Reflex conditioning training- evaluation and implementation of a rehabilitation measure for patients with spastic hemiparesis of the lower extremity

Status

Recruiting

Phases

Unknown

Study type

Interventional

Source

DRKS

Registry ID

DRKS00038514

Enrollment

Registered

2025-11-26

Start date

2026-04-27

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

I64

Interventions

Group 1: Interventiongroup: Baseline tests in the first two weeks (3x75 stimulations without visual feedback)

Gait- and balanceanalysis in weeks 0, 7, 13 and 24

Conditioning (1x 20 controls trials + 3x 75 training trials for 10 weeks, 3x/week with visual feedback) --> reflexconditioning spastic side Follow-up assessment after 24 weeks (3x75 stimulations witho

Conditioning (1x 20 controls trials + 3x 75 training trials for 10 weeks, 3x/week with visual feedback) --> reflexconditioning non spastic side/ cross education Follow-up assessment after 24 weeks (3x

Gait- and balanceanalysis in week 0, 7, 13 and 24

alternative training program

after 12 weeks controll testing (3x75 stimulations without visual feedback)

after 24 weeks follow-up assesment (3x75 stimulations without visual feedback)

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: - 6-12 months post-stroke, after reaching a relatively stable plateau - unilateral plantar flexor spasticity (hemiparesis) - clearly recognizable stretch reflex upon mechanical stimulation of the pedal - no change in medication during the training intervention - ability to walk at least 10 m with or without assistance

Exclusion criteria

Exclusion criteria: - Motor neuron injury - history of myocardial infarction or heart failure - use of pacemakers or other active implants - a medically unstable condition - cognitive impairments that affect the ability to give informed consent or to successfully complete the protocol

Design outcomes

Primary

Measure	Time frame
The aim of this study is to further develop and test a rehabilitation intervention to reduce the reflex amplitude in the soleus muscle in spastic hemiparesis. This training reduces the amplitude of the soleus stretch reflex, which decreases spasticity and also leads to neuronal reorganization in the lower extremity, thus improving motor control. This method has been successfully used in electrically stimulated H-reflex conditioning and is intended here to be transferred to a comparatively simpler and thus more widely applicable stretch reflex conditioning. As part of this longitudinal study, reference tests will be carried out over 2 weeks, after which the patients will be trained for 10 weeks. Clinical tests of movement quality will be performed throughout the course, i.e., before, during, and after the training period. A renewed evaluation of reflex activity and clinical tests will take place after a further 12 weeks to verify the stability of the effects. The goal is to develop a sustainable and thus less burdensome, as well as more cost-effective rehabilitation measure which, in the future, by eliminating electrical stimulation, will also be accessible to patients with active implants, such as pacemakers. However, within the scope of this project, the normalization of the EMG signals with reference to electrostimulation will be carried out for the quantification of the effects. Operationalization of the Study: 1. Portable Perturbation Device (Pedal): has already been developed and is available at the Institute of Biomechanics and Orthopaedics at the German Sport University Cologne. The strength of the reflex is conditioned using surface electromyography and visual feedback. The control of the pedals is managed by the EPOCS software. Before each training session, surface electrodes for electromyography (EMG) recording are placed on the M. soleus (SOL) and the M. tibialis anterior (TA). Subsequently, the recruitment curve of the SOL H-reflex is first recorded fo	—

Measure

Time frame

The aim of this study is to further develop and test a rehabilitation intervention to reduce the reflex amplitude in the soleus muscle in spastic hemiparesis. This training reduces the amplitude of the soleus stretch reflex, which decreases spasticity and also leads to neuronal reorganization in the lower extremity, thus improving motor control. This method has been successfully used in electrically stimulated H-reflex conditioning and is intended here to be transferred to a comparatively simpler and thus more widely applicable stretch reflex conditioning. As part of this longitudinal study, reference tests will be carried out over 2 weeks, after which the patients will be trained for 10 weeks. Clinical tests of movement quality will be performed throughout the course, i.e., before, during, and after the training period. A renewed evaluation of reflex activity and clinical tests will take place after a further 12 weeks to verify the stability of the effects. The goal is to develop a sustainable and thus less burdensome, as well as more cost-effective rehabilitation measure which, in the future, by eliminating electrical stimulation, will also be accessible to patients with active implants, such as pacemakers. However, within the scope of this project, the normalization of the EMG signals with reference to electrostimulation will be carried out for the quantification of the effects. Operationalization of the Study: 1. Portable Perturbation Device (Pedal): has already been developed and is available at the Institute of Biomechanics and Orthopaedics at the German Sport University Cologne. The strength of the reflex is conditioned using surface electromyography and visual feedback. The control of the pedals is managed by the EPOCS software. Before each training session, surface electrodes for electromyography (EMG) recording are placed on the M. soleus (SOL) and the M. tibialis anterior (TA). Subsequently, the recruitment curve of the SOL H-reflex is first recorded fo

—

Countries

Germany

Contacts

Public ContactUwe G. Kersting

Deutsche Sporthochschule Köln

u.kersting@dshs-koeln.de022149825630

Outcome results

None listed

Source: DRKS (via WHO ICTRP) · Data processed: Aug 10, 2026