NCT05778474: CLAPENDAS

Mechanical Determinants of Upper Limbs Oscillation During Gait

Completed Last updated 18 November 2025

What this trial tests

trial testing Healthy subjects in Multiple Sclerosis in 25 participants. Completed in 31 December 2024.

Timeline

27 May 2020

Primary endpoint
31 December 2024

31 December 2024

Quick facts

Lead sponsor	Istituto Auxologico Italiano
Status	Completed
Study type	OBSERVATIONAL
Enrollment	25
Start date	27 May 2020
Primary completion	31 December 2024
Estimated completion	31 December 2024
Sites	1 location across Italy

Drugs / interventions tested

• Healthy subjects — full drug profile →
• Pathologic group

Conditions studied

• Multiple Sclerosis — all drugs for Multiple Sclerosis →
• Poststroke/CVA Hemiparesis — all drugs for Poststroke/CVA Hemiparesis →
• Parkinson Disease — all drugs for Parkinson Disease →
• Cerebral Palsy — all drugs for Cerebral Palsy →

Sponsor

Istituto Auxologico Italiano — full company profile →

Who can join

Adults 18 to 80, any sex, with Multiple Sclerosis or Poststroke/CVA Hemiparesis. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

It is unclear why humans typically swing their arms during gait. To date, the debate on how to arm swing comes about (i.e. whether it is caused by accelerations of the shoulder girdle or muscular activity) is still going on. There needs to be consensus on whether the arm swing is actively controlled or merely passive and on why humans swing their arms during walking (i.e. what the purpose of arm swing is, if any). Suggested reasons include minimising energy consumption, optimising stability, and optimising neural control. Pathologies such as hemiplegia after stroke, Parkinson's disease, Cerebral Palsy, Spinal Cord Injury, and Multiple Sclerosis may directly affect arm swing during gait. Emerging evidence indicates that including arm movements in gait rehabilitation may be beneficial in restoring interlimb coordination and decreasing energy expenditure.

This project hypothesises that the arms swing, at least at low and intermediate walking speeds, reflects the body's Center of Mass (CoM) accelerations. Arm swing may thus depend mainly upon the system's intrinsic mechanical properties (e.g., gravity and inertia). In this perspective, the CoM is seen as moving relative to the upper limbs rather than the other way around. The contribution of major lower limb joints, in terms of power injected into the body motion, will be simultaneously explored.

The study aims to investigate the mechanism and functions of arm swinging during walking on a force treadmill. To simulate asymmetric walking, healthy subjects will be asked to walk with a toes-up orthosis to induce claudication and asymmetry in ankle power. In this way, it will be possible to highlight the correlation among arm swinging, ankle power, and the acceleration of the CoM in a 3D framework. In addition, subjects affected by unilateral motor impairments will be asked to walk on the force treadmill to test the experimental model and highlight significant differences in the kinematic parameters of the upper limbs.

The question of whether arm swing is actively controlled or merely passive and the relationship between arm swinging and the total mechanical energy of the CoM will be faced.

Asymmetric oscillations of the upper limb will be related to dynamic asymmetries of the COM motion, and of the motion of lower limbs. In addition, cause-effect relationships will be hypothesized. Finally, the dynamic correlates of upper limb oscillations will make the clinical observation an interpretable clinical sign applicable to rehabilitation medicine.

Results from the present study will also foster the identification of practical rehabilitation exercises on gait asymmetries in many human nervous diseases.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. Plantar flexors are the main engine of walking in healthy adults.
   Rota V, Caronni A, Scarano S, Amadei M, et al · · 2025 · PMID 40697531 · DOI 10.3389/fspor.2025.1595065