dynamic Gait Index (DGI)12.3 ± 3.313.4 ± 3.215.7 ± 3.3
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.005 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 1.074.4 degrees of freedom
Secondary6-minute Walk Test

Distance walked in 6 minutes over 12-meter back-and-forth pathway as a measure of functional exercise capacity.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · meters
6-minute Walk Test
metersBaselineKAFOC-Brace
6-minute Walk Test204.9 ± 73.9213.7 ± 80.9226.0 ± 84.3
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.583 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 0.185
SecondaryStair Assessment Index (SAI) - Down

A 14-point ordinal scale (0 - 13) used to assess different gait patterns during descent of stairs. The range of total scores for the SAI is from 0 to 26, with a higher score indicating a more normative gait pattern and needing less assistance.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Stair Assessment Index (SAI) - Down
score on a scaleBaselineKAFOC-Brace
Stair Assessment Index (SAI) - Down4 ± 3.34.5 ± 3.56 ± 4.2
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.0078 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 1.28
SecondaryFrequency of Falling

Frequency of falling by using C-Brace compared to KAFO/SCO as measured by the number of falls in 3-month period by recollection at baseline and recorded in a Falls Diary during home-use periods

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · number of falls in a three month period
Frequency of Falling
number of falls in a three month periodBaselineKAFOC-Brace
Frequency of Falling4.9 ± 20.14.0 ± 16.81.1 ± 3.3
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.0020 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): -3.41
SecondaryFear of Falling

Two questions on patients' fear of falling indoors and outdoors based on an 11-point scale (0 = no fear, 10 = max. fear). The total score will range from 0 to 20, with 20 being maximum fear of falling.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Fear of Falling
score on a scaleBaselineKAFOC-Brace
Fear of falling indoors3.3 ± 2.93.3 ± 2.82.2 ± 2.6
Fear of falling outdoors5.5 ± 3.05.2 ± 2.94.4 ± 3.0
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.0023 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): -1.11
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.0066 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): -0.973
SecondaryProbability of Falling More Than Once When Using C-Brace Compared to KAFO/SCO

Proportion of subjects having reported falling more than once will be compared between KAFO and C-Brace home-use periods

Time frame:
3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Count of participants · Participants
Probability of Falling More Than Once When Using C-Brace Compared to KAFO/SCO
ParticipantsKAFOC-Brace
Probability of Falling More Than Once When Using C-Brace Compared to KAFO/SCO2512
Statistical analysis
  • KAFO vs C-Brace · McNemar · p = 0.006 (P-value not adjusted for multiple comparisons)
SecondaryReintegration to Normal Living (RNL) Index Questionnaire

11 items measuring satisfaction regarding perceived physical functioning, and social and emotional life. Higher scores represent higher levels of participation. The range of the adjusted total score is 0 to 100.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Reintegration to Normal Living (RNL) Index Questionnaire
score on a scaleBaselineKAFOC-Brace
Reintegration to Normal Living (RNL) Index Questionnaire71.5 ± 19.871.7 ± 17.674.0 ± 19.8
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.08 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 2.82
SecondaryEQ-5D-5L

Measure of health status composed of 5 dimensions: mobility, ability to self-care, ability to undertake usual activities, pain and discomfort, anxiety and depression. Each dimension is rated on a 5-point scale indicating the level of perceived problems for each dimension (level 1 indicating no problems and level 5 indicating extreme problems). The raw score is then aggregated and normalized based on region to a 0 to 1 scale (where 0 represents maximum issues and 1 represents no problems).

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
EQ-5D-5L
score on a scaleBaselineKAFOC-Brace
EQ-5D-5L0.71 ± 0.190.72 ± 0.190.74 ± 0.18
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.151 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 0.009Wilcoxon Signed Rank Test V=1124.5, effect size r = 0.125 p=0.151
SecondaryWork Limitations Questionnaires WLQ-25

25-item questionnaire to evaluate at-work disability and productivity loss under four sub-scales: time demands, physical demands, mental/interpersonal demands, and output demands. Scale scores range from 0 (limited none of the time) to 100 (limited all of the time).

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Work Limitations Questionnaires WLQ-25
score on a scaleBaselineKAFOC-Brace
Mental/Interpersonal86.1 ± 13.388.4 ± 11.591.0 ± 13.7
Output82.0 ± 17.981.9 ± 17.084.6 ± 17.3
Physical37.5 ± 24.834.5 ± 23.324.3 ± 18.8
Time79.2 ± 20.178.3 ± 24.679.8 ± 19.8
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.281 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): -2.1016.7 degrees of freedom
SecondaryOrthotics & Prosthetics User Survey (OPUS)

A self-report questionnaire designed to evaluate the outcome of orthotic and prosthetic services. Three of the five domains will be administered: lower extremity functional status (20 items, score ranges from 0 - 80, with high score being easier), health-related quality of life index (23 items, score ranges from 0 - 92, with higher score being better) and satisfaction with device (11 items, score ranges from 11 - 55, with higher score being more satisfaction) scales. The domains of upper limb functional measure and satisfaction with service are not applicable in this study.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Orthotics & Prosthetics User Survey (OPUS)
score on a scaleBaselineKAFOC-Brace
Quality of Life56.6 ± 7.356.9 ± 6.958.0 ± 8.0
Lower Extremity Functional Status45.3 ± 6.246.6 ± 6.348.8 ± 6.3
Satisfaction with Device49.8 ± 10.550.6 ± 9.751.3 ± 13.7
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.00019 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 1.9948.4 degrees of freedom
SecondaryMedical Outcomes Study Short Form (SF-36)

36-item scale constructed to survey health status and quality of life. It assesses eight health concept scales: physical functioning, role functioning/physical, role functioning/emotional, energy/fatigue, emotional well-being, social functioning, pain and general health. Each scale score ranges from 0 to 100 with 100 being the highest (better) score.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Medical Outcomes Study Short Form (SF-36)
score on a scaleBaselineKAFOC-Brace
Emotional Wellbeing76.2 ± 16.475.5 ± 16.379.2 ± 15.16
Energy/Fatigue52.2 ± 21.352.3 ± 20.356.8 ± 20.1
General Health54.1 ± 22.254.2 ± 23.858.2 ± 23.8
Health Change47.4 ± 24.248.0 ± 26.056.5 ± 26.4
Pain55.6 ± 25.357.4 ± 24.959.5 ± 26.7
Physical Functioning29.7 ± 22.631.1 ± 23.844.3 ± 23.3
Role limitations due to emotional problems78.1 ± 36.982.2 ± 34.386.1 ± 28.8
Role limitations due to physical health36.5 ± 39.744.9 ± 43.251.0 ± 41.2
Social Functioning74.2 ± 23.075.1 ± 25.077.3 ± 24.4
Statistical analysis
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.0226 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 3.1922.1 degrees of freedom
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.0020 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 6.79
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.0049 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 10.1
  • KAFO vs C-Brace · t-test, 2 sided · p = 0.0000647 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 12.637.35 degrees of freedom
SecondaryQuebec User Evaluation on Satisfaction With Assistive Technology (QUEST)

12-item instrument used to assess satisfaction with a specific assistive device. Each questions is rated on a 5-point scale, with 1=not satisfied at all and 5=very satisfied. The first 8 questions comprise the Device subscale and the last 4, the Services subscale. Each subscale and the total score are presented as averages ranging from 1 to 5, with higher scores representing greater satisfaction.

Time frame:
Baseline, 3 months after initial home use period, and 3 months after cross-over home use period
Reported as:
Mean · score on a scale
Quebec User Evaluation on Satisfaction With Assistive Technology (QUEST)
score on a scaleBaselineKAFOC-Brace
Device4.05 ± 0.674.05 ± 0.724.00 ± 0.63
Service4.60 ± 0.644.66 ± 0.704.79 ± 0.42
Total4.23 ± 0.594.27 ± 0.644.27 ± 0.49
Statistical analysis
  • KAFO vs C-Brace · Wilcoxon Signed Rank Test · p = 0.301 (P-values not adjusted for multiple comparisons. P-values \< 0.05 used as threshold for statistical significance.) · Mean difference (final values): 0.28
SecondaryPatient-Related Outcome Questions

Two questions asking how the specific orthoses affected activities they enjoy and their quality of life. Each question is on a 5-point scale, with 1=much worse and 5=much better.

Time frame:
3 months after cross-over home use period
Reported as:
Median · units on a scale
Patient-Related Outcome Questions
units on a scaleKAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCO
To what extent has the C-Brace enabled you to engage in the activities that you enjoy?4 (3 to 4)4 (3.75 to 5)
To what extent has the C-Brace impacted your quality of life?4 (3 to 4.5)4 (4 to 5)

Adverse events

Collected over For C-Brace, the period of time for adverse events was the 3-month window after the device had been fitted. In addition to the 3-month home use period, for KAFO/SCO there was often an extra month or two, especially for patients randomized to start with C-Brace since it takes time to fabricate the device and adverse events can occur during that waiting period.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
KAFO/SCO0/102 (0%)10/102 (9.8%)66/102 (64.7%)
C-Brace2/88 (2.3%)6/88 (6.8%)57/88 (64.8%)
Most frequent serious events
Showing 10 of 16
Most frequent serious events
EventKAFO/SCOC-Brace
Prostate cancerReproductive system and breast disorders0/571/46
Intestinal haemorrhageGastrointestinal disorders0/1021/88
Chest PainGeneral disorders1/1021/88
Foot fractureInjury, poisoning and procedural complications0/1021/88
SyncopeNervous system disorders0/1021/88
Deep Vein ThrombosisVascular disorders1/1021/88
CholecystolithiasisHepatobiliary disorders1/1020/88
COVID-19Infections and infestations1/1020/88
Hip FractureInjury, poisoning and procedural complications1/1020/88
Lumbar spinal stenosisMusculoskeletal and connective tissue disorders1/1020/88
Most frequent other events
Showing 10 of 76
Most frequent other events
EventKAFO/SCOC-Brace
Battery holder defectProduct Issues1/2—
BeepingProduct Issues1/23/88
Injurious FallInjury, poisoning and procedural complications21/10210/88
Unexpected mode switchProduct Issues1/74/88
Pain in legMusculoskeletal and connective tissue disorders8/1028/88
Skin AbrasionSkin and subcutaneous tissue disorders3/1028/88
Back PainMusculoskeletal and connective tissue disorders8/1027/88
Joint MalfunctionProduct Issues7/1022/88
Pain in footMusculoskeletal and connective tissue disorders3/1026/88
Increased fall frequencyGeneral disorders6/1021/88

Baseline characteristics

Intention to Treat Group

Age, Continuous
Age, Continuous(years)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Mean56.1 ± 15.255.4 ± 12.455.8 ± 13.8
Sex: Female, Male
Sex: Female, Male(Participants)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Female261945
Male263157
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Caucasian403878
Asian6612
Black or African American224
Other448
Region of Enrollment
Region of Enrollment(participants)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Netherlands437
Austria011
United States202242
Germany282452
Body Weight
Body Weight(kg)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Mean77.5 ± 15.882.8 ± 16.380.1 ± 16.2
Height
Height(cm)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Mean170.1 ± 11.3170.3 ± 11.3170.2 ± 11.2
Work/employment status
Work/employment status(Participants)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Employed172542
Retired222143
Unemployed13417
Side/bilateral orthosis
Side/bilateral orthosis(Participants)KAFO/SCO, Then C-BraceC-Brace, Then KAFO/SCOTotal
Right182341
Left262147
Bilateral8614

3 further baseline measures are reported on the registry.

08

Study locations

13 sites
  • Hanger Clinic
    Sarasota, Florida 34233, United States
  • Scheck & Siress
    Chicago, Illinois 60657, United States
  • Hanger Clinic
    Houston, Texas 77025, United States
  • Hanger Clinic
    Seattle, Washington 98116, United States
  • Orthopädisches Spital Speising Speisingerstraße 109
    Wien, Austria
  • BeMoveD - Berlin Movement Diagnostics
    Berlin, Deutschland 10117, Germany
  • Katholisches Klinikum Koblenz-Montabaur
    Koblenz, Rhineland-Palatinate 56073, Germany
  • Johannesbad Raupennest GmbH & Co. KG
    Altenberg, 01773, Germany
  • Zentrum für Healthcare Technology der Privaten Hochschule Göttingen
    Göttingen, 37073, Germany
  • BG Klinikum Hamburg gGmbH Zentrum für Rehabilitationsmedizin
    Hamburg, 21033, Germany
  • Universitätsklinikum Heidelberg, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie
    Heidelberg, 69118, Germany
  • Pohlig GmbH
    Traunstein, 83278, Germany
  • Adelante Kenniscentrum
    Hoensbroek, Limburg 6432 CC, Netherlands
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03906656
Lead sponsor
Otto Bock Healthcare Products GmbH
Responsible party
Sponsor
First posted
Apr 8, 2019
Start date
Mar 11, 2019
Primary completion
Aug 23, 2022
Completion
Aug 23, 2022
Results posted
Sep 19, 2024
Last update
Sep 19, 2024

Study contacts

Frank Braatz, Dr. med.
principal investigator · Zentrum für Healthcare Technology der Privaten Hochschule Göttingen

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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