Imaging Lymphatic/Cerebrospinal Fluid (CSF) Drainage From the Head and Neck in Persons With Traumatic Brain Injury: Demonstration of Feasibility and Evaluation of Manual Therapy to Improve Drainage and Facilitate Cognitive Recovery
Imaging Lymphatic/CSF Drainage From the Head and Neck in Persons With Traumatic Brain Injury: Demonstration of Feasibility and Evaluation of Manual Therapy to Improve Drainage and Facilitate Cognitive Recovery
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Eva Sevick, PhD
- Phone Number: (713) 500-3560
- Email: Eva.Sevick@uth.tmc.edu
Study Contact Backup
- Name: John Rasmussen
- Phone Number: (713) 500-3393
- Email: John.Rasmussen@uth.tmc.edu
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- The University of Texas Health Science Center at Houston
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Female participants must complete the Female Enrollment Form. Those subjects of childbearing potential must have a negative urine pregnancy within 36 hours of study drug administration and also agree to use one of the medically accepted methods of contraception listed on the form for a period of one month following the study. Female subjects of non-childbearing potential, defined as physiologically incapable of becoming pregnant, must meet the criteria listed on the Female Enrollment form, but are not restricted to the use of contraception following study participation.
- Participants must be able to sit upright for periods of 30 minutes.
- Participants should have a body mass index between 19 and 30 kg/m2
- Initial post-resuscitation Glasgow Coma Scale score following blunt head trauma of 3 to 12 or coma (not due to sedation) greater than 6 hours. Emergence from Post-traumatic Amnesia as documented by serial administration of the Orientation-Log or Galveston Orientation and Amnesia Test
- Have an anticipated hospital length of stay of 5 days or more following screening and consent.
- Able to provide consent.
Exclusion Criteria:
- Women who are pregnant or breast-feeding
- Persons who are known to be allergic to iodine
- Persons who have extensive soft tissue damage to the neck region, including carotid artery dissection, spinal cord injury, or other conditions, that makes lymphatic drainage techniques undesirable.
- Women who are of child bearing potential who do not agree to use medically acceptable contraceptives for one month following the study.
- Subjects who are participating in another interventional trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Manual Lymphatic Drainage (MLD)
|
The participant will be placed in a supine position and manual lymphatic drainage will be performed for 50 minutes.
During the three intervening days, daily 50 minute sessions of manual lymphatic drainage will be provided.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
change in Near-Infrared Fluorescence Lymphatic Imaging (NIRF-LI) assessment of lymphatic drainage
Time Frame: day 1, day 5
|
2 NIRF-LI sessions will be conducted separated by 3 days.
|
day 1, day 5
|
|
change in cognitive test results as assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS)-Global health( GH) scale
Time Frame: day1,day2,day3,day4,day5
|
Nine of the 10 PROMIS GH items are scored on a Likert scale from 1 to 5, with 5 representing the best health.
Pain which is the 10th question is scored from 0(no pain) to 10(worst imaginable pain).
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the Patient Health Questionnaire-9 (PHQ-9)
Time Frame: day1,day2,day3,day4,day5
|
This scale consists of a set of 9 questions each scored form 0(not at all) to 3 (nearly every day), a higher score indicating a worse outcome.
Total score ranges form 0-27.
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the Multilingual Aphasia Examination III-Controlled Oral Word Association
Time Frame: day1,day2,day3,day4,day5
|
This is used to asses phonemic fluency.
Participant is asked to name words that begin with a particular letter in one minute and examiner will write down the words said by the participant.
This will be reported y the number of words participants say in one minute
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the Trail Making Test(TMT)
Time Frame: day1,day2,day3,day4,day5
|
Scores are reported as the number of seconds required to complete the task; therefore, higher scores reveal greater impairment.
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the learning trial
Time Frame: day1,day2,day3,day4,day5
|
This will be assessed by the number of words participants can remember
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the delayed recall trial instructions
Time Frame: day1,day2,day3,day4,day5
|
This will be assessed by the number of words participants can remember after 20-25 minutes delay
|
day1,day2,day3,day4,day5
|
|
change in cognitive test results as assessed by the Semantic Category learning trial
Time Frame: day1,day2,day3,day4,day5
|
There are 12 words that participants will categories as Four-legged Animals, precious stones and human dwellings for a total score from 0-12 a higher number indicates a better outcome
|
day1,day2,day3,day4,day5
|
|
Change in processing speed, as assessed by the Wechsler Adult Intelligence Scale -IV
Time Frame: day1,day2,day3,day4,day5
|
Two subtests from the Wechsler Adult Intelligence Scale - IV are used (Coding and Symbol Search).
Age-adjusted standard scores are calculated for each of subtest.
The 2 subtest scores are then combined to create the Processing Speed Index.
Processing Speed Index will be reported as a percentile (0% to 100%), with a higher percentile indicating a better outcome
|
day1,day2,day3,day4,day5
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in NIRF-LI detected lymphatic drainage
Time Frame: day1,day5
|
response of NIRF-LI detected lymphatic drainage in response to manual lymphatic drainage by imaging drainage before and after manual lymphatic drainage
|
day1,day5
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Eva Sevick, PhD, The University of Texas Health Science Center, Houston
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Wounds and Injuries
- Pathologic Processes
- Inflammation
- Craniocerebral Trauma
- Trauma, Nervous System
- Brain Injuries
- Pathological Conditions, Signs and Symptoms
- Brain Injuries, Traumatic
- Neuroinflammatory Diseases
- Therapeutics
- Complementary Therapies
- Physical Therapy Modalities
- Rehabilitation
- Therapy, Soft Tissue
- Musculoskeletal Manipulations
- Massage
- Drainage
- Manual Lymphatic Drainage
Other Study ID Numbers
Other Study ID Numbers
- HSC-MS-21-0080
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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